Hey! It'll depend on your stats too and the story that you weave about your path. If you don't come across believable, it will be harder. I know applicants that changed from another field into derm at the end of third year and did have a harder time matching despite 10+ interviews (meaning that they did not match) and the issue that came up was basically directed at "how genuine are you?" sorts of questions...so you just have to be prepared for that. I'm not sure if you are changing from one direction (such as switching from ophtho or ortho or radiology, etc.) or if you just made you first full commitment and decided on derm but wanted to give you the heads up there. FYI, the ones that did not match took a year of research afterwards and did match so it's not that you won't match but there is a delay... other factors come into play too like your stats and your connections.
You can definitely match without a year of research but I would say that, it has to be a case by case basis that incorporates your stats, your experiences, your skills, and your story. A research year is a nice way to set everything in a nicer package but you have to go to a productive one. You don't want to solely be working on a five year clinical trial because you never get any publications doing that.
For ideas, as a start if you are still thinking fellowships, you might want to try calling places that you really want to go to and see what they can offer. The fellowships for medical students around the nation are likely filled by now but some include UCSF (two faculty here that can really help you with publications if you do work with them) and wake forest. You might try contacting them. The reality is that you'll need to remain persistent and try to be as productive as you can over the summer. I'll post to this thread again if I think of any other ideas.
