First of all, where the hell IS everyone on this forum. It seems that every single student I know wants to purue derm, but there's NO ONE on this forum (?)

Okay, I'm an MS-III in a little, podunk D.O. hospital in Ohio, and just heard the news that a 40-something y/o IM attending just got a PGY2 spot in a Derm program (I think in WV). Anyone know how common this is? I guess my question is...if I can't match into Derm straight out of internship (which I likely can't), what are my chances after completing another residency?

I'm just trying to figure out if there's any way possible for those of us with average board scores to ever match into ultra-competitive fields like Derm or Rads.

derm is so ridiculously competetive right now that I would say that if you don't get it after med school, don't bother applying if you are doing a different residency. Residency programs get reimbursed from medicare for training residents, but every resident only has a limited number of years that medicare will pay programs for. Some programs are wealthy enough that they don't really care about this (it's around 100K for US grads), but given equal applicants, they will certainly take this into consideration. Research and connections are the only real ways into allopathic derm residencies. Your best bet is probably with DO derm spots right now, and I don't know too much about their selection criteria.

In my program, all of us have prior residency experience. A lot of the other DO programs are the same way. Allopathic programs, however, are limited because they are reimbursed for PGY1-5 ONLY (any non-surg residency). DO programs are a bit strange- in fact many are non funded at all. These topics have been addressed in detail on the following forums:
pub50.ezboard.com/bdermatology
www.doctorsbookmark.com/cgi-bin/yabb/YaBB.cgi