when people apply derm...

[crys20]

This may be an ultra-dumb question, but I am a first year.

I understand the competitiveness of derm. I was looking at the NRMP 2005 data just now, and I see that of 100 applicants with 240-250 Step 1s, 69 matched derm and 31 didn't. Eek!

So, my question is. If you want to apply derm and are in that awesome, but maybe not awesome enough for derm range in terms of numbers and everything else, but you don't want to scramble....Do people ever apply to derm and, say, IM positions as well? So for instance, if they don't match at any of the derm programs they theoretically interview at and rank all of them first - they would still match into, say, their backup plan of an IM residency rather than derm? Just curious what all the unmatched folks do.

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[ny skindoc]

This may be an ultra-dumb question, but I am a first year.

I understand the competitiveness of derm. I was looking at the NRMP 2005 data just now, and I see that of 100 applicants with 240-250 Step 1s, 69 matched derm and 31 didn't. Eek!

So, my question is. If you want to apply derm and are in that awesome, but maybe not awesome enough for derm range in terms of numbers and everything else, but you don't want to scramble....Do people ever apply to derm and, say, IM positions as well? So for instance, if they don't match at any of the derm programs they theoretically interview at and rank all of them first - they would still match into, say, their backup plan of an IM residency rather than derm? Just curious what all the unmatched folks do.

Yes its common to apply to Derm and another field such as IM or peds as well as a back up so thats not a problem. People who dont match sometimes reapply or do research fellowships in a Derm dept to improve their application and make contacts.Its all a question of how motivtaed you are to pursue derm and how much time and effort you will spend on it.If an alternative specialty can work for you then thats the best way to go.

 

[NYCPRDOC]

This may be an ultra-dumb question...

I have an even dumber question: what's derm's appeal? Other than a great salary and lifesyle, is there anything else to it? I mean, do dermatologists wake up most days and say, "Man, I couldn't be more satisfied that I chose a career in derm."
Now don't get it twisted: money and a great quality of life is a VERY HUGE motivating factor for me, and I'm in no way trying to knock this field -- I'm just trying figure out why it draws some of the "best" medical talent in this country (I'm basing this on grades and test scores only) year after year. Is the work that interesting? Anyway, if any residents/practicing derms could shed some light I'd appreciate it. Thanks.

 

[salmonella]

Don't know if this is true or not, but someone just told me that 20 years ago derm was the easiest specialty to get into, all filled with med sch slackers because derm was not well respected back then and most people did not consider it a "medical" specialty. Certainly this is not true today!

 

[cdql]

I've heard that as well. Just goes to show that things in medicine are cyclical. What's popular today might not be the same way 5, 10, 20 years from now!

 

[dermsurg]

derm has been pretty appealing for a long time and also has been pretty competitive for a long time.

 

[crys20]

Ya, I mean I would have never given it a second thought until I saw first hand how cush the life is. It does make it appealing.

So, I'm a first year as I said, and we have electives to do for 4 weeks or so over the summer between M1 and M2, pretty your-choice-ish. I'm kinda thinking about a) doing something cool abroad, like an Africa trip people go on @ my school or b) thinking that if I'm gonna want to do derm or something like it, maybe some researh gig, maybe in derm?

What do ya'll think? I'm still just so unconvinced that I would ever score hi enough to be competitive - so then you just did a summer of derm research for nothing, right? But then there are those days when I think maybe I am becoming quick enough to actually be that kind of a med student. Just don't know.

 

[Sophie]

I have an even dumber question: what's derm's appeal? Other than a great salary and lifestyle, is there anything else to it? I mean, do dermatologists wake up most days and say, "Man, I couldn't be more satisfied that I chose a career in derm."
Anyway, if any residents/practicing derms could shed some light I'd appreciate it. Thanks.

I'm only a 1st year, so I obviously don't know what being a dermatologist is really like, but since no one else has answered this I'll give you my reasons for being interested in it.

1) Self-esteem issues. I was a psych major in college, and have always been really interested in self-esteem, how dependent personality is on appearance/confidence, and how a person's opinion about their appearance can shape all of their life decisions, level of happiness, etc. (e.g. as a teenager I got acne, and it made me want to be invisible. I became more shy, chose to go out with my friends less, and was very conscious of my appearance. A dermatologist got rid of my acne, I became more confident, more social, got involved w/ school groups/made more friends, and felt like a more worthwhile person. It may be silly to have something like that affect you that much, but it happens.)
2) Instead of guessing at whether the patient's liver is messed up, or trying to figure out where the primary cancer site is by running a bunch of tests, you actually get to SEE what you're dealing with most of the time.
3) Patient compliance. Sure if someone has high blood pressure they want to lower it, but "exercise and eat right" advice is more likely than not going to be ignored, and if the medication you prescribe makes them sick, they might just not take it - after all, they usually don't really notice the high blood pressure, so it's not very motivating to fix. A noticeable rash or acne, on the other hand, is pretty motivating.
4) Personal experience. I've been to dermatologists more than to any other kind of doctor, for moles, rashes, burns, and acne. After seeing a bunch of them, I've kind of got an idea of what they do, what their work environment is like, and how happy or (un)stressed they appear.
5) Patient population. It's nice to have relatively healthy patients who are rarely ever going to die on you.
6) And last, the skin is pretty interesting.

If any of these are misconceptions on my part and someone with actual experience wants to correct me I'd be very appreciative.

 

[PathOne]

Some answers, in no particular order:
1. Yes, having a backup plan, even with stellar stats, is a good idea - unless you want to do Derm so bad, so you're willing to spend 1-2 years in research, with the associated, not insignificant, opportunity costs.
2. Yes, Derm is closely related to Int Med. In fact, until the late 60s, it was a small subspecialization after Int Med, and to this very day, a few combined Derm-Int Med programs exists.
3. Money is an important, if not exclusive, motivating factor in Medicine. In the 1960s, Psychiatry was considered the top field, probably in part due to high incomes compared to other specialities. Today, Derm, which probably has the highest pay per effective hour, except for Dermpath, is near the top, while Psychiatry, which pays relatively little, isn't that competitive. However, high pay also attracts outstanding people, which is certainly an attraction when working in Derm.
4. Hopefully, people choose Derm because they find it interesting, and not (solely) due to high status/money etc. The interesting thing about Derm is that most cases are fairly easy to dx, but a few are truly mind-boggling. The main downside is, that treatment options are relatively few, compared to other fields.
5. The future competitiveness for Derm will probably follow the historical pattern. I.e. depend on compensation issues. If pay for Derm procedures will decline relative to pay in other fields, competitiveness is likely to decrease. There's not a natural law of medicine dictating that you NEED to be a super-doc to become a Dermatologist.

Best of luck to all who wants to enter the field, and to all others too, of course.

 

[ny skindoc]

Don't know if this is true or not, but someone just told me that 20 years ago derm was the easiest specialty to get into, all filled with med sch slackers because derm was not well respected back then and most people did not consider it a "medical" specialty. Certainly this is not true today!

No this is not true.Derm has been highly competitive since the early 1970s.
Prior to that time there were in fact very few Derm residency programs in existence and interest in skin issues was low it was possible that anyone interested in Derm could get in.In the 1960s it was said that about half of all US dermatologists had trained at the NYU skin and cancer program.
In more recent years derm has become the focus of much basic research and increased popularity as the popualtion has aged and skin cancer and melanoma have increased.The number of US med school grads has also greatly increased since that time.There are many reasons people choose the field as stated above.Most dermatologists I'v met are very interested in skin related problems.Its like any other organ system.Some people like studying kidneys and lungs..for others its skin.Its not inherently more or less interesting than the others.

 

[cdql]

I wonder if any derm applicants apply to other highly competitive fields?

It seems like a big drop off between getting into a derm program and then getting into an IM program?

I can imagine it must be difficult (esp seeing how derm is so competitive nowadays) as one has to do rotations in derm, aways in derm, and derm research is always a benefit. But those things are also required of applicants who want to go into something equally as competitive (e.g. ophtho for one)

How would one go about juggling that into their schedule? (if it is at all possible? i know our school isn't very happy about letting students go to two away rotations in one field. I imagine it would start a war if a student came in asking for two derm away rotations and then an away ophtho rotation for instance!)

 

[crys20]

More questions. When do people do derm-related research? Summers in preclin years? Can you work that into 3rd year?

Also, if you apply to derm and IM programs, do IM programs know you are also applying derm - essentially they are your backup, and would this influence their ranking of you post-interview, or even getting an interview to begin with?

 

[Sophie]

More questions. When do people do derm-related research? Summers in preclin years? Can you work that into 3rd year?

I haven't a clue as to your 2nd question, but I can answer the 1st (for my school, at least). Here you can do research the summer between 1st and 2nd years, all year 2nd year (we're required to do some sort of project, and the schedule is a bit lighter to accommodate that), and you can dedicate some rotation time in 4th year to research. I've heard it's possible to work some brief, somewhat superficial research into 3rd year, but I'm guessing that'd be hard. There's also an option to take a 5th year to devote entirely to research.

 

[porokeratosis]

I wonder if any derm applicants apply to other highly competitive fields?

It seems like a big drop off between getting into a derm program and then getting into an IM program?

I can imagine it must be difficult (esp seeing how derm is so competitive nowadays) as one has to do rotations in derm, aways in derm, and derm research is always a benefit. But those things are also required of applicants who want to go into something equally as competitive (e.g. ophtho for one)

How would one go about juggling that into their schedule? (if it is at all possible? i know our school isn't very happy about letting students go to two away rotations in one field. I imagine it would start a war if a student came in asking for two derm away rotations and then an away ophtho rotation for instance!)

Before deciding Derm was my career choice, I was deliberating between 2 highly competitive fields, Derm and Radiation Oncology. I truly enjoyed both fields. I actually did 1-year of research in Rad Onc at a nationally recognized institution with well-known faculty. I had great mentors in both fields who encouraged me to join their own field, respectively. It was a difficult choice, but I finally decided on Derm because of skin issues in myself, family, and close friend, so it was much easier to relate to my patients (fortunately, not too many cancers to relate to in myself, family, or friends). Although I considered applying to both fields (Derm & Rad Onc) at the same time, I decided against it. I only applied to Derm.

I'm very happy and satisfied with my ultimate career choice in Dermatology

 

[cdql]

First of all, congrats!

Secondly, so you're saying the best way to go about this is to really make sure you're passionate about derm before applying? And basically to rule out other highly competitive fields?

(From others that I've spoken to, it seems to be that most people list IM/peds as a backup)

 

[porokeratosis]

First of all, congrats!

Secondly, so you're saying the best way to go about this is to really make sure you're passionate about derm before applying? And basically to rule out other highly competitive fields?

(From others that I've spoken to, it seems to be that most people list IM/peds as a backup)

I'm saying it's great when you enjoy what you do, especially in medicine...because it's easy to become jaded in medicine...when you enjoy your medical specialty, whatever that medical specialty may be (Derm, Rad Onc, Orthopedics, Neurosurgery, IM, Peds, etc), and you wake up most mornings, smile, & feel satisfied with your job, then you're truly blessed

You're correct, some people apply to Derm and a "back up" specialty that is less competitive, usually IM or Peds. It makes sense because getting into a Derm residency is CRAZY COMPETITIVE and there's no guarantee that you'll get in...But I don't see nothing wrong with applying to 2 competitive specialties. Why not?! I didn't do it because after much thought and consideration, I realized that Derm was the specialty for me. If I did NOT get into Derm residency the 1st time applying, then the 2nd time I might have considered applying to both Derm and Rad Onc.

 

[Cholinergic]

If a school is P/F, grades won't make an impression unless you get AOA, right?
Besides board scores what else is "necessary" to be competitive? Is doing research enough or do you have to be published?

 

[cdql]

How would you distinguish yourself from others and get into AOA if your school is just pass/fail? Are you sure there isn't an high pass/pass/fail system?

Research is another good step (probably almost required now) to be a competitive applicant.

I think publications are obviously good but if not, the next best thing is to be able to speak fluently, intelligently, and enthusiastically about your research project at interviews.

For instance, basic science projects typically don't generate as many papers as clinical research but there are PDs out there who value basic science research more and may be more interested in what you did and what you accomplished rather than how many papers you churned out in medical school. (And let's face it, for the vast majority of medical students, their contribution to the paper is most likely editing it and the review of a couple of patient charts)

 

[MOHS_01]

No this is not true.Derm has been highly competitive since the early 1970s.
Prior to that time there were in fact very few Derm residency programs in existence and interest in skin issues was low it was possible that anyone interested in Derm could get in.In the 1960s it was said that about half of all US dermatologists had trained at the NYU skin and cancer program.
In more recent years derm has become the focus of much basic research and increased popularity as the popualtion has aged and skin cancer and melanoma have increased.The number of US med school grads has also greatly increased since that time.There are many reasons people choose the field as stated above.Most dermatologists I'v met are very interested in skin related problems.Its like any other organ system.Some people like studying kidneys and lungs..for others its skin.Its not inherently more or less interesting than the others.

No, dermatology was not competetive, relatively, in the early 70's -- it did not become very competetive until the early 90's. It was an late match program at that time, and did not become ultra-competetive like it is today until the late 90's, at which time it went to a regular match. During the 70's and 80's there were many unfilled derm spots across the country -- not exactly the definition of competetive. Many of the faculty teaching dermatology today would not be dermatologists if they had to come through today's match process, and the honest ones openly admit that.

In the early 80's people used derm as a back-up plan, something that is very hard to imagine today.

 

[Cholinergic]

How would you distinguish yourself from others and get into AOA if your school is just pass/fail? Are you sure there isn't an high pass/pass/fail system?

Research is another good step (probably almost required now) to be a competitive applicant.

I think publications are obviously good but if not, the next best thing is to be able to speak fluently, intelligently, and enthusiastically about your research project at interviews.

For instance, basic science projects typically don't generate as many papers as clinical research but there are PDs out there who value basic science research more and may be more interested in what you did and what you accomplished rather than how many papers you churned out in medical school. (And let's face it, for the vast majority of medical students, their contribution to the paper is most likely editing it and the review of a couple of patient charts)

Thanks. We're definitely P/F. I'm currently involved in a really good clinical research project and I'm doing a lot more than editing. I'm testing the patients, writing the paper, etc. I'm just starting to think about derm (almost done with 2nd year!). Maybe I should try to get to know some people in the derm department?

 

[cdql]

Sounds like a good idea

Not sure how you would go about doing that smoothly (I'm guessing popping in just to say hi might come off a little desperate ), but it's always nice to have contacts in something you're interested in!

 

[YupGypsy]

I'm looking at the NRMP 2006 results and it says that only 30 derm spots were offered? Are you kidding me?