Completed by:Kanade Shinkai, UCSF Dermatology Residency Program Director (approved by the Derm Interest Group leadership team)
Date completed/updated: May 2016
- What can students do in the 1st and 2nd years to explore and/or prepare for this career?
Since exposure to dermatology is rare during the 1st and 2nd years of medical school, the key is getting involved:
• Join the Dermatology Interest Group (DIG): great way to find out about informational workshops/ meetings/ career panels, volunteer events, research opportunities. [contact: firstname.lastname@example.org]
• Participate in Dermatology Homeless Clinic: part of the UCSF Homeless clinic, the dermatology clinic meets every other week and focuses on cutaneous complaints of shelter residents. It’s a rich opportunity to learn clinical dermatology and meet different dermatology residents and faculty members, who precept the clinic. There are also great leadership opportunities to serve as coordinators for this clinic. Each year one to two students are selected to serve as coordinators for derm homeless clinic and these students hold these positions for all 4 years [contact: email@example.com]
• Get a mentor. There is an active mentoring program through the DIG, where DIG members are individually paired with a career mentor.
• Consider doing a research project over the summer after 1st year: this is a project that could culminate in a research poster, a meeting abstract, or possibly a publication (the latter usually requires ongoing work during the academic year).
• Explore the American Academy of Dermatology’s online dermatology modules (https://www.aad.org/education/basic-derm-curriculum/suggested-order-of-modules ).
• Attend the bi-annual meetings of the San Francisco Dermatologic Society. This is a wonderful opportunity to hear dermatology experts speak about their clinical interests and research, see interesting case presentations, and interact with trainees and faculty of UCSF and Stanford, as well as dermatologists from the Bay Area. [http://www.sfderm.org]
- What common variations exist in the length/content of residency programs for this career?
• Traditional residency program: internship (internal medicine, surgery, pediatrics, or transitional year) + 3 clinical dermatology years. Unless you are strongly considering pediatric dermatology, internal medicine internship is looked upon most favorably (preliminary year in medicine is recommended over a transitional year).
• 2+2 research program (offered by some, but not all, departments): internship + 2 years of clinical dermatology + 2 (or more) years of integrated research and clinical exposure. The research is almost always basic science, not clinical research, and these track positions are almost exclusively filled by individuals with advanced scientific degrees (masters, PhD).
• Dermatology and Internal Medicine combined residency programs: 5 years total of combined training and board certification in both specialties (not offered at UCSF). Please see the link for a description of the combined program with participating institutions. (http://www.abim.org/certification/policies/combined-training/internal-medicine-dermatology.aspx#programs)
- What common variations exist in this career after training?
There are 4 post-residency fellowship opportunities:
• Procedural dermatology: 1 year, specialized surgical training that includes advanced training in Mohs Micrographic surgery, reconstructive surgery, cosmetics (botulinum toxin, fillers, lasers, liposuction) procedures.
• Pediatric dermatology: 1 year, specialized training in treating skin disorders in children. Preference for fellowship selection is given to individuals who have done a pediatrics residency or a pediatrics internship.
• Dermatopathology: 1-2 years, specialized training in reading biopsies of skin malignancies and inflammatory disorders. Both dermatology and anatomic pathology residents are eligible for dermatopathology training.
• Medical dermatology: 1 year, specialized training in complex medical dermatology, including disorders of skin with significant systemic manifestations and the use of systemic immunosuppression. There are specific programs that focus on areas within medical dermatology, such as rheumatology/dermatology.
- What is a typical workday for someone in this field?
Depends on chosen subspecialty. The typical dermatologist will see 30-50 patients a day with a mix of procedures, cosmetics, medical dermatology visits. Almost all dermatologists do quite a bit of surgery: dermatologists do a number of surgical procedures (biopsies, cancer excisions) as well as cosmetic procedures (botulinum toxin, filler, chemical peels, lasers, liposuction, vein sclerotherapy). Most dermatologists have nights and weekends off though the high clinical volume requires a significant amount of pager call (i.e. answering phone calls). Since the specialty is primarily outpatient, the typical workday starts at 8am and ends at 6pm. Some dermatologists that are affiliated with large hospitals may be part of inpatient dermatology consult services (typically seen after the clinic day ends).
- What is the culture of this career?
• Dermatology is a very small field – many dermatologists know one another and the small size of our specialty and frequent meeting opportunities allows wonderful connections between dermatologists who live all over the world. Dermatologists are highly involved with their specialty with excellent participation in local organizations (such as San Francisco Dermatology, CalDerm and other state and national societies).
• People who typically choose this field have a preference for: doing procedures, thinking about a broad spectrum of diseases (almost every disease has a cutaneous manifestation), highly-academic people (requires a very large fund of knowledge, residency is reading-intensive), variety of ages seen (from children to the elderly), variety of conditions seen (mole checks to systemic lupus), variety of health status (from very healthy to very sick), doing cosmetic procedures, seeing high volume of patients during short visits (typical dermatologist sees 30-50 patients a day), dedicated to giving back to the specialty.
- How compatible is this career with raising a family? How is this different for men and women?
• Most dermatologists enjoy excellent work-life balance due to a largely outpatient practice, no inpatient/ overnight call, and flexible days worked.
- What are the most important qualities or character traits for a person in this field?
• is self-motivated
• enjoys high clinical volume, lots of variety in their clinical practices
• enjoys, is adept at performing procedures
• has ability to master clinical material across a broad spectrum of diseases and disorders
• prioritizes commitment to serving/giving back to the specialty, being part of the dermatology community
- How competitive are the residency programs in this field?
• This is a relatively competitive residency program process. The typical applicant applies to 60-80 programs, will be invited to 5-15 interviews. Each interview will entail 1-2 days visiting a program and having approximately 8-10 individual or panel interviews typically lasting ~10-20 minutes each during that visit. The 2014 AAMC data for outcomes from the match for dermatology are:
• Students at UCSF typically do very well with the residency match process. The key is to have good mentorship throughout the application process, including an individual or two (typically academic faculty) who will mentor you and advocate on your behalf through writing you a highly individualized letter of recommendation and calling programs to support your application.
- How competitive is the job market after residency?
• Depends on the type of practice and geographic location. Job opportunities for dermatopathologists and dermatologic surgeons are rare in the big cities but there is great need for these specialists in more suburban/rural locations. Pediatric and medical dermatologists are highly sought after, though some cities are saturated (NYC, LA, SF). There is tremendous need for general dermatologists (individuals who do all types of dermatology) in rural areas.
• The average starting salary of a general dermatologist who works 4-5 days a week in an urban setting (2016) is approximately $325,000.
- What programs have been popular among UCSF applicants, or how should applicants go about considering programs?
• The top dermatology programs in the country include: UCSF, UCLA, U Penn, NYU, Harvard, Columbia, Stanford, Northwestern.
• Applicants are strongly encouraged to apply broadly across the US. The typical applicant will apply to 60-80 programs though an extremely strong candidate could successfully match with 30-40 applications. Research-oriented applicants to the 2+2 program would likely apply to 30-40 programs as there are fewer programs nationwide that support such research-oriented trainees.
• Key considerations include: opportunity to see a broad variety of diseases, types of patients, opportunity to work in different clinical settings (VA, county system, upscale practice, community practice, inpatient hospital), availability of experts in different specialties (ie pediatric dermatology, hospital dermatology, dermatologic surgery, dermatopathology), the size of a program (ranges from 3-21 residents), clinical teaching faculty, didactic curriculum (is it resident-led or faculty-taught?), research opportunities (if desired), track record with developing academic careers/mentorship. Cost of living is also an important consideration for individuals applying to residency.
• Please note that there can be a disconnect between the reputation of a medical school and the dermatology residency training – ie there are SUPERB dermatology residency programs at medical schools that you may have never heard of (and vice versa). It is important to review the list of programs with a mentor.
- What resources (eg, websites, books, professional groups) would you recommend for students interested in learning more about this field?
- American Academy of Dermatology
- Society for Pediatric Dermatology
- American Society of Dermatopathology
- American Society of Dermatologic Surgery, Mohs College Society
- Medical Dermatology Society
- Dermatology Foundation
- National Psoriasis Foundation
- San Francisco Dermatologic Society
- How important is each the following for admission to a competitive program?
USMLE Step 1, 2
Board scores are not as important as they used to be. See mean scores of matched applicants in the AAMC table. A score of <225 may be problematic depending on the strength of the rest of your application. The key issue with board scores is that some programs still continue to use board scores as a “cut-off” for screening applicants. This cut off is usually 200-225 and sometimes higher. It will be very difficult, and possibly impossible, to match in dermatology with a board score of <200 or if the board was not passed on the first attempt.
Recommend more significant involvement in a few organizations rather than superficial involvement in many; leadership positions are notable.
Recommend research in dermatology >> other specialties. Original research papers are more highly regarded over case reports (500 words).
If an applicant has strong research background in another field (such as PhD in basic science or in another medical specialty), it is still recommended that they do some research in dermatology.
Honors in third year
Strong candidates have honors in >50% 3rd year clerkships. At the most competitive programs, honors in all clerkships is typical of the applicants who are ranked highly. Honors in core rotations such as internal medicine, surgery, pediatrics is especially important.
May consider an away elective on the east coast or mid-west if the student is “born, raised, and schooled” entirely in California. There is significant geographic bias in the residency selection process whereby individuals who have done all of their schooling in California typically do not leave the west coast and thus are disadvantaged when applying to mid-west or East coast programs. Consider doing an away elective at NYU, U Penn, Harvard, Columbia. This should be discussed with a mentor.
Other: experience in dermatology (clinical, research, or otherwise)
It is virtually impossible for a student to match in dermatology if they have never done a clinical rotation, research project, or volunteer experience in dermatology.
Letters of recommendation
Need 2-3 VERY STRONG letters of recommendation from dermatologists, ideally well-known (senior) academic dermatologists.
Timing: The letters (and ERAS application) are due October 1st of 4th year so please give your letter writers at least 4 weeks to write your letter. It is important to note that if you are scheduled to do a dermatology elective in September, it will likely not be possible to get a letter of recommendation from that elective as there will not be enough time for the letter-writer to get to know you well enough to write a high quality letter.
Goals: An ideal application includes 3 strong dermatology references and an excellent letter of support from internal medicine. Your letter writers should speak about your clinical skills, your research excellence, your personal attributes (not every letter writer needs to address all points but they should be covered somewhere and you can direct letter writers to cover a particular topic if you do not think it will be covered by other writers.)
Please note: if you have a dermatology research mentor at another institution (ie from a summer experience), it is still very important to get a letter from your home school (ie UCSF) to demonstrate that you have connected with your home department; because you are a UCSF student, it is highly likely that faculty at other schools will call faculty at UCSF to inquire about you.
- What are my chances of matching? Is it too late to consider dermatology as a specialty?
• It is highly recommended to have a meeting with your mentor AS EARLY AS POSSIBLE to review your board scores, clinical grades, CV, and discuss your career goals. They can help you estimate your chances of matching and areas of your application that you may wish to strengthen, and whether you need to take a year off to develop your commitment to dermatology. If you have any areas of grave concern (i.e. very low board score, failed a clerkship), please discuss with one of the residency program directors or the confidential dermatology advisor as they have more experience in strategies for dealing with this.
• Is it too late? It is generally not recommended to try to apply in dermatology if you have not had any clinical or research experience in dermatology by the summer of 4th year. Why: you will not have enough experience in dermatology or connections to get strong support for your application. In these cases, it may be worth taking time off, or applying to internship only, and pursuing a clinical or research fellowship in dermatology after internship, then applying later.
• Once you apply, you'll know a lot based on the number of interviews you get. The magic number of interviews that suggests a high likelihood of matching is around 7. If you have fewer than 4, you may want to consider a backup plan. Not matching is not a disaster; the match rate for second round applicants is still high. Most of the individuals who match on the second try do so with a notably improved application with new publications, fellowship experiences, etc – i.e. do not submit the same application as in 4th year. Third and fourth attempts to match are generally not successful.
- What should I do if my board scores are low?
• Electives and research experiences for students with scores lower than 225 can be key.
Some programs do screen applicants based on scores and if they know you, they are more likely to pull your file for an interview anyway. Some options for students with lower board scores include: taking a year off and doing a productive research project, doing a research fellowship (after internship) in clinical research, cutaneous oncology, psoriasis, hair/nail, etc.
• A word on taking a year off between 3rd and 4th year: It is not essential but may be recommended if other components of your application are weak. However, please note that a research year must be productive and highly mentored. A year without publication or some other tangible result may hurt rather than help.
• If you are planning to take a year off, you should contact the program director(s) of the Pathway relevant to your interests (e.g., Clinical and Translational Research, Molecular Medicine, Global Health) < http://meded.ucsf.edu/pathways/five-pathways > so that you can find out options for funding and important application deadlines. In addition to the general intramural funding within UCSF, students may be able to apply simultaneously for funding through specific programs depending on their interests. For example, students with basic science projects can apply for the Howard Hughes Medical Institute Medical Research Fellows Program (this award is highly competitive). Students with global health projects can apply for Doris Duke International Clinical Research Fellowship. Students from underrepresented in medicine backgrounds and students interested in health disparities research (regardless of background) can apply for funding through PROF-PATH (Promoting Research Opportunities Fully – Prospective Academics Transforming Health). Deadlines for these applications are relatively early. Students must meet with advisory college mentors, program directors, and mentors before submitting a letter of intent to pursue a yearlong project in October of MS3. Project proposals are initially reviewed in December, and final submissions (including multiple letters of recommendation) are due in January. The process requires significant planning, so it is advisable to identify a mentor and project as early as possible. Overall, about 70% of students applying for Pathways are funded. Additional derm-specific funding sources may be available through the American Dermatology Association, American Skin Association, North American Contact Dermatitis Society, and American Acne and Rosacea Society.
- Advice on personal statements?
- It can be hard to write a statement that stands out and unfortunately many of them sound the same. You want to leave the reader with something that is memorable about you, but not too much of an outlier. Don't be afraid to be explicit about your goals and show it to some people you trust. But don't show it to too many people - it dilutes the originality and personal voice that really has to come through.
- Though you want the statement to be personal, it is generally not recommended to describe a cutaneous condition that you have experienced (severe acne, atopic dermatitis, psoriasis, melanoma) unless you have a very unique aspect of this that you would like to discuss or explore. This is a common pitfall for students (i.e. many students write about this and thus it ends up not being very original).
- It is generally recommended for the style to be straightforward, easy to read, and succinct. Do not attempt to be creative or artsy unless creative writing is really your forte. Be certain to not obscure the message of your qualifications and commitment to the specialty with your artistic flair.
- A general format would be:
- Paragraph 1: I want to be a dermatologist because (ie how you decided on derm) and be clear on why you are a doctor.
- Paragraph 2: describe your experiences, accomplishments in dermatology. Be specific and be comfortable highlighting your successes. i.e., “I collaborated with Dr. John Smith of University to perform analysis of melanomas taken from 340 patients to determine the patterns of XYZ staining and associate the relevance of this staining pattern to patient prognosis and survivorship; this work resulted in an oral presentation at the annual AAD meeting in Denver 2014 and also a first-author publication in the JAAD.” In the essay be gracious to your mentors (OK to name drop).
- Paragraph 3: Summarize your story, your path to dermatology and indicate whether there are any particular career aspirations (ie to become a pediatric dermatologist – only state this if this is 100% certain, otherwise ok to leave this more general)
- The personal statement is a really good chance to explain any particular circumstances: low board score (because of illness, death in family), why you are switching from another specialty into dermatology, why you want to move to Chicago (because partner is being relocated there or your entire family lives there). Please seek guidance on this aspect from mentors to make sure that the circumstances you hope to describe are appropriate and properly worded.
- What do I do if I am asked to draft my own letter of recommendation?
- This sounds a bit awkward at first, but it turns out to be both routine and to your advantage. It saves the writer time and allows you to put in the time and effort in the areas that are really important to you. It is also a chance to emphasize thematic points that will be consistent with the rest of your application or highlight things that you want to get extra attention that might not be obvious to the writer.
- One basic outline is:
- Paragraph 1: What is the relationship, ie How do you know each other and how long have you worked together?
- Paragraph 2: What you have accomplished
- Paragraph 3: Personal attributes. This is the hardest part for most people. This it is an opportunity if there are themes you want to highlight so feel free to take a stab at it.
- Paragraph 4: Summary paragraph. Good for a line or two that is the impression you want to leave with the readers.
- To make it easy to read, keep it to one page. Put in ERAS information also - it also saves the writer time from having to look it up.
- Should I apply in something else as a back-up plan?
• This should be discussed with your mentor or with the confidential dermatology advisor. First, it is logistically very difficult to interview for dermatology, internship, and a 2nd specialty at the same time, unless the internship program (ie internal medicine) is the same as the 2nd specialty. You do not want to create such a hectic interview schedule that you show up to your dermatology interview(s) exhausted!
• If you have been counseled that your chances of matching in dermatology are very low, but you still wish to apply: consider applying broadly in dermatology (plus internship) and your 2nd specialty and see where you get interviews. If you get only 1-2 dermatology interviews, then it will likely be possible to interview in both specialties, and then list dermatology at the top of your rank list. However, if you decide to rank the 2nd specialty, do so with caution. If you are even remotely a good candidate for dermatology, you will likely be a very strong candidate for a 2nd specialty and may match in that specialty. Because matching is a binding agreement, it will be very difficult to switch later. Bottom line: it is important to decide whether your priority is to match in dermatology (and risk not matching, then apply again later) or whether your priority is to match in something (then okay to rank both specialties). Please seek advice and mentorship if you are considering this.
- How do I find a research mentor? What type of research should I do?
• Join the DIG mentoring program: there is individualized pairing of mentees/ mentors. This person will be your main career mentor. It’s okay if their research interest isn’t exactly aligned with yours – they will be a very valuable resource to help you find research mentors/ projects either here at UCSF or at another institution.
• Look at the UCSF Department of Dermatology website for research interests of faculty and contact a mentor directly. After establishing a mentorship relationship, it is advisable to notify the current career advisors for dermatology. The advisors play an important role in the application process (including responding to outside programs’ inquiries about students), so it is best if they are familiar with your derm-related projects/activities.
• It is strongly recommended that you limit the number of mentors to focus on deeper relationships rather than talking with/ doing research with many mentors. There are limited mentors in the department so consider switching mentors if you feel that a mentoring relationship isn’t working rather than accumulating multiple mentors. It is also strongly recommended that your primary mentor is somebody other than the residency program director or the confidential derm advisor.
- Talk to current Residents in the Dermatology Department or previous students who have matched into Dermatology from UCSF (see recent match lists). They can often give advice regarding good mentorship and perspective on the faculty you are considering doing research with.
• Consider what types of projects you have time for. Remember that any clinical research will likely entail writing an IRB or recruiting patients and will require time – a summer at the very least but more likely a year off. Though first year seems very busy, it is one of the least busy years of medical school and possibly the best time to engage in a research project if you are managing the academic load well. The summer between 1st and 2nd year, 2nd year, and 4th year are other good times to pursue ongoing research. It is very difficult to do research during 3rd year. Be transparent with your mentors about what types of obligations you have with school or clerkships to ensure that your timeline meets theirs. In general, it is recommended to consider some type of clinical case series or clinical review (which is almost guaranteed publication) in addition to an original research project (which are typically more time consuming and not guaranteed to be published).
• Aim to submit your research publications by the summer of 4th year at the latest. The ERAS application will require you to list submitted manuscripts separate from works that are published; in general submitted manuscripts are not as highly regarded because there was a study that demonstrated that very few manuscripts listed as submitted were ultimately published (this study was done specifically on dermatology applicants).
• Please note: it is not necessary to do multiple research projects with different faculty (in fact this is strongly discouraged).
• It is imperative to make every attempt to FINISH any projects that you start, and to complete them according to your research mentor’s expected timeline; failure to fulfill a project commitment or to meet a deadline may result in losing your research mentor’s support and possibly even their willingness to write you a letter of support.
• There are several opportunities to engage in research during residency and in fellowships. A 2+2 program or a year off are not the last opportunity and are not required to have an academic career.
• Think about funding options – some are general funding, while others are more relevant depending on the research project. Do your homework and ask your mentor if any of these funding options make sense: Dean’s research award, grants through CTSI RAP program, American Dermatology Association grant, American Skin Association, North American Contact Dermatitis Society.
- What 3rd year clerkship program should I do? (Traditional, VALOR, MODEL SFGH, PISCES, KLIC, LIFE, etc)
- UCSF SOM offers a variety of programs that students may choose for 3rd year clerkships. These programs provide a wonderful array of unique opportunities to work with specific communities and populations. The deadline to choose is often in the winter quarter of 2nd year. It is important to note that there is no "right" or "wrong" program for a derm applicant – different students have gone through different programs and have successfully matched. The choice of a 3rd year clerkship program is a highly personal one and should be based on your desire to work with certain communities/patient populations and how you best learn as a student.
- DIG will provide an informational session to all 2nd years that will cover this decision.
- Planning considerations for 3rd year:
• Consider doing the 140.01 elective (2 week basic dermatology elective), if available/ feasible. It is strongly recommended to do this in the second half of the year, after you have more clinical experience under your belt, as you would want to perform strongly in this rotation. However, a benefit of taking it earlier (in the first half of the year) would be if you are torn between two potential future specialties and want to make a decision sooner rather than later. This would be an important point to discuss with your mentor.
- Planning considerations for 4th year: remember, ERAS application must be completed by October 1st, which is when the dean’s letter (aka MSPE) is uploaded. Oct 1 is the deadline for a majority of dermatology programs. Keep in mind that ERAS application opens September 15th which is often when a majority students submit their internal medicine application (relevant if you are applying into an internal medicine preliminary/transitional year). Thus it may be worthwhile to submit your application by September 15th. Some preliminary internal medicine programs do send out interview invitations in the time between Sept 15th and Oct 1st.
• Try to do dermatology as early as possible. Take the 140.01 basic 2 week elective back-to-back with the 2 week 140.08 advanced elective. You will choose the focus of your 140.08 elective when you arrive for the 140.01 (as faculty schedules/ availability changes). Consider doing a 150.01 research elective during the late spring or early summer to finish up writing any manuscripts you have been working on so that you can submit them as early in the summer as possible.
• Do your medicine sub-I in the beginning of your 4th year - late spring/early summer. It is preferable to have your medicine sub-I grade before your application is due, and this is often where some students choose to get one of their Medicine letters of recommendation.
• Take USMLE Step 2 CK at a time so that your score will be reported on your ERAS application (ideally before September 1)
• Plan for any away electives to be during the summer (ideally before September 1st) if you are planning to get a letter of recommendation from that rotation (see above table on letters of recommendation).
• Do you need to do an away elective? Consider it if: you are “born, raised, schooled” exclusively in California (see #12 table above), if you have a particular program that you would like to match in (consider this an “audition” rotation), or if you have nothing to lose (i.e. you are not a strong candidate because of grades, board scores, but you would really like to try to match because you feel that your personality/clinical skills shine best in person). If you “look perfect” on paper, there are potential risks to doing an away elective and it may be in your best interest to not rotate outside of UCSF. However, doing an away elective is by no means a guarantee that you will get a letter of recommendation or an interview from that institution.
• You do not need to do multiple away electives. Presumably, you will be a dermatologist in the future so you should instead take the necessary electives to prepare yourself for internship (i.e. how to read an EKG, radiology, procedures courses, cardiology, ID, rheumatology elective, etc).
• Plan to take the entire month of January and possibly also December (if possible) for interviews. As it may be difficult to navigate with limited vacation time, you may consider doing a more flexible research month. Most dermatology interviews are in January and are only offered on 1 day so it is imperative that your schedule is as flexible as possible.
• An overview of highlights of the 4th year are:
- June-mid-August: peak season for doing dermatology electives, derm research, one sub-I (preferably medicine unless you are pursuing pediatric internship year – in that case, then a pediatric sub-I is more relevant), taking Step 2 CK, and writing your personal statement
- mid-August: recommend to take Step 2 CK before this date, as it will require approximately 4-6 weeks to get your scores posted to your ERAS file. It is strongly recommended, though not essential, to have your Step 2 CK score included on your ERAS file; it is an important data point for many programs. If you have a weak Step 1 score, it is IMPERATIVE to have your Step 2 CK score included on your ERAS file (hopefully improved). Please take Step 2 CS according to the SOM guidelines (not an important consideration for dermatology residency)
- ERAS application opens in mid-August or early September so you can begin to work on your application online (without officially sending it to programs yet)
- September 1: last day to ask faculty to write a letter of recommendation. This is not a firm deadline but more of a suggestion of courtesy – giving a faculty member 4 weeks to write a letter is standard and the letter is due in final form by October 1st. This means that it may be important to do any dermatology elective with a faculty member from whom you are hoping to get a letter at the latest in August.
- September 15th – First possible day to submit your application on ERAS. This is often when a majority of internal medicine applicants submit their application. This is relevant if you are doing a preliminary/transitional internal medicine year. Some prelim programs send out interview invitations between Sept 15th and Oct 1st.
- October 1st: MSPE (aka Dean’s letter) is posted. Most programs download their apps on this day so it is essential that all of your application and letters are submitted before this date.
- October/ November/December: preliminary year interviews
- January >>> December: dermatology interviews
- mid-February: rank lists are due
- mid-March: MATCH!
- What’s the most important piece of advice for a student applying in dermatology?
• MENTORSHIP is the key to successfully matching in dermatology. If you are considering a career in dermatology, it would be worthwhile to (a) join the DIG and (b) establish a relationship with a dermatology mentor, and to do these as early as possible. Please note that it is not necessary to meet with multiple mentors (and in fact is strongly recommended against). You should have a key career mentor (which you can get through the DIG mentorship program) and perhaps also a research mentor (if you are doing research in an area outside of your career mentor). It would be worthwhile to meet with ONE of the residency program directors (currently Kanade Shinkai and Erin Mathes) or the confidential dermatology advisor (Amanda “Mandy” Raymond) at some point when you have officially decided to apply in dermatology; please note it is only necessary to meet with ONE of them, not all three.
• Attend as many DIG workshops/panel discussions as possible. These are HIGH-YIELD sessions and can make your mentorship meetings more individualized to discussions re: your specific career goals, needs.
• Please consult your mentor frequently to help you navigate the residency application process. Key decisions:
- picking a research mentor/ research project
- 3rd year scheduling, choosing a 3rd year track
- 4th year scheduling, including away electives and whether to take a year off
- which programs, how many programs to apply to
- which programs, how many programs to interview at
- how to rank programs/ how to reach out to/ communicate with your top choice program. This is an important step following interviews and you should set up a mentor meeting to specifically discuss this.
Over 3 billion people in over 125 countries don´t have access to dermatologic care of any kind! Whereas 12.4% of family medicine visits occur due to dermatological problems, 59% of patients in Uganda were found to have dermatological problems during a humanitarian mission in 2013, stress Kesmarszky, Jakkel and Szabo (2016), in this report. The associated mortality rate in these area was as high as those of meningitis, hepatitis B and rheumatic heart disease, they argue.
There are many ways you can offer a helping hand to humanity as a dermatologist, and lots of stories about dermatologists who´ve enjoyed spending their time working with other people in mind. You can travel or support an organization in your own country, or you can get specific training and/or participate in missions during or after your study through your university or health institution.
Help At Home
Have you heard of Camp Discovery? It´s the Amercian Academy of Dermatology´s week-long camp for kids and teenagers with serious skin conditions. They enjoy fishing, boating, swimming, and arts and crafts. Why not get involved in the next camp or donate funds to support this wonderful effort to improve children’s´ lives? Volunteers can select the week that is most convenient to them, and all costs, including transportation, are taken care of by the American Academy of Dermatology.
Suzanne Olbricht, MD, FAAD is from Burlington, Massachusetts. They supports the Academy´s SPOT Skin Cancer initiative by raising funds for a shade structure at the Smithsonian National Zoo and is able to give back in a way that´s meaningful to her and have a lasting impact. Their magazine Aspire documents stores about the dermatology community and how individual dermatologists´ volunteer work is helping needy patients and advancing skin health. You can donate to this cause even if you´re not from the USA.
There are many benefits to be had and enjoyed by volunteers who offer their time abroad. They include:
- Learning about a different culture
- Sharing skills and expertise
- Gaining perspective on the impact of wealthy countries on less developed countries
- Learning a foreign language
- Getting inspired by others
- Gaining expertise and knowledge in your field of expertise
So what might you see when out on a mission after an earthquake, for example? In Yucatan, Mexico, sunscreen is a luxury and 12.7% of 1071 Mayan patients seen by dermatologists volunteering there required sunscreen for conditions like photodermatitis, polymorphous light eruption, NMSC, vitiligo, melasma and post-inflammatory pigment changes, for example.
Have you ever wanted to go on a disaster relief mission? Dermatologists can! During one disaster relief mission in Haiti, dermatologists saw scabies, head lice, tinea capitis and allergic/contact dermatitis. These conditions were exacerbated by overcrowding and poor living conditions. One boy was thought to have injuries from the earthquake, but he actually had xeroderma pigmentosum. He had several AKs and squamous cell cancers. Another boy with a broken leg had HIV-associated epidermodysplasia verrucoformis.
Though the facilities available when volunteering abroad vary considerably and may be very limited, some missions include excellent supplies and sophisticated equipment. The facilities available during a mission in Haiti involved a 50-bed trauma emergency room, 12 operating rooms, a 20-bed recovery room, a 30-bed intensive care unit, 400 intermediate-care beds, full radiologic and laboratory support and 500 minimal-care beds, all neatly situated on USNS Comfort during Operation Unified Response Haiti.
The ADD, mentioned above, provides funding for 15 senior dermatology residents every year. They go to Boswana for 4-6 weeks, and learn how to practice dermatology with finite resources, caring for patients with tropical and HIV-related conditions. The airfare is paid for and you´re given a stipend for accommodation and food.
Another MOHS surgeon in Florida, Dr. Strasswimmer, teaches cutaneous surgery methods to practitioners in Africa. In Africa, there is a high incidence of NMSC before the age of 8 in albinism patients. Their dark-skinned mothers often don´t know how to take care of children with albinism, which occurs in one out of 1,800 newborns. In Sub-Saharan Africa, there´s a care unit for people with albinism. The building houses a pharmacy and compounding facility where cost-effective sunscreen is made; a training center for local and outreach sun protection; people with albinism are trained in machine sewing to enable them to work inside; there´s a team that visits surrounding towns and offers cryotherapy and sun protection education.
Another method of helping people abroad is through teledermatology. It reduced the number of face-to-face visits needed, and some can occasionally be used for international diagnosis, in remote, sparsely-populated areas. Photos and patient chart information can be sent to the USA, Europe or Australia, or wherever you´re practicing. Ask your organization if you can carry on helping in this way once your mission has ended. Here is a story about a new global telemedicine initiative helping people in Africa.
Train with The Military
The military has three dermatology training institutions that offer residency training programs and a dermatopathology fellowship program. Could this be a viable option for you? Here´s more information. Juan A. Rosario-Collazo, MD, won a Humanitarian Service Medal during his years of service.
Check out young pioneer for inspiration - Jill S. Waibel, MD just won the JDD Humanitarian Award in 2016.