Same as above. Your scores are good. You would need to make connections.
You would need a good narrative of why you're switching from rad onc to derm. My assumption (which could be incorrect for sure) would be the bad job market, so you'd have to prove to me that you are actually interested in derm opposed to jumping ship from rad onc. I get that what we all do are jobs, but when there are so many good candidates coming our way, that tends to be one of the top things we use to screen people.