Derm residency backup?

[SAPHO]

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So I know this is taboo, especially in the derm world but most of derm applicants probably have a backup specialty in case they don't match in derm. I would be curious to find out how many applicants have one and which specialty they are going for.
Personally I'm applying to radiology as a back up plan and would be happy with it as a career although derm is still my number one choice.
Anybody would like to share their thoughts?

 

[asmallchild]

So I know this is taboo, especially in the derm world but most of derm applicants probably have a backup specialty in case they don't match in derm. I would be curious to find out how many applicants have one and which specialty they are going for.
Personally I'm applying to radiology as a back up plan and would be happy with it as a career although derm is still my number one choice.
Anybody would like to share their thoughts?

I don't recommend it. I don't know how competitive radiology is but it would be foolish to apply for radiology and dermatology at the same institution

If you limit the number of dermatology programs you apply to because of this, you are sacrificing your shot at your desired specialty because of a backup plan

If you limit the number of radiology programs you apply to because of this, it's a tenuous backup plan at best (how many programs are left? Are they likely to be all community based programs? Will you truly be happy to match at a backup of its not in the field of your choice, not in the location of your choice, not of the caliber of your choice?)

 

[DermViser]

The ones that I have known who did backups did something like Derm and IM, Derm and Peds, making sure they weren't at the same institutions esp. home institutions. I'm sure if you planned it out quite well you could pull off Derm and Rads, although it might be hard to explain if you had research for 1 but not the other.

@asmallchild, Radiology has apparently become much less competitive now.

 

[dermie1985]

I personally thought of applying IM as a back-up (though didn't end up doing it).I think most derm applicants I know were also considering internal medicine as their "back-up" career given that (in many other countries) derm is practically just a medicine sub-specialty. I think the alternative is just to make sure you apply to and try and interview at high quality preliminary internal medicine programs (i.e. Brigham, Mass General, etc. as examples) and rank them alone in the case that none of the dermatology options work out. That way if you don't match into dermatology, you can (1) at least attend a rigorous preliminary medicine program and (2) either segway that into a full categorical internal medicine position at that institution or get a good recommendation to transfer to another program (this is completely do-able if you're at a high-quality internal med program), or (3) make good connections with your prelim programs derm department (assuming you went to a prelim program with a good internal department) and re-apply for dermatology either during your intern year or while on a gap research year fellowship. That's my current plan at least.

 

[DermViser]

I personally thought of applying IM as a back-up (though didn't end up doing it).I think most derm applicants I know were also considering internal medicine as their "back-up" career given that (in many other countries) derm is practically just a medicine sub-specialty. I think the alternative is just to make sure you apply to and try and interview at high quality preliminary internal medicine programs (i.e. Brigham, Mass General, etc. as examples) and rank them alone in the case that none of the dermatology options work out. That way if you don't match into dermatology, you can (1) at least attend a rigorous preliminary medicine program and (2) either segway that into a full categorical internal medicine position at that institution or get a good recommendation to transfer to another program (this is completely do-able if you're at a high-quality internal med program), or (3) make good connections with your prelim programs derm department (assuming you went to a prelim program with a good internal department) and re-apply for dermatology either during your intern year or while on a gap research year fellowship. That's my current plan at least.

Yup. That's usually the way most people do it who would only be satisfied with Derm and nothing else. Some of the national DIGA officers (in the past) had backups - if you look at the list and see where they are now, you'll see some didn't get into Derm and went into another field. I think OP can pull off applying for Derm and Rads together. Just make sure as you get a Derm interview at one place just don't apply for Radiology at that same place. I'm assuming he/she is doing this bc he thinks he might not be a competitive enough applicant for Derm. Just make sure you coordinate it carefully -- proper letter writer labeling one letter for Derm and one for Rads.

 

[asmallchild]

I personally thought of applying IM as a back-up (though didn't end up doing it).I think most derm applicants I know were also considering internal medicine as their "back-up" career given that (in many other countries) derm is practically just a medicine sub-specialty. I think the alternative is just to make sure you apply to and try and interview at high quality preliminary internal medicine programs (i.e. Brigham, Mass General, etc. as examples) and rank them alone in the case that none of the dermatology options work out. That way if you don't match into dermatology, you can (1) at least attend a rigorous preliminary medicine program and (2) either segway that into a full categorical internal medicine position at that institution or get a good recommendation to transfer to another program (this is completely do-able if you're at a high-quality internal med program), or (3) make good connections with your prelim programs derm department (assuming you went to a prelim program with a good internal department) and re-apply for dermatology either during your intern year or while on a gap research year fellowship. That's my current plan at least.

This is what I did as well and what I recommend if your ultimate goal is to match in dermatology

 

[DermViser]

This is what I did as well and what I recommend if your ultimate goal is to match in dermatology

I think the bigger question is when to decide whether the goal is derm or nothing else. In theory, derm programs should have good mentors to help people evaluate their chances and improve on their applications, but this is not always the case. As you get further and further away from med school graduation, your options decrease exponentially, and thus many who would only have been happy w/derm would have rather done something else.

 

[GFYS]

Unless academics is your thing, get a medical license and do whatever floats your boat. It's the repetition that makes you good at a procedure not specialty, just ask any RN in a plastic surgery practice.

 

[DermViser]

Unless academics is your thing, get a medical license and do whatever floats your boat. It's the repetition that makes you good at a procedure not specialty, just ask any RN in a plastic surgery practice.

🙄

 

[sore eye asses]

Unless academics is your thing, get a medical license and do whatever floats your boat. It's the repetition that makes you good at a procedure not specialty, just ask any RN in a plastic surgery practice.

It's true, my passion for alleyway abortions has led to a bustling practice and I didn't have to do a pesky OB residency. What i find I'm best at is managing the complications. I just have a natural knack for these sorts of things. This stuff is easy. Haha, toodles!

 

[medstudent7860]

If I apply to Derm and an IM backup at the same institution, I can see how they would find out because I'd be applying for the prelim in IM and then IM itself. But since OP is planning on applying to Rads as a backup, how would they find out? Even if it's at the same institution, the departments and program directors are different and wouldn't necessarily discuss candidates. Also, if I apply to Derm and IM backup but a transitional year for derm, how does the interview process work? What department do I interview with for the transitional year? Because if it's not IM, then I could apply to both at the same institution, right?

 

[asmallchild]

If I apply to Derm and an IM backup at the same institution, I can see how they would find out because I'd be applying for the prelim in IM and then IM itself. But since OP is planning on applying to Rads as a backup, how would they find out? Even if it's at the same institution, the departments and program directors are different and wouldn't necessarily discuss candidates. Also, if I apply to Derm and IM backup but a transitional year for derm, how does the interview process work? What department do I interview with for the transitional year? Because if it's not IM, then I could apply to both at the same institution, right?

I think you misunderstand

The recommendation is to apply for a prelim IM year. If you should fail to match, many (not all) prelim programs can create a path for you to continue as a categorical resident (this may even be something you can feel out on your prelim interview day)

I do not recommend applying for a categorical IM residency if your goal is to ultimately end up in derm. You are right that in all likelihood, different PD's won't chat about their applicants. But why run the risk if you are serious about derm? If you have that little confidence in your ability to match, it would probably make more sense to move straight to the backup plan

 

[SAPHO]

The general consensus that I got from talking to the derm residents at my home program is that it would be foolish not to have a back up plan. Realistically, there are plenty of well-qualified applicants who will not match in derm this year and next year, even with a research year in. I do not want to go unmatched.

And Rads has gotten significantly less competitive. I am an average derm applicant but a much above average Rads applicant. Hence the multitude of Rads interviews so far. Rads has the advantage of being a buyers' market right now. I have gotten interviews at big name institutions.
Derm and Rad department are completely seperate and do not interact so the likelihood of either finding out that I am applying to a different specialty is very small.

This does not make me any less motivated to go into derm, just realistic about my chances of matching. Mtaching into derm is becoming more and more difficult each year. But I'm still hopeful...

 

[asmallchild]

The general consensus that I got from talking to the derm residents at my home program is that it would be foolish not to have a back up plan. Realistically, there are plenty of well-qualified applicants who will not match in derm this year and next year, even with a research year in. I do not want to go unmatched.

And Rads has gotten significantly less competitive. I am an average derm applicant but a much above average Rads applicant. Hence the multitude of Rads interviews so far. Rads has the advantage of being a buyers' market right now. I have gotten interviews at big name institutions.
Derm and Rad department are completely seperate and do not interact so the likelihood of either finding out that I am applying to a different specialty is very small.

This does not make me any less motivated to go into derm, just realistic about my chances of matching. Mtaching into derm is becoming more and more difficult each year. But I'm still hopeful...

The likelihood of the departments funding out is small but not zero.

Derm applicants are always looking for a leg up and using radiology as a backup plan would be a significant downgrade at many departments if they were to find out.

To many (and I would agree for the most part), it does speak to a lack of total commitment to dermatology but perhaps more tellingly, a lack of confidence. I agree everyone has a different background and if you aren't the strongest applicant and cannot afford to go unmatched, using radiology as a backup plan may not be a terrible idea

But it definitely means you arent putting your best foot forward in derm (particularly if you're sharing it with derm residents at your home program. I suspect the derm residents at your program mean a backup plan more along the lines of a strong prelim program or research fellowship rather than another specialty that has also been traditionally lumped with derm as "cushy")

 

[DermViser]

The likelihood of the departments funding out is small but not zero.

Derm applicants are always looking for a leg up and using radiology as a backup plan would be a significant downgrade at many departments if they were to find out.

To many (and I would agree for the most part), it does speak to a lack of total commitment to dermatology but perhaps more tellingly, a lack of confidence. I agree everyone has a different background and if you aren't the strongest applicant and cannot afford to go unmatched, using radiology as a backup plan may not be a terrible idea

But it definitely means you arent putting your best foot forward in derm (particularly if you're sharing it with derm residents at your home program. I suspect the derm residents at your program mean a backup plan more along the lines of a strong prelim program or research fellowship rather than another specialty that has also been traditionally lumped with derm as "cushy")

I really think it's a Catch-22, unfortunately. Derm forces you to put all your eggs in one basket. I think a lot of times derm faculty are not necessarily up to speed with respect to how competitive things have gotten and expect all people to be Derm or nothing. Many of them also aren't good advisors in terms of telling people straight up that they should not apply to derm bc they are afraid of the backlash that might happen. Many derm faculty will find any reason to cut someone - and someone who has a backup is giving them the perfect reason, no matter how reasonable that would be. Much different than Plastics, where it's expected you would apply to categorical General Surgery as well, and many do so.

To OP, I would be very careful about your backup plans in other specialties -- don't tell classmates, don't tell derm residents, don't tell your derm attendings who have written letters. Make sure all your interviews are separate.

 

[DermViser]

If I apply to Derm and an IM backup at the same institution, I can see how they would find out because I'd be applying for the prelim in IM and then IM itself. But since OP is planning on applying to Rads as a backup, how would they find out? Even if it's at the same institution, the departments and program directors are different and wouldn't necessarily discuss candidates. Also, if I apply to Derm and IM backup but a transitional year for derm, how does the interview process work? What department do I interview with for the transitional year? Because if it's not IM, then I could apply to both at the same institution, right?

Transitional years are usually handled by the IM department. There is no transitional specialty.

 

[GFYS]

Unless academics is your thing, get a medical license and do whatever floats your boat. It's the repetition that makes you good at a procedure not specialty, just ask any RN in a plastic surgery practice.

Not sure why I was flagged for inappropriate behavior for posting the above. The point I was trying to make is that if you become licensed in another specialty, there are plenty of derm offices that would be happy to hire you to see general derm patients. You'll find this in every major city and in derm practices with multiple locations staffed with NPs and PAs. If aesthetics is your thing, you can open your own medspa or partner up with a medspa seeking a medical director. As for the expertise and complications with lasers and minimally invasive procedures like fillers and neurotoxins, you definitely need training for good outcomes, especially in facial anatomy. After that it comes down to number of procedures, appropriately managing patient expectations, and your artistic sense. Did you know there's a thriving walk-in aesthetic shop right across the street from Bloomingdale's in the city run by an internist? Numerous companies provide aesthetic training (for a fee) and the companies that make devices/products also provide training options for "non-core" physicians, though they will never admit that to plastics, derms, facial plastics, and ophthos. In my earlier post I was in no way suggesting performing actual surgery without proper training or outside a credentialed theater, though it is funny that ob/gyns and dentists are the largest growing segment for injectables.

 

[DermViser]

Not sure why I was flagged for inappropriate behavior for posting the above. The point I was trying to make is that if you become licensed in another specialty, there are plenty of derm offices that would be happy to hire you to see general derm patients.

🙄

 

[asmallchild]

Not sure why I was flagged for inappropriate behavior for posting the above. The point I was trying to make is that if you become licensed in another specialty, there are plenty of derm offices that would be happy to hire you to see general derm patients. You'll find this in every major city and in derm practices with multiple locations staffed with NPs and PAs. If aesthetics is your thing, you can open your own medspa or partner up with a medspa seeking a medical director. As for the expertise and complications with lasers and minimally invasive procedures like fillers and neurotoxins, you definitely need training for good outcomes, especially in facial anatomy. After that it comes down to number of procedures, appropriately managing patient expectations, and your artistic sense. Did you know there's a thriving walk-in aesthetic shop right across the street from Bloomingdale's in the city run by an internist? Numerous companies provide aesthetic training (for a fee) and the companies that make devices/products also provide training options for "non-core" physicians, though they will never admit that to plastics, derms, facial plastics, and ophthos. In my earlier post I was in no way suggesting performing actual surgery without proper training or outside a credentialed theater, though it is funny that ob/gyns and dentists are the largest growing segment for injectables.

I'm going to lock this thread. There are enough responses (and I've certainly made my opinion clear) on what to do as a backup to dermatology.

I don't believe you are trolling (although it's hard to give someone too much laxity when they have only two posts) but you are clearly not informed about how dermatologists practice and your comments are sure to inflame others on this board. I assure you there are NOT plenty of derm offices that would be happy to hire a non-dermatologist to see general derm patients (the malpractice carrier for the group may have something to say about this as well).

Those kinds of practices do exist and are looked down upon equally by both dermatologists and patients who know anything about appropriate/quality skin care.