Dermatology-Medicine Combined Residency - Too late to apply?

[Thenewguy02]

I'm a 4th year with a complete application for internal medicine. I'm really interested in cutaneous lymphomas and I recently learned about the Med-Derm combined residency - it sounds like exactly what I want to do. However, I think it may be too late for me to apply. I can't take a research year at this point. I really enjoy inpatient medicine and am completely happy with internal medicine - but I do now wonder if Med-Derm would be the best way for me to go if possible

I have step 1/2 in the upper 250's. I have my medicine letters complete (Chair, SubI attending, Clerkship attending, Research Mentor). They are oncology focused and very strong letters. My research mentor is very prominent in cutaneous lymphoma research, is internal medicine trained, and is a professor of medicine and a professor of dermatology. This would be my only dermatology letter. I have not done a dermatology elective, nor talked to the department. I do not know if it would be possible to complete one before the applications are released. I go to a top 10 school, have 3 basic science papers mid author in neuro, an ENT clinical paper, and have submitted a paper on T cell lymphoma that will hopefully be accepted in a high impact journal, as well as a cutaneous lymphoma case report. I've started some additional research projects in derm as well through my primary mentor. There are 5 total programs that accept 1-2 residents per year in Med-Derm. Would this be a pipe dream or something achievable? What could I do in the next two months to achieve this?

---

Members don't see this ad.

 

[Dr. Doctor MD]

I'm a 4th year with a complete application for internal medicine. I'm really interested in cutaneous lymphomas and I recently learned about the Med-Derm combined residency - it sounds like exactly what I want to do. However, I think it may be too late for me to apply. I can't take a research year at this point. I really enjoy inpatient medicine and am completely happy with internal medicine - but I do now wonder if Med-Derm would be the best way for me to go if possible

I have step 1/2 in the upper 250's. I have my medicine letters complete (Chair, SubI attending, Clerkship attending, Research Mentor). They are oncology focused and very strong letters. My research mentor is very prominent in cutaneous lymphoma research, is internal medicine trained, and is a professor of medicine and a professor of dermatology. This would be my only dermatology letter. I have not done a dermatology elective, nor talked to the department. I do not know if it would be possible to complete one before the applications are released. I go to a top 10 school, have 3 basic science papers mid author in neuro, an ENT clinical paper, and have submitted a paper on T cell lymphoma that will hopefully be accepted in a high impact journal, as well as a cutaneous lymphoma case report. I've started some additional research projects in derm as well through my primary mentor. There are 5 total programs that accept 1-2 residents per year in Med-Derm. Would this be a pipe dream or something achievable? What could I do in the next two months to achieve this?

Med-Derm is a very weird field and the competitiveness is also pretty strange. Most people who apply are looking for only derm and use these programs as back-ups, and as such it's not uncommon for 1 spot to end up in SOAP every year or so. However, there are also a lot of people who are genuinely interested in med-derm and really want these positions.

It's hard to tell what exactly these programs want, but ideally they're looking for someone who has a strong application for both medicine (which you have) and derm, as well as a compelling reason for why you want the dual pathway (and not just a backdoor to derm).

I would actually recommend that you apply since it would only be $100 for all 5-6 programs and they tend to be somewhat different than regular dermatology residencies. I wouldn't have high hopes going in, but anything can happen and with your stellar IM app, some cutaneous lymphoma research, and coming from a top 10 school, I wouldn't be surprised if you got a couple Med-Derm interviews. Once you get the interview, you're in a good place since some programs can fall very far down their rank list since since so many general derm applicants rank them low.

Good luck!

 

[Dral]

Look into a heme onc fellowship. If lymphoma is what you are interested in, I think you would get more out of a fellowship if you can find one that either sees or lets you explore cutaneous lymphoma.

Learning all the minutia for Derm seems like severe overkill if you’re just interested in lymphoma.

I could be wrong, but I think fellowship would also teach you more about the underlying basic science/Immunology principles of lymphoma.

Learning the Derm path behind it could be an advantage of Derm residency, but residents really don’t see much of cutaneous lymphoma path since it is so super specialized.

Other than CTCL, we (derms) pretty much send lymphomas to heme/onc. Even CTCL gets sent if/when it gets to plaque/tumor stage. Also, of the strictly cutaneous lymphomas several end up having an indolent course anyway (like primary cutaneous cd4+ small medium T-cell lymphoproliferative disorder).

Since the programs are so few, I’m not necessarily dissuading you from applying, but just offering up some insights and an alternative.

 

[Thenewguy02]

I appreciate the input! Sorry for the delay - busy weekend.

It seems as though I would be able to apply Med-Derm, and may be able to get in, but the difficulty in applying would also be why I should not necessarily consider it - I have a total of one day shadowing dermatology, I don't have the exposure needed in the field to understand if it would be worth it. My next step should be attempting to fit in a dermatology elective in the next two months, which may not be possible, to see if I want to dedicate an extra 2 years + to the additional practice of dermatology.

Heme/onc is the primary plan. I just recently stumbled onto this program, which looks like exactly what I would like to do: Fellowship Program. I have never heard of any programs like this. Do either of you have any insight into this program or similar? I only see a single page of information. Their wording makes it sound as though they either want people who have completed their residency or those who have only done intern year.

 

[Dr. Doctor MD]

I appreciate the input! Sorry for the delay - busy weekend.

It seems as though I would be able to apply Med-Derm, and may be able to get in, but the difficulty in applying would also be why I should not necessarily consider it - I have a total of one day shadowing dermatology, I don't have the exposure needed in the field to understand if it would be worth it. My next step should be attempting to fit in a dermatology elective in the next two months, which may not be possible, to see if I want to dedicate an extra 2 years + to the additional practice of dermatology.

Heme/onc is the primary plan. I just recently stumbled onto this program, which looks like exactly what I would like to do: Fellowship Program. I have never heard of any programs like this. Do either of you have any insight into this program or similar? I only see a single page of information. Their wording makes it sound as though they either want people who have completed their residency or those who have only done intern year.

Very good point brought up by Dral and you about not whether you "can" match Med-Derm but if you "should" and based on your goals, I think doing a med derm residency would probably be a waste of time. You would likely be slightly less prepared for both derm and IM than your colleagues doing just one or the other. Not to mention if CTCL is all you are interested in then that leaves 99.9% of general dermatology that you would have to slog through. CTCL is very rare, and some of the larger or better programs tend to have a CTCL faculty with CTLC clinics, but even in these programs, CTCL will be a small fraction of what you would do.

So even if you could get into Med-Derm, I think it would likely be a waste of several extra years, especially if you are aiming for Heme/Onc fellowship.

I don't know about that specific program you listed, but I'm guessing based on name alone that it would align with your goals. I think this would be a much better route to go down than Med-Derm if you want to do CTCL.