If you want to get into derm, the way that 99% of people do it is through the match.
There are some programs that are notorious for having slots that the fill outside of the match. It is not something you can rely on (I'm actually not even sure of the legality of those slots if challenged) and there's usually a significant amount of favoritism involved (e.g. you are related to a faculty member, you are married to a faculty member, you are married to someone couples matching and your significant other is highly coveted to the point where the other department chair will contact the derm chair and beg for you to be taken outside of the match, you've done research with highly influential faculty for a long time and they are carving out a spot for you, etc)
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