Dermatology: to scramble or not

[sustentaculum]

I didn't match derm but matched to prelim. I had 5 interviews (mostly home institution and away rotations) so I knew that the chances were like 50/50 at best so was not entirely surprised. I saw a bunch of openings for radiology which sparked my curiosity so after meeting with my dean decided to apply through SOAP, wondering what will happen. Got 3 "interviews" today so i guess will see if i get anything tomorrow. But what if I do? Accept or not? Truth is, I still am derm at heart, and that's not going to change overnight. I had always planned on doing a research fellowship if i don't match. But what if the fellowship doesn't help me get a position? Should i just accept the radiology position if offered and then continue applying to derm? I know radiology is total 5 years so even if I spend 1 year doing it it won't affect my future funding, right? And I can still continue to do derm research in the meantime. I'm just really scared of pausing my training. I hope someone understands and can give some sound advice. I don't know if I did one year of radiology would make me look worse for derm in the future, even though I've invested alot into derm these past few years.

stats:
Step 1 233
step 2 248
rank: 3rd quartile
non-AOA
clerkships: few honors, mostly near-honors
med school: top 20
research: mediocre (2 posters, 2 abstracts)

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[asmallchild]

I didn't match derm but matched to prelim. I had 5 interviews (mostly home institution and away rotations) so I knew that the chances were like 50/50 at best so was not entirely surprised. I saw a bunch of openings for radiology which sparked my curiosity so after meeting with my dean decided to apply through SOAP, wondering what will happen. Got 3 "interviews" today so i guess will see if i get anything tomorrow. But what if I do? Accept or not? Truth is, I still am derm at heart, and that's not going to change overnight. I had always planned on doing a research fellowship if i don't match. But what if the fellowship doesn't help me get a position? Should i just accept the radiology position if offered and then continue applying to derm? I know radiology is total 5 years so even if I spend 1 year doing it it won't affect my future funding, right? And I can still continue to do derm research in the meantime. I'm just really scared of pausing my training. I hope someone understands and can give some sound advice. I don't know if I did one year of radiology would make me look worse for derm in the future, even though I've invested alot into derm these past few years.

stats:
Step 1 233
step 2 248
rank: 3rd quartile
non-AOA
clerkships: few honors, mostly near-honors
med school: top 20
research: mediocre (2 posters, 2 abstracts)

My recommendation would be to pursue a research fellowship if your heart is truly set on dermatology. 5 interviews in dermatology is nothing to sneeze at and while your stats are not the strongest, I suspect a research fellowship should land your the dermatology position you desire.

Accepting a radiology position if your heart is not truly set on radiology is a disaster waiting to happen. It won't work out well for you or for your program. It's understandable to have some loss of confidence or to not be able to think clearly after failing to match but I wouldn't let that cloud your judgment into entering a field you aren't truly passionate about. Accepting the radiology position and continuing to apply for dermatology is an even worse idea. Your radiology program will not be happy and while I can't speak for all programs, I can say with certainty your chances would decrease at my home program if you were reapplying as a radiology resident.

At the end of the day, you have to decide what you truly want to do and pursue that with all your focus. If that's radiology, then interview, accept, and close the chapter on dermatology. If you have any inkling dermatology is still the field for you, I think it would be worthwhile to take some time off to clear your mind, pursue that research fellowship, and try again. Best of luck with whatever you decide

 

[Dral]

My recommendation would be to pursue a research fellowship if your heart is truly set on dermatology. 5 interviews in dermatology is nothing to sneeze at and while your stats are not the strongest, I suspect a research fellowship should land your the dermatology position you desire.

Accepting a radiology position if your heart is not truly set on radiology is a disaster waiting to happen. It won't work out well for you or for your program. It's understandable to have some loss of confidence or to not be able to think clearly after failing to match but I wouldn't let that cloud your judgment into entering a field you aren't truly passionate about. Accepting the radiology position and continuing to apply for dermatology is an even worse idea. Your radiology program will not be happy and while I can't speak for all programs, I can say with certainty your chances would decrease at my home program if you were reapplying as a radiology resident.

At the end of the day, you have to decide what you truly want to do and pursue that with all your focus. If that's radiology, then interview, accept, and close the chapter on dermatology. If you have any inkling dermatology is still the field for you, I think it would be worthwhile to take some time off to clear your mind, pursue that research fellowship, and try again. Best of luck with whatever you decide

Totally spot on advice.

If you accept a Rads position and then apply to Derm, you would have a lot of 'splainin to do. Even if you are just up front honest, you spend your time in the already short interview time sorting out why you are in a Rads first year...instead of telling the interviewer about the cool Derm research you've been doing during that year.

Most importantly, you have to make the decision of what you want (per asmallchild's advice)

 

[HalladayWeekend]

I also didn't match despite 4 interviews and excellent feedback. I tried to be more regionally focused with my apps (still applied to 70 programs)...

Step 1: 246
Step 2: 259
Top 1/3 of class- was eligible and applied for AOA but was not chosen
Mix of HP's and H's on clerkships
Case report that was submitted (and accepted during application season) and some basic science research that is underway (but nothing published)

I am doing a prelim year at an academic med program that has a derm program as well. Will take the next few weeks to think about what next. I thought about possibly SOAPing into another field but I'm not prepared to make a career choice/enter a field I have little to no experience in a day or so. Any advice on what to do next?

 

[kuli]

To both the OP and HalladayWeekend---

As someone who was extremely interested in Dermatology, but ended-up applying to a different field, going into a field that you are not absolutely (at least theoretically) passionate about is the wrong decision. Sure it will take you a little more time to boost the competitiveness of your applications, but this can realistically be accomplished by maintaning relationships with your mentors and finding a research fellowship that also has a good mentor and a strong track record of matching their fellows. Also, giving yourselves more time to contemplate your future options as well as developing more contacts within the dermatology field will only be extra benefits of pursuing a research fellowship. I agree with the previous posters and have personal experience pursuing a field other than dermatology. Life is too short to wish you had chosen another field, particularly with all of the time and energy you have already dedicated to your education and future careers. Fortunately, I have been able to successfully transition into dermatology, but I should have started here

If you have any other specific questions, feel free to PM me. Best of luck with your futures!!!

 

[Dral]

I also didn't match despite 4 interviews and excellent feedback. I tried to be more regionally focused with my apps (still applied to 70 programs)...

Step 1: 246
Step 2: 259
Top 1/3 of class- was eligible and applied for AOA but was not chosen
Mix of HP's and H's on clerkships
Case report that was submitted (and accepted during application season) and some basic science research that is underway (but nothing published)

I am doing a prelim year at an academic med program that has a derm program as well. Will take the next few weeks to think about what next. I thought about possibly SOAPing into another field but I'm not prepared to make a career choice/enter a field I have little to no experience in a day or so. Any advice on what to do next?

In the case that you don't SOAP into one of the open Derm positions:

Ok, you are in a fairly good position. Assuming you want to pursue Derm further: You just have to proceed in the correct way. You obviously knew what you were doing when you made your rank list and have an academic prelim at a place with a Derm program. Good so far.

Your next step comes VERY shortly after Friday. You will need to be proactive about securing your proper rotation schedule during intern year. You should email your future intern year PD/chiefs. I'm not sure who you should start with...maybe email the PD to ask who the scheduling chief is.

Either way, explain your situation to both. Express to them that you are very flexible in your rotation schedule, but that it would really help your career options if you can use one of your elective months for a Dermatology rotation EARLY IN THE YEAR.

This rotation should be July, Aug, or Sept. July might be too early as you are still adjusting. Aug may be perfect. That way you have plenty of time to rotate through the Derm dept, get a project or two started, and get a good letter before you apply again. Keep up on your Dermatology knowledge. Study study study and knock the socks off of the Derm department when you rotate through (without being desperate/creepy).

Seen this work first hand for a fellow intern...they matched at a great program that wasn't even at our intern year's institution...but they had the support/letters of our program's Derm department.

I would think most med departments should be willing to work with you on this one if you explain your situation. If you match, you just have to find a research year fellowship during the intervening year (assuming you still want to stay active/get a paycheck without working at McStarbucks Bell)...shouldn't be too difficult if you can tell them they don't have to work to match you...you're just there to do research for the year.

If you have support of your med school's derm dept, you can ask the PD to look out for PGY2 derm positions that may open up. Be ever so vigilant for these positions because it means you would not have to skip a year. If you become comfortable with the Derm dept at your intern year institution, you can ask the PD or someone to do this for you there as well. The way I understand it, PD's are usually the first ones who become aware of these types of openings.

Best of luck!

Feel free to PM me if you have any questions.