Thanks for the reply. I guess my bottom line is this: w/ 259 step I and junior AOA, do I need to deprive myself of even more sleep to get some type of research going this year (3rd yr)
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You have outstanding numbers (great grades, Junior AOA, and USMLE step 1 score). Definitely good enough to match. But now you have to work on the rest of your application - Derm letters of rec (LOR) and publications. I would place Derm LOR's as 1st priority. Derm is a small elitist profession and everyone pretty much knows each other in some way...sometimes residency programs will call the dermatologist(s) that wrote your LOR and ask about you. It happened to me a few times during the Derm application process because my Derm mentors told me programs called them. Very praising LOR's from well-known dermatologists are the best LOR's, but difficult to obtain.
TIP: Very praising letters from unknown junior Derm faculty is better than mediocre LORs from well-known faculty.
Are you starting your 3rd year of med school? Or are you about to start your 4th year of med school? If you are just starting your 3rd year of med school, then I would still concentrate on getting "Honors" on as many 3rd year clerkships as possible. Grades in 3rd year are the most important in any specialty application. I would also try to set up a Derm elective in mid- to late- 3rd year (preferably after your Internal Medicine clerkship) to rub elbows with dermatologists. If you have time to publish, go for a case report which is easy to type up. But remember, getting "Honors" is priority over publishing something. If you are starting your 4th year, then it's too late to publish or do research...my best advice is then to do a Derm elective ASAP and get your Derm LOR's in before mid-October.
Where do you go to med school? Is it affiliated with its own Derm program? Is your med school a well-known U.S. med school (Ivy league, etc), middle-tier U.S. school, low-tier U.S. school, or foreign med school. The more well-known your med school is, the better your chances of matching in Derm w/ your current stats. Also, if a Derm program is affiliated with your med school, that's the best place to network with dermatologists and get LOR's. However, if you are from a foreign med school (Caribbean, European, Asian, etc), then your chances of matching are slim to none.
In any case, good luck