I mean, in general, PatsyStone is right.
It's not that clinical grades say much about your clinical acumen or future potential to lead a field. In Derm, every candidate seems to have a string of High Honors or Honors with Distinction or whatever an 'A' is at your medical school. If you do not have that string of great clinical grades, it's just another reason to disqualify you against the army of candidates that would love to have your spot. There is some nuance though.
Medicine clerkship is the most important in 3rd year for Derm; Derm sees itself as very medically heavy. If you can only Honor one, Honor medicine. You should Honor your Derm elective but that goes without saying.
I will note that it is hard for Program Directors to really interpret what grades in your medical school truly represent. I know my 3rd grades were very average but programs couldn't really tell; it never got brought up. My school did us a favor by not putting in our Dean's letter what % of people got this grade and what % of people got that grade. My school also didn't use AOA or 'code' words such as 'excellent student, outstanding student, good student, etc.'. If you go to a school that has AOA and ranks you in some way or the other, the longstory short is get the best grades you can with Medicine and Derm being the most important. Of course, if you have a a couple of Nature papers in your backpocket, grades may not be essential to your candidacy.
