According to the American Academy of Dermatology, “A dermatologist is a physician who has expertise in the diagnosis and treatment of pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases.”

If that sounds like the goal of your career in medicine, read on. We have compiled a list of frequently asked questions that come up when you are thinking, “Okay, so I know what I want, but how do I get there?”

• What is the nature of the typical dermatology practice? In a primarily outpatient setting, dermatologists draw from a broad yet complex knowledge base involving medicine, pathology and surgery when serving patients both young and old.

• When do I start making my plans to apply for dermatology? As soon as you have an inkling that you are interested in this specialty, attach yourself to your school’s faculty. They are usually very approachable and enthusiastic about your interest. You may not have all the right questions, but they can point you in the right direction. You may begin by shadowing in a clinical setting during the Spring break of your first year and then becoming involved in some research during your only free summer.

• How academically competitive do I have to be to apply, for example, as measured by board scores? The place of USMLE Step I and II scores in the application process varies from one institution to another. At UT Southwestern, it is no longer a filter. A number of other programs will not consider your application if you do not make the threshold USMLE score they require. Getting anyone to state an actual figure is another story . . . Generous estimates are presumed to be 230 and higher. Aim at making an honors grade in your derm rotation, of course!

• Do I have to be AOA to get into derm? Yes and no. If you distinguish yourself as such academically, it can only work to your advantage; however, there are AOA applicants that do not match. The entire package you present is very important.

• How important is a research track record in applying to derm? Dermatology is a specialty that is particularly amenable to both basic science and clinical research. If you have a passion for any area in dermatology research, by all means pursue it. Programs are looking for the quality and consistency of your work, not just mere quantity. You do not have to feign interest in, for example, a research track program when you know you will be miserable in private. Express your genuine interests and stay open to ideas from your mentors.

• Should I apply for an away rotation? By all means, if you are interested in a particular program, visit. One of our resident liaisons emphasizes that the reason to do an away rotation is for you to find out about the program, not as a “pre-interview.” You may discover that a certain program is all you dreamed it would be, or you may find that you would be miserable there. Either way, your final decision will be strengthened. You might want to start with a program at your home school so that you will excel when you visit an outside program. Some sources suggest looking for rotations that combine research with clinicals, especially if you already had a pure clinical rotation. Of note, if you intend to do research away, plan on a summer, two to three months or an entire year (for example as a Doris Duke fellow). The longer you work with a faculty member, the more thorough your evaluation from them will be. A good way to look for faculty to work with is to search for a topic of your interest and pursue those actively involved in that area.

• How do I get a glowing letter of recommendation from a faculty member? Well, just as with any other rotation, you have to work with them, distinguish yourself, and discuss your goals. Ask for mentorship early and cultivate a relationship as you navigate medical school in general. Be prepared to provide your personal statement, resume and whatever they may need in addition to assess you.

• How do I go about defining my niche in dermatology? A common question you will get asked as you begin to apply and interview is “after residency, where do you hope to make your mark?” For someone just beginning to traverse the specialty, this may seem like a tall order. You may get a subscription to a derm journal, attend grand rounds on Thursday mornings, scan the research notice-boards and ask your mentor for exposure to the finer divisions of dermatology. As your interests are shaped by your medical school training, the picture should become clearer. One of our resident liaisons adds that not all programs require that you have a niche, but it is helpful to show that you have a passion for some particular aspect of dermatology.

• How many programs should I apply to? As many as possible. The more exposure you allow, the more your chances of getting an interview. A fourth year who matched in 2004 said she applied to 40 programs.

• Are there any programs to definitely include or avoid? The only places you should avoid are those located where you could never live for three or more years. For specifics about individual programs, your best sources of information are the residents and fourth years who have had first-hand experience.

• When exactly is the typical derm interview season? December to February.

• How does the UTSW program compare with the rest of the country? Our dermatology program ranks in the country’s top 5 in several areas. Our program engages in cutting edge research and is at the forefront of clinical advancement.

• What do our residents do after graduation? One half of them go into clinical research and the other half practice primarily clinical medicine.

• What about the combined medicine-dermatology programs?   There are four such five-year programs: the University of Pennsylvania, University of Minnesota, Northwestern University, and the University of Wisconsin.  There are no graduates yet from these programs; therefore, the application of the combined coursed has not been assessed. Applicants to these programs are eligible to sit for the Internal Medicine and Dermatology boards.

• What questions should I ask the programs at which I interview? Inquire about the composition of the education. Are some aspects of derm emphasized over others or is it a good mix? What are the program strengths and weaknesses? Are there any major changes planned in the future? What proportion of applicants interviewed are accepted? This is the short list . . . you will think of many more on your own.

• Do I need a back-up plan? YES!! Definitely! No matter how strong you feel your application package is, it is safest to have a back up plan, given the notoriously low applicant-position match rate in derm. The only advice is to avoid applying for an equally competitive alternative. If you don’t match, you may want to reapply while proceeding through your intern year, which comes upon you very quickly, so plan early to avoid struggling to scramble at the rear.

BOTTOM LINE: Go for what you want; be genuine; aim high and pursue your dream as if all you could do was win!

If you have more questions or answers to add to our pool, feel free to contact me or Jessica Zmolik on Groupwise.                                                            

Nnenna Agim, Resident