IM Resident planning to apply to Dermatology after Residency

[nalasimba]

I'm considering Dermatology now that I'm in Internal Medicine. I have below-average Step 2 CK score (235 to 240) when I got into IM. If I apply for Dermatology Residency upon completion of my IM Residency (and let's say Medicare Funding is not an issue for the programs I will be applying to), how much would my Step 2 CK play a factor considering that I will have Step 3 and IM Board Scores during application?

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[PhillyMed777]

Step 1 and step 2 scores will play a huge factor (depending on which you have, since step 1 is P/F now)
Step 3 less important (but if it’s particularly bad, might stand out to people)
IM scores I can’t see as very helpful

 

[nalasimba]

Step 1 and step 2 scores will play a huge factor (depending on which you have, since step 1 is P/F now)
Step 3 less important (but if it’s particularly bad, might stand out to people)
IM scores I can’t see as very helpful

Just to clarify, Step 1 and Step 2 scores will be a huge factor compared to my finishing my IM residency and the board scores that came from it?

 

[PhillyMed777]

Just to clarify, Step 1 and Step 2 scores will be a huge factor compared to my finishing my IM residency and the board scores that came from it?

That is correct
Even if you did well on IM board scores we are not comparing apples to apples.
Everyone takes step 1/2, therefore, it makes infinite more sense to use that as one standardized metric. It is a common screening tool.

A sub 240 step 2 will be detrimental.
You’ll need a solid story, exemplary research, and to make connections.

 

[nalasimba]

That is correct
Even if you did well on IM board scores we are not comparing apples to apples.
Everyone takes step 1/2, therefore, it makes infinite more sense to use that as one standardized metric. It is a common screening tool.

A sub 240 step 2 will be detrimental.
You’ll need a solid story, exemplary research, and to make connections.

Thanks. What is an example of exemplary research you've seen in Derm?

 

[PhillyMed777]

Thanks. What is an example of exemplary research you've seen in Derm?

Exemplary for derm? Like 40+ pubs with high quality stuff

Perhaps I shouldn’t have used the word exemplary…
8-12 is normal
20+ is outstanding
40+ exemplary

However there are many that match even without 8; probably a factor of connections, excellent grades/boards, well connected med school (with internal program), and great performance on away rotations
Everything is just one data point. You can make up for a slight deficiency with other strong aspects

 

[nalasimba]

excellent grades/boards, well connected med school (with internal program), and great performance on away rotations

I will be finishing my residency by the time apply; hence, I will no longer be in medical school and will not have any away rotations.

 

[dozitgetchahi]

I'm considering Dermatology now that I'm in Internal Medicine. I have below-average Step 2 CK score (235 to 240) when I got into IM. If I apply for Dermatology Residency upon completion of my IM Residency (and let's say Medicare Funding is not an issue for the programs I will be applying to), how much would my Step 2 CK play a factor considering that I will have Step 3 and IM Board Scores during application?

When you take the ABIM boards, nobody cares about the score. P/F is all that appears publicly.

ITE scores can’t be used for promotion or GME admissions decisions. So I’m not sure what you are referring to here.

 

[nalasimba]

When you take the ABIM boards, nobody cares about the score. P/F is all that appears publicly.

ITE scores can’t be used for promotion or GME admissions decisions. So I’m not sure what you are referring to here.

Understood. I thought taking ABIM boards even though it's P/F is worthy achievement because not all IM residents pass them on the first try.

 

[Dral]

Do you have a Step 1 score or did you take it P/F? If you have a step 1 score and it's a good score, that could help you stand out against all the other P's since programs are so used to that metric and still getting used to not having it.

 

[asmallchild]

I will be finishing my residency by the time apply; hence, I will no longer be in medical school and will not have any away rotations.

I've been conversing with someone via PM about an IM to derm pathway. Perhaps you are the same person under a new username. Or perhaps you are a different person.

But my advice to both of you would be the same.

You cannot go into this doing the bare minimum and expect to match dermatology with success. The question is why would a dermatology program take an IM resident when there are so many qualified 4th year medical students they could choose from? (This is particularly relevant if you've failed to match into dermatology as a medical student and then opted to do IM first with an eye to reapply into dermatology) Selecting a highly qualified 4th year medical student means there are no funding issues that the dermatology residency program has to worry about.

Your Step 3 score and IM board scores will not factor much because you are being compared against an applicant pool that doesn't have those scores.

As phillymed777 mentioned, the typical pathway is exemplary research. Most people need to take additional time off AFTER IM training to do this research. This can sometimes be years of research. During this time, it will give you an opportunity to potentially do more away rotations. Beyond the research, this is an opportunity for a dermatology mentor and a dermatology program to get to know you very well. In this scenario, you become a known quantity. At the rank list meeting, your dermatology mentor can go to bat for you and say "Yes, there are lots of very qualified MS4s out there applying for this coveted spot but I've worked hand in hand with nalasimba for 1 year/2 years/3 years/etc etc and I know what he/she can bring to the table." That is the true advantage of research and finding a derm mentor.

But the point is, you cannot expect to complete 3 years of IM residency and then waltz into dermatology. There will be a significant amount of work and networking involved. Is it worth it to do this when you can already start practicing in internal medicine or pursue a fellowship off the tree of internal medicine? That is the more persional question that only you can answer.

 

[nalasimba]

Do you have a Step 1 score or did you take it P/F? If you have a step 1 score and it's a good score, that could help you stand out against all the other P's since programs are so used to that metric and still getting used to not having it.

Took it P/F.

I've been conversing with someone via PM about an IM to derm pathway. Perhaps you are the same person under a new username. Or perhaps you are a different person.

But my advice to both of you would be the same.

You cannot go into this doing the bare minimum and expect to match dermatology with success. The question is why would a dermatology program take an IM resident when there are so many qualified 4th year medical students they could choose from? (This is particularly relevant if you've failed to match into dermatology as a medical student and then opted to do IM first with an eye to reapply into dermatology) Selecting a highly qualified 4th year medical student means there are no funding issues that the dermatology residency program has to worry about.

Your Step 3 score and IM board scores will not factor much because you are being compared against an applicant pool that doesn't have those scores.

As phillymed777 mentioned, the typical pathway is exemplary research. Most people need to take additional time off AFTER IM training to do this research. This can sometimes be years of research. During this time, it will give you an opportunity to potentially do more away rotations. Beyond the research, this is an opportunity for a dermatology mentor and a dermatology program to get to know you very well. In this scenario, you become a known quantity. At the rank list meeting, your dermatology mentor can go to bat for you and say "Yes, there are lots of very qualified MS4s out there applying for this coveted spot but I've worked hand in hand with nalasimba for 1 year/2 years/3 years/etc etc and I know what he/she can bring to the table." That is the true advantage of research and finding a derm mentor.

But the point is, you cannot expect to complete 3 years of IM residency and then waltz into dermatology. There will be a significant amount of work and networking involved. Is it worth it to do this when you can already start practicing in internal medicine or pursue a fellowship off the tree of internal medicine? That is the more persional question that only you can answer.

Understood. No—I have not PM'ed anyone on this site, and I'm a different person than the one you were referring to.

And Thanks for chiming in. Sounds like Dermatology may even be an uphill battle for me as a resident. I guess, I know I'll be sub-specializing as an IM resident and would want to continue further education; I was giving Derm a thought instead of subspecializing, but it seems it's even a tougher road than I initially thought. Thank you for sharing your thoughts.