How to improve chances into Derm as IMG?

[neuroace]

Background = 2nd yr Australian Med student at Irish Med School. Yet to sit USMLE's. For now just prepping for USMLE, but my question is- what else can I do to improve my chances to Match into Dermatology in the US. When I return to Sydney i'll probably shadow some Dermatologist - but i dont understand how i can get research papers under my name; i can never seem to find anyone writing one that i could help with.

Any good-hearted help is appreciated 🙂

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[PhillyMed777]

The only way I see this happening, apart from being a top med student, is to do a year long research fellowship at an institution with a history of taking their research fellows, That too preferably fmgs.

 

[neuroace]

-Research with solid publications (preferably first paper author in derm in as high impact a journal as you can achieve)
-As many electives as possible in derm in USA to get to know people and get them to write the best LORs for you as possible (this may be most important because many IMGs applying to derm will have the previous ones, some IMGs are already attending level dermatologists in their nation, including applicants from Australia)
-See NRMP advance data tables for 2017. For PGY-1 >92% are US MDs. PGY-2>81% are US MDs.
-Definitely apply to a backup specialty (e.g., FM) because the odds are highly against you, even if you're a super star.

and there are medical students who start with research and publishing in derm as medical students

Do you have any advice as how a 2nd year med student can be a first paper author in derm in as high impact a journal (considering, like most 2nd yrs, I know nothing and dont have the resources to conduct a research paper. I also cant seem to find any availability when i email universities asking to co-author a research paper. Do you advise i try and write one independantly that critiques already established data? Or how should i approach this?). Electives are a 3rd year thing if i'm correct, so i'll keep that in mind for later. Yes, i agree Derm is very very competitive- but If you look at Chart 3 p5 of the 2016 NRMP 2016 report, 48% of non-us IMG matched to derm so i guess that's something..

!! The medical students who start with research and publishing in derm as medical students- how do they do this? Do they do it themselves, or do a summer research program? As I explained, i wont be in IRE during their summer research program time, so do you have any suggestions as to how to still get this research and publishing done? !!

a year long research fellowship at an institution with a history of taking their research fellows

Does this mean i'd take a year off med school and stay in the US and work in research? Do you know of any institutions that are IMG friendly?


I'm grateful for these replies.

 

[ERDOC555]

Yes, i agree Derm is very very competitive- but If you look at Chart 3 p5 of the 2016 NRMP 2016 report, 48% of non-us IMG matched to derm so i guess that's something.

Keep in mind though that there is a massive self selection and some of these applicants are absurdly overqualified. They could be PhDs, already trained foreign Dermatologists, Cardiologists, Surgeons, etc.

To get into a US Derm Residency as a D.O./IMG/FMG you tend to need to be even better than the slew of near perfect graduating seniors and research fellows competing for the same spots. The normal rules of 250+/Research/AOA = Derm go out the window as an IMG. Why would any program take a risk on a random medical student from these schools over the MD students I mentioned before? They don't unless you're an absurdly qualified candidate or the child of a PD.

 

[Foot Fetish]

Keep in mind though that there is a massive self selective and some of these applicants are absurdly overqualified. They could be PhDs, already trained foreign Dermatologists, Cardiologists, Surgeons, etc.

To get into a US Derm Residency as a D.O./IMG/FMG you tend to need to be even better than the slew of near perfect graduating seniors and research fellows competing for the same spots. The normal rules of 250+/Research/AOA = Derm go out the window as an IMG. Why would any program take a risk on a random medical student from these schools over the MD students I mentioned before? They don't unless you're an absurdly qualified candidate or the child of a PD.

How can I become the child of a PD?

 

[Promethean]

I have a good friend who is a 2nd year who designed her own research project on a topic related to her field of interest. She planned everything out and took it to faculty at the school explaining what she wanted to do and why and how it would be funded. She'd been so organized and professional that no one had really appreciated that she didn't have a faculty PI, and that did become a problem for obtaining IRB approval. Unfortunately, she wanted to do the project before going off on rotations, and having to find a faculty member willing to take such a large role in the project closed her narrow window of opportunity.

This isn't an enormous tragedy. The project will keep and she'll be ready to break it out and get 3-4 years of follow up work out of it when she gets to residency. That said, you can indeed do the same thing. Consider a derm related question that you'd like to find an answer to. It doesn't need to be big. No one expects a student to have a simple cure for melanoma in their back pocket.

Though, with your Australian connection, you probably could whip up an interesting publication out of your nation's successful public health campaign against skin cancers, even without doing a lot of new research. It is a derm-related topic that is relevant to many other countries. A literature search into the history of skin cancer in OZ and how it was addressed could be written up in a way that would be really interesting to people in Ireland, with all its fair skinned folks and the US where many have an unhealthy obsession with tanning. Even a low impact publication is an extra line on your CV.

So, that is just a free idea from a random dude on the internet with zero interest in specializing in Derm. You, who have an interest in the topic, can doubtless come up with better ideas connected to your own curiosities within the field.

Best luck!

 

[Promethean]

One big positive in your court... how is your accent? American's are gaga for certain foreign accents. I've seen some intolerable people given much more deference than they deserved just because they had one of the handful of accents that we perceive as especially charming. I wouldn't be shocked if it didn't get you a few points, if you manage to land an interview.

 

[neuroace]

history of skin cancer in OZ and how it was addressed could be written up in a way that would be really interesting to people in Ireland

Interesting point! I have actually written up an Abstract regarding UV Damage in Australia- it took me a day to whip up and i never got it published [always wanted to be in PubMed] because quite frankly... i dont know how... hahah.

And, i've been told by quite a few here, i've got a "sexy" Aussie accent. The game is, getting an interview to show it off! 🙂

 

[Promethean]

Interesting point! I have actually written up an Abstract regarding UV Damage in Australia- it took me a day to whip up and i never got it published [always wanted to be in PubMed] because quite frankly... i dont know how... hahah.

And, i've been told by quite a few here, i've got a "sexy" Aussie accent. The game is, getting an interview to show it off! 🙂

You get published by contacting journals (generally by checking their website) for their submission guidelines. You find one that matches what you've written or want to write. You edit your work to match the guidelines, if that is possible. If they specify something that you can't accomodate, then move right along and find another. Repeat until you find a journal open to what you have to submit, and then you send it in according to whatever directions they have published.

Be wary of journals that ask you to pay them for considering your submission. That is a thing, but it is controversial and should really be a last resort when there are so many other options for publication.

It is ideal to submit only to one journal at a time, so that if one decides to pick it up, you don't have someone else out there considering it. You don't want to be in a position of having two journals accepting it for publication at the same time. Someone will have to be disappointed, and that is a good way to burn a bridge for the future. So, it is best to have a few peices that you can be shopping around at the same time. Circulating 3 or 4 articles out to as many different journals at once is as efficient as sending each one to multiple journals at the same time.

I know I make it sound easy to have several articles/abstracts/etc ready to ship out at any given time. Who has time for that? Full disclosure, I haven't pursued professional publication in medicine/science myself. I just have a bit of experience with other kinds of periodicals, and I've used that experience to help others with journal submissions.

None of this is really hard to do. It is just about having the audacity to decide to try. Once you make up your mind to do it, the way forward starts to open up, almost on its own.

 

[neoevolution]

If you look at Chart 3 p5 of the 2016 NRMP 2016 report, 48% of non-us IMG matched to derm so i guess that's something..

t

I might be wrong, but I think those charts only include applicants who attended an interview and ranked at least 1 derm program in their match percentage. Derm is competitive enough that I'd expect many FMGs don't get any interviews at all, even with self-selection.

 

[neuroace]

t

I might be wrong, but I think those charts only include applicants who attended an interview and ranked at least 1 derm program in their match percentage. Derm is competitive enough that I'd expect many FMGs don't get any interviews at all, even with self-selection.

Chart 3 shows the Percent Matched by Preferred Specialty. I read through the whole thing- nothing about interview discrepancy.

 

[neuroace]

They could be PhDs

I understand it's competitive- but the mean USMLE score for non-US IMG was 238 [matched] & Percentage who have phD was 12.5% for derm non-US IMG who matched.

 

[ERDOC555]

I understand it's competitive- but the mean USMLE score for non-US IMG was 238 [matched] & Percentage who have phD was 12.5% for derm non-US IMG who matched.

That's all correct and supports my point that those matching derm have crazy good backgrounds. A 238 average is actually pretty poor for derm, which means these people have other highly desirable traits, for example PHDs and other degrees and experiences. 12.5% PHDs is pretty crazy, then add in other doctors who have completed other residencies, and applicants who have dozens of publications. The point remains that IMG/FMG/DO all need a super compelling background to even get an interview.

Also what the other poster was saying was that the match statistics don't include anyone who got 0 interviews, so the true match rate for IMGs is far lower and probably slightly lower for American MDs as well, compared to what is posted.

Example: 100 IMGs interview and rank at least 1 program = 48% match rate reported
Reality: 200 IMGs apply Derm, 100 don't get any interviews whatsoever, 100 do get 1 or more interviews, 48 match. True match rate = 24%

Basically the match data that is published has a far too small denominator for every class (IMG/FMG/DO/MDSenior) of applicant. It doesn't include all the terrible applicants that couldn't even get a single interview.

EDIT: Just looked over the data, ignore my PhD comment. Basically you only had 8 people in the entire world match IMG derm, 1 was a PhD. Basically you can't extrapolate good data from only 8 people, except for the mean number of research experiences which was absurd 25 and 33 respectively.

So there's your answer, you need a crap load of derm research and an above average step

 

[neuroace]

So there's your answer, you need a crap load of derm research and an above average step

I agree. I think my flaw lies in initially looking over the TOTAL amount of positions offered. So to be honest, a better question would be how to improve my chances in Diagnostic Radiology- something the assessment here indicated i should do and i have one of the highest chances for as IMG and fits kinda well to me.

I think the advice would be around for the same for DR as what ive received for Derm- Step 1 + Observerships + Research [feel free to add anything ive missed out, kudo's if you can].

In a dream world cosmetic derm is something im quite in love with- but a 4th pref match is better than none..

 

[neoevolution]

Chart 3 shows the Percent Matched by Preferred Specialty. I read through the whole thing- nothing about interview discrepancy.

Preferred specialty requires that derm be their first rank, which requires getting at least an interview. I don't think NRMP collects interview offer data, but extrapolating from match statistics shows that IMG are underrepresented in the Derm match. Unless there's some reason to think they're less interested in derm, I'd assume that's because programs find them less desirable and are therefore less likely to offer them interviews.

 

[AlbinoHawk DO]

Keep in mind though that there is a massive self selection and some of these applicants are absurdly overqualified. They could be PhDs, already trained foreign Dermatologists, Cardiologists, Surgeons, etc.

To get into a US Derm Residency as a D.O./IMG/FMG you tend to need to be even better than the slew of near perfect graduating seniors and research fellows competing for the same spots. The normal rules of 250+/Research/AOA = Derm go out the window as an IMG. Why would any program take a risk on a random medical student from these schools over the MD students I mentioned before? They don't unless you're an absurdly qualified candidate or the child of a PD.

Agreed. When I did research at a top 10 institution there was a research PD dermatologist from Germany that wanted to get his US license; last I heard he was taking the boards. I would think this guy will match. It's nothing like your traditional med student.

 

[carolp]

As an IMG applying for Derm in the US you have mainly 2 options:

1. Transfer to a US MD school, get >240 (preferably >260), multiple papers, connections, multiple aways, see Derm forum for additional advice.

Or

2. Graduate top of your class, take step 1/2, get >240 (preferably >260), do a Derm residency, practice Derm as the only dermatologist in a underserved country, get published in top journals, get published in the NYT, do a research fellowship in the US, get in at the program where you did the research fellowship.

Other ways I've seen is to do a peds residency at a Harvard affiliated hospital, become an attending then apply for Derm planning to do peds Derm. Or have connections into a research fellowship that frequently takes their own. None of these options are easy or short. Some IMGs do get accepted to Derm every year but don't be fooled by their low step scores, these people literally are superstars/the only dermatologist in subsahara Africa/multi published in nature etc.

 

[neuroace]

get published in the NYT

Sure I dont have to cure cancer too? 😉

Which research fellowships take their own, in general? I may or may not have quite a few connections in the US..