HOW TO OBTAIN A POSITION IN A DERMATOLOGY RESIDENCY PROGRAM 

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As a first-year medical student, start by making an appointment with your career advisor or student affairs dean in the Office of Medical Education to get advice on how to gain early exposure to dermatology, and seek out opportunities to get to know the dermatology faculty and residents in your school. Join the Dermatology Interest Group (DIG) at your medical school or start a chapter if you do not have one. You can find more information about DIG at their national website (derminterest.org). Run for an executive position in DIG so that you can develop a close relationship with residents and faculty involved with DIG. Use this platform to learn about community-based activities sponsored by the interest group, such as the SPOTS program (spotseducation.org). It is also helpful to identify medical students in the class above you who are planning to go into dermatology as well as students who recently matched into dermatology. These individuals can provide insight and helpful resources at your home institution. Moreover, attend Grand Rounds and local dermatology conferences when possible. This will help you to learn more about dermatology and become familiar with the faculty and residents. After some time of observation, you could identify a faculty member or resident to approach as a mentor. Inform your mentor(s) that you are interested in learning about research projects, case reports and volunteer experiences, and ask them to keep you in mind if they learn of any opportunities in these areas.

Keep in mind that Grand Rounds are generally open to medical students; however, at some institutions, smaller educational sessions (i.e. journal club, didactics) may also be open to medical students. It is best to ask before attending. Also, some institutions may have designated faculty career advisors who can provide you with advice and connect you with early opportunities. How to Obtain a Position in a Dermatology Residency Program Pathway to successfully match into dermatology MS1 MS2 MS3 MS4 DIGA Shadowing Volunteering DIGA Shadowing Volunteering Clinical Rotations LOR Scholarly activities Step 2 Application process Interview process Figure 1. Schematic representation for successfully matching into dermatology by year in medical school. Skin of Color Society | How to Obtain a Position in a Dermatology Residency Program 2 MS1 and MS2 years should be focused on exploring all areas of dermatology and getting to know the current faculty and residents. However, be mindful and do not be too aggressive. 

Remember faculty are busy clinicians. If you reach out to a faculty member and do not get an immediate response, be patient. Wait at least two weeks before sending a polite follow-up email. This is also a great time to shadow a dermatologist to make sure dermatology is right for you. While shadowing, ask yourself “Can I do this for 40 years of my life?” Remember you are committing to a lifelong career so go into dermatology for well-explored reasons. Exploration, self-awareness and reflection are important aspects of choosing a career in dermatology. Additionally, be aware that there are various subspecialties within dermatology (i.e. general, pediatric, procedural, dermatopathology) and various practice settings (private vs. academic). Taking the time to shadow early on will help you understand if this is truly a field of interest and perhaps help narrow down a specific focus. Determining a subspecialty in dermatology early on is not expected; however, if you do have a particular interest within dermatology, you should explore it, as you may be asked to explain this interest during the interview process. As dermatology is a competitive field, it is a priority to focus on mastering the curriculum content and maintaining good academic standing. Aim for your personal best in your core academic curriculum and clinical rotations.

Alongside your institutional curriculum, you should study USMLE Step 1 “the Boards” exam material. Start practice questions early to help identify key concepts, along with understanding Step 1 question and answer formats.

Finally, develop your extracurricular interests and seek volunteer or leadership opportunities. You can participate in activities to help the underserved or reduce healthcare disparities. Consider volunteering at a local free clinic and exploring whether these clinics offer dermatology services with which you may become involved. Many programs are putting emphasis on a “culture of caring” in addition to clinical grades and USMLE Step 2 scores. Sustained community service is highly regarded by residency programs. If you do not have a home dermatology program or cannot identify a local mentor, seek a mentor through the American Academy of Dermatology (AAD) (server.aad.org/mentorship/search/Default.aspx), the Skin of Color Society (skinofcolorsociety.org/about- socs), or the Women’s Dermatologic Society (WDS) mentorship program (womensderm.org/awards/award-programs/ mentorship-award-program).

SUMMER AFTER FIRST YEAR OF MEDICAL SCHOOL

This is the time to conduct research. It has been well documented that research experiences and publications are strongly associated with successfully matching, so it is important to prioritize this endeavor. Select a research project that is feasible to complete within this timeframe or that can be continued during your MS2 and MS3 years. Aim for your manuscripts to be accepted by a journal by September of your MS4 year, which is when your application for dermatology residency is due. Joining an already established project is a good start with a reasonable projected stop date to have time to prepare adequately for Step exams. If you commit to a research project - own it. Take initiative. Be responsive to your mentors, answer emails promptly, collaborate with other research personnel effectively, and gather all materials such as clinical tables, figures, clinical images and histopathology images efficiently. Anticipate what your team will need, perform tasks in advance and inform your supervisors of your progress often. Make sure to follow through on all tasks to completion. For novice writers, consider referencing material on the basics of medical writing (e.g. The Clinicians Guide to Medical Writing by Robert B. Taylor, etc). Discuss and construct a broad outline of goals and timeframe for your research project that explicitly align to your research mentor’s expectations. 

Your research mentor should be able to provide you a letter of recommendation, so do an outstanding job. Remember, if the hypothesis is not proven, this is still worthy of a publication. Prior to starting the project, discuss the potential for publication in a peer-reviewed journal. Provide your mentor with a list of upcoming dermatology conferences that you think may be good opportunities to present your work. Many medical schools provide funding for their students to present research. If you are unable to identify a research project within dermatology, obtaining a publication in an alternate field may also be regarded well. Be able to explain this research interest and, if applicable, provide a brief but illustrative story of your transition to interest in dermatology or how your project may relate to dermatology.

Keep in mind, there is no magic number for scholarly activity projects to match into dermatology, but most of the applicants had five or more abstracts, presentations, or publications at the time of the application. This is also the time to shadow dermatologists and plan for MS2 year with a continued focus of USMLE Step exams. Depending on your interests and resources, consider global medical electives (some medical schools have a global medicine track) as there are opportunities to participate in dermatology focused clinics abroad.

SECOND YEAR MEDICAL STUDENTS (MS2)

MS2 year should be seen as a continuation of your MS1 agenda. Furthermore, if you did not decide until your second year of medical school that you wanted to pursue a career in dermatology, it is not too late. You can still spend time looking for mentorship opportunities and research projects in MS2, MS3, and MS4 years. During your MS2 year, it is important to dedicate time to be well-prepared for the USMLE Step 1 exam. This will help you solidify your pre-clinical medical school curriculum. Note that, previously, performing well on Step 1 was strongly associated with an increased chance of matching. Now that Step 1 is pass/fail, there may be more emphasis on Step 2 performance.

However, most dermatology residency programs now are committed to a holistic application review process, with exam scores only a part of the overall evaluation. We also encourage future UIM applicants to consider applying to the AAD Diversity Mentorship program. This program is primarily aimed at 3rd and 4th year medical students who desire additional mentorship. Mentors are encouraged to help with publications, letters of recommendation and guidance through the application process. Consider taking advantage of this program to use this time for your away rotations. Alternatively, this program can be completed in the summer of your MS1 and MS2 year to coordinate research and obtain early exposure to dermatology; however, the majority of recipients complete this program during their MS3 and MS4 years.

THIRD YEAR MEDICAL STUDENTS (MS3)

MS3 clinical rotations are critical. Residency program directors use recommendations and evaluations from this clinical year to ascertain your clinical abilities and ability to function well as a resident. Key components to clinical evaluations are working well with the team and taking ownership of your patients. Prepare for transition to clinical rotations by discussing expectations with upperclassmen and fellow classmates who completed rotations. Obtain feedback from your clinical preceptors early in the rotation and make meaningful strides to meet or exceed expectations. When planning for your rotations, consider starting with internal medicine and surgery to have a foundation upon which to build when working with the dermatology team on consults and in clinic. Plan to complete your first dermatology rotation at your home institution once you have had the bulk of your core clinical rotations. After completing a rotation at your home institution, seek feedback on your clinical performance to use for any potential away rotations.

In January and February of your MS3 year, you should begin to consider planning for away rotation applications through the Visiting Student Learning Opportunities (VSLO™) program. Many dermatology applicants complete 1-2 away rotations in the beginning of their fourth year of medical school (i.e. summer or fall of the year you are applying), though they are not required. You may apply for more than one rotation per time slot but be sure to withdraw additional applications once you have been assigned. Visit your local Office of Diversity and Inclusion to identify medical schools that offer specific rotations for UIM students. These programs may include supplemental funding.

Though completing an away rotation is not necessary, it may improve the likelihood that you match to the program at which you rotate. It is extremely important that you take this opportunity to get to know faculty. Schedule a meeting early on with the program director and/or chair to discuss your interest and possible research opportunities. Meetings are often scheduled by the department administrative assistant. This appointment is to introduce yourself and convey your interest in the field and the program. Attend the meeting with a printed version of your up- to-date curriculum vitae. Please keep in mind that some programs have many rotators and program directors and chairs are not able to meet individually with every student. During away rotations, dress professionally and make sure not to do things that may be portrayed negatively - do not spend time on your cell phone/ watch during clinic hours or conferences, do not perform procedures or interview patients without prior permission, do not complain or convey an impression of laziness or boredom. 

Also, bring a clean white coat, arrive early every day to lecture and clinical responsibilities, and be able to present patients without reading verbatim from a cell phone or typed note. Be prepared to give a presentation on a topic of interest during grand rounds. If this is not required, you may offer to do so. In preparation for your home and away rotations, you can review the Basic Dermatology Curriculum on the AAD website (aad.org/member/education/residents/bdc).

Be comfortable using dermatological terms to describe the cutaneous exam, along with knowing the first line treatments for the most seen dermatological disorders such as acne, eczema, psoriasis, warts and skin cancer. Read about patients and dermatology cases you come across during your rotation. At the completion of your MS3 year, you should have scheduled your rotation at your home institution as well as your away rotation(s), if applicable. You should also have begun to think about 2 or 3 dermatology faculty members to ask for a strong recommendation letter. At least two letters from dermatologists is encouraged. As a third/fourth, many will obtain a letter from a faculty member during their internal medicine rotation, though a letter from a faculty member who can speak strongly about you as a person and a student is best. Complete all outstanding publications or prepare them for submission. Start your personal statement and allow time for several revisions. Your personal statement should describe specific experiences and anecdotes to illustrate your abilities and qualities that make you a good candidate. Skin of Color Society | How to Obtain a Position in a Dermatology Residency Program 4 Do not list accomplishments. Let your letters of recommendation toot your horn, not your personal statement. This is an opportunity to highlight your narrative and strengths that are not found easily in the rest of your application. The personal statement is an important component of the holistic review process because it allows the selection committee to better understand how your experiences and attributes will help you contribute to learning, patient care, and teaching. If possible, have your dermatology mentor and local dermatology resident review your personal statement. If you are genuinely interested in a specific program you can personalize your personal statement to that specific school detailing why you are interested in their program however program signaling through ERAS is the preferred way to demonstrate specific interest in a program. Some programs will have applicants fill out a secondary application where you may also get a chance to highlight why you want to attend that specific program. Be honest and submit the secondary application in a timely manner.

Towards the middle to end of MS3, schedule the USMLE Step 2 CK and CS exams. Given that Step 1 is pass/fail, it may be helpful to complete your Step 2 CK exam prior to applying. Many, but not all, residency programs require or prefer completion of USMLE Step 2 prior to submission of rank lists in February of your MS4 year.

FOURTH YEAR MEDICAL STUDENTS (MS4)

Electronic Residency Application Service (ERAS) opens in July of your MS4 year. Reference the American Medical Association database on each residency program through Fellowship and Residency Interactive Electronic Database Access (FRIEDA) (ama-assn.org) prior to applying.

Programs start accepting applications in September with interviews typically taking place from November to early February. Upon completion of ERAS, some programs may require a supplemental application. This information is provided on ERAS or on the institutional website. Be sure to check the program website directly if it is not listed on ERAS. It is encouraged to submit your completed application early, and no later than the final day before residency programs may begin reviewing submissions on ERAS (specific dates may vary and be sure to check the ERAS website). The current deadline for the MSPE submitted by your school is October 1st.

Submitting applications to every program can be cost prohibitive. An application signaling system was started in 2023 that gives applicants 3 gold signals and 25 silver signals. These 28 signals are for the applicant to indicate which programs they are particularly interested in. There is a lower likelihood that applicants will receive interview invites at nonsignaled programs. For many dermatology applicants, applying to only the 28 signaled programs will likely be sufficient.

Applicants may consider applying to more programs (up to 40-50 programs), but applying widely (>60 programs) will likely not be of additional benefit. Please note that it is important to signal your home program and any away rotation programs if you are interested in them- they will not assume your interest. Apply some level of scrutiny when selecting programs, taking into consideration location, reputation and research opportunities. Be aware that some dermatology residencies have programs with special tracks, such as research or Internal Medicine/Dermatology joint residencies, which may require unique application considerations.

The cost of application fees and interview travel must be considered. If possible, begin saving for this early on in medical school to avoid taking on additional loans. Currently the interviews are being conducted virtually to help decrease the financial cost to applicants.

Prior to submitting your application, have your mentors review your application and personal statement. Ask for letters of recommendation prior to August 15. Who writes your letter and how well they know you is an important part of your application. Provide letter writers with your curriculum vitae, personal statement draft, and ERAS cover sheet. Ensure that several of your letter writers are academic clinicians. It is imperative to have a letter from dermatology faculty who knows you well. It may be helpful to have a letter from someone who is well known nationally, but only if they also know you well.

Most dermatology programs are advanced (or categorical) programs, meaning you are expected to begin your training after having completed a PGY-1 intern year. Generally, acceptable internships are in internal medicine, general surgery, pediatrics, family practice, obstetrics and gynecology, emergency medicine or a transitional year. The majority of dermatology residents complete an internship in internal medicine or a transitional year. While you may be focused on perfecting your dermatology application, keep in mind that your application for an internship will also require a personal statement, letters of recommendation and a careful consideration of where to apply. Often, the personal statement and letters of recommendation can be slightly adjusted such that they are eligible for both, however it is important to obtain individualized guidance on ensuring that your internship application is well-prepared.

Additionally, MS4 is generally the time when medical students are selected for membership into the Alpha Omega Alpha Honor Society. While not every school has a chapter, membership in this society is a factor that residency program directors may consider in interviewing and ranking candidates as it demonstrates a commitment to scholarship, leadership, professionalism, and service. While it is just one characteristic considered in a holistic review, membership to this honor society is a positive factor.

THE INTERVIEW

Complete mock interviews with at least one mentor priorto the actual interview. Look up commonly asked questions during residency interviews and practice them with your mock interviewer. Make sure you have a good answer for each question and ask your interviewer for guidance and constructive criticism on your demeanor, energy level, eye contact, body language, vocabulary, and content of your answers.

Know the program! Access the department website to get to know faculty and residents. Attend webinars that may be hosted by your programs of interest. Perform a literature search and familiarize yourself with faculty publications. Contact any upperclassmen who have interviewed at the program to get insight on the interview process. You can also contact the interview coordinators or department administrator(s) to get an idea of the activities during interview day. Of note, the interview coordinator is the person you will be interfacing with prior to and after your interview day. They are an important member of the program, and it is in your best interest to treat this person with the utmost consideration and respect.

In addition to knowing your interviewers be sure to know your application thoroughly. You can and likely will be asked questions on any aspect of your application.

Practice a list of commonly asked questions:

• Tell me about yourself.
• Why dermatology? Why our program? What are your goals?
• What are your strengths?
• What are your weaknesses?
• Tell me about your research?
• Tell me about an interesting patient?
• Who are your role models and why?
• What are your interests outside of dermatology?
• What questions do you have?
• What could you offer this program?

The publication How to Obtain an Orthopedic Residency (aaos.org/globalassets/about/diversity/how-to-obtain-an- orthopaedic-residency.pdf ) also has a list of questions to consider asking while on the interview trail. When answering the above questions try not to sound rehearsed or portray yourself as overconfident.

The Successful Match: Rules to Succeed in Residency Match authored by Drs. Rajani Katta and Samir P Desai is another resource. These authors also have a podcast as well as a section for dermatology applicants. Visit thesuccessfulmatch.com. Currently interviews are being conducted virtually.
Make sure you check your internet connection and computer camera in advance. Do not have anything distracting in thebackground, and ensure there is good lighting.

If interviews return to being in person in the future, plan to be 10 minutes early on your interview day. If possible, find the location prior to the interview. Again, pay attention to your appearance. A dermatology residency interview requires professional dress. Dress professionally. If you must question yourse lf then it is probably not a good choice to wear. The best choice is a comfortable suit and shoes without any flashy accessories. Be prepared for variable weather during the winter months. If you are flying, carry your interview clothes with you in case your checked baggage does not arrive in time.

With interviews being done virtually, many programs host a virtual meet-and greet with their residents prior to the interview day. Although this may be a more informal atmosphere, make sure you approach it as part of the interview process. Be an active participant in the session.

It is important to talk to residents from each program during your interview experience to get a better idea of the program. Remember, you are being interviewed throughout the process,from interacting with staff when scheduling the interview to speaking with residents at the very end of the interview day.

Always have questions prepared to ask of each interviewer. Do not speak to anyone in an overly-familiar way. You must be professional with everyone. If interviews return to in person, do not drink more than one glass of alcohol if it is offered in a welcome dinner.

Finally, be kind to your fellow applicants as these will be your potential classmates and peer colleagues in the future.

POST INTERVIEW

It is now advised that applicants do not write thank you letters or letters of intent to programs after the interview.

Begin the ranking process immediately after your interview.Make a list of pros and cons that will help you keep track of programs once you have completed your interviews.

Given the competitive nature of the dermatology match, think about what you would do if you were not to match. Always have a plan B. Many go on to complete their preliminary or transitional year and then re-apply.

A research year can also be taken to build on scholarly activity and strengthen an application before re-applying. Others may consider dual-applying in another specialty (this would need to be planned in advance of ERAS submissions, with preparation of two applications). Consider what plan is right for you. As a physician, there are many fascinating careers available to you. Everyone doesn’t match in dermatology, but all students have the opportunity for a fulfilling career in medicine.

Special Circumstances

For those who have come to a decision to pursue dermatology residency later in their medical school career or identified a gap in their scholarly exploration, you may consider a gap/ glide year. This should be considered a time for growth and exploration of the field of dermatology both in its clinical arenas (diseases and treatment paradigms) along with the areas of scholarly discovery currently in the field. This should be balanced with the extended time of delaying graduation, along with additional financial considerations.

CONCLUSIONS

A lack of diversity exists in the field of dermatology due to many factors. However, we hope understanding and knowing the application process in detail might provide useful information for potential URM candidates who might consider dermatology as a specialty (Figure 1). There are growing opportunities to develop and explore interest in the specialty of dermatology through mentorship, publications, podcasts, and online resources. A diverse workforce has been shown to provide better care and reduce healthcare disparities; therefore, diversity should be a goal for the field of dermatology as well. Dermatology is a fascinating field of medicine and can be very fulfilling and rewarding in many ways. If you ultimately decide you want to pursue dermatology, we hope this guide will help you successfully match into a dermatology residency program.

AAD Diversity Mentorship Program
aad.org/member/career/awards/diversity

NthDimensions
nthdimensions.org/programs

Women’sDermatologicSociety
womensderm.org/awards/award-programs/student-summer-research-fellowship

FREIDA(AMAResidencyandFellowshipDatabase)
ama-assn.org/medical-students/preparing-residency/freida

NRMP-NationalResidencyMatchingProgram
nrmp.org
students-residents.aamc.org/applying-residency/article/eras-timeline-md-residency/

Minorities in Medicine to get information on groups under represented in medicine.
students-residents.aamc.org/deciding-if-medicine-you/advancing-diversity-medicineapps.acgme.org/ads/Public/Programs/Search/ResidencyApplicationServices

ERAS - Electronic Residency Application Service
aamc.org/services/eras/

SkinofColorSociety
skinofcolorsociety.org/