Actually, a few did not fill or fill completely. It looks like 47 AOA positions were matched while 5 did not fill, and last year, there were 403 matched ACGME spots (ratio .12:1).
For reference, let's look at some other specialties:
--Pathology: 0 AOA spots and 526 ACGME spots
--Anesthesia: 31 AOA spots matched, 1563 ACGME spots filled (ratio .02:1)
--Peds: 51 AOA filled, 12 did not; 2611 ACGME spots filled last year (ratio .02:1)
--Radiology: 21 AOA spots matched, 8 did not; ACGME spots filled last year, 1079 (ratio: .02:1)
--Neurology: 31 AOA neurology spots and 665 matched ACGME spots filled (ratio .03:1)
--Ophtho: 14 matched and 1 unmatched in AOA, 464 ACMGE spots filled and 1 did not (ratio .03:1)
--PM&R: 13 matched and 3 unmatched in AOA, 385 ACGME spots last year (ratio .04:1)
--ENT: 20 AOA spots matched, 293 ACGME spots filled last year (ratio .07:1)
--Urology: 20 AOA spots and 285 ACGME spots filled (ratio .07:1)
--Ortho: 108 AOA spots matched and 3 did not; 692 ACGME spots filled last year (ratio .16:1)
So, despite being larger fields in ACGME, there are fewer AOA anesthesia, radiology, neurology, and optho spots than there are in dermatology. Also, while there are a similar number of ACGME PM&R and derm spots, there are far fewer PM&R spots relative to derm in the AOA match. Does this seem odd to anyone else? I mean we need a hell of a lot more pediatricians than dermatologists, so why does the AOA approve so many derm spots and so few peds/radiology/anesthesia spots? (I realize the answer is probably that most peds hospitals are affiliated with allopathic medical schools and that the AOA probably has low standards for approving derm spots at community private practices that are too cheap to higher a PA).
Looking closer, it seems like some of the AOA derm programs appear to be of questionable quality (this is a random list of only some of the programs)
1. Tri-County dermatology pays 20k per year, has 2 dermatologists, and was approved to fill 2 spots this year.
2. The program at the "Colorado Dermatology Institute" takes 1 resident/year, has 4 dermatologists, no in-house dermatopathologist, but one does have Mohs training.
3. St. Joseph Mercy is in Ann Arbor/Ypsilanti, MI and takes 4 residents/year. I do not understand how a community program can sustain a high level of volume and complex cases in the same town as the University of Michigan, which takes 7-8 residents per year. If that weren't enough, Henry Ford is also a large program (6/year), and has clinics throughout the Detroit metropolitan area. Between Michigan and Henry Ford, I cannot believe there is enough med-derm or non-AD/scabies/impetigo/molluscum peds-derm left over for four residents a year to learn from.
4. Northeast Regional Medical Center in Kirksville, MO (population 17,505), takes 1 resident per year, has 3 dermatologists (none did a procedural fellowship), however, there is a path trained dermatopathologist
However, some do seem OK-ish
1. North Fulton Hospital, Roswell, GA
http://dermatologynfhmc.wix.com/gaderm
2. Palisades Hospital, North Bergen, NJ
http://www.palisadesmedical.org/Content/106/dermatology-residency-program.html
One thing that I learned during my derm rotations, and something I was cognizant of during my interviews, was that community dermatologists do not like handling complex/weird diseases, and they are more than happy to refer them to the nearest academic center. Similarly, working at a county hospital and/or VA will allow you to see and manage advanced diseases and allow you to develop your surgery skills. Also, dermatopathology is not always cut-and-dry, and having the opportunity to learn from multiple dermatopathologists and see how they diagnose biopsies can be invaluable. I realize not all program have a VA or county hospital (Mayo, Cleveland Clinic, UChicago, Henry Ford, Johns Hopkins), however, these institutions are major hospitals that have a tremendous amount of inpatient and outpatient volume. Looking forward, I don't know how many of the programs will be able to meet ACGME requirements, but given the tremendous breadth of pathology within the field, is it fair to residents or future patients to allow small private practice groups to sponsor residency spots?
