Nepotism and Family Connections

[charmiedermie]

Ok, so I really have to get this off my chest after going thru the huge stress of interview season, which is almost over. I'm partly venting, but I think it's a good discussion. I've been finding out some interesting things on the interview trail:

Indiana - one of the first year residents is the son of a derm attending.

Cleveland Clinic - one of the incoming residents is a daughter of a big derm who did his Dermpath fellowship at the Cleveland Clinic. She went to a newly created med school that doesn't even have a Derm residency.

Stanford -- 2 derm attendings are husband and wife, with wife having left an OB-Gyn residency and got a derm spot at Stanford

University of Texas at Houston -- 2 derm attendings on staff are husband and wife, wife who is a FMG got a derm spot there

Kansas -- 2 faculty on staff are husband and wife, wife got a derm spot there after husband got the PD position.

Miami -- I can't even.

This one makes me the most mad -- at OSU, where the PD came up with this standardized LOR to use, which was a pain for my letter writers to fill out on top of their own letters, chooses an applicant whose dad owns a company involved in allergic contact dermatitis and patch testing which is the area of the PD's expertise and with whom the PD has directly worked with. All of that applicant's pubs are in that area coauthored with his dad and his brother.

None of these people were AOA.

Has Derm really gotten to where family connections and nepotism matter much more to getting a derm spot than actual academics? Everytime I keep hearing about how grades, board scores, and research are so pivotal and important for Derm and yet here you have people who get to skip all those hoops, no questions asked.

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[IlDestriero]

beati possidentes

 

[asmallchild]

Ok, so I really have to get this off my chest after going thru the huge stress of interview season, which is almost over. I'm partly venting, but I think it's a good discussion. I've been finding out some interesting things on the interview trail:

Indiana - one of the first year residents is the son of a derm attending.

Cleveland Clinic - one of the incoming residents is a daughter of a big derm who did his Dermpath fellowship at the Cleveland Clinic. She went to a newly created med school that doesn't even have a Derm residency.

Stanford -- 2 derm attendings are husband and wife, with wife having left an OB-Gyn residency and got a derm spot at Stanford

University of Texas at Houston -- 2 derm attendings on staff are husband and wife, wife who is a FMG got a derm spot there

Kansas -- 2 faculty on staff are husband and wife, wife got a derm spot there after husband got the PD position.

Miami -- I can't even.

This one makes me the most mad -- at OSU, where the PD came up with this standardized LOR to use, which was a pain for my letter writers to fill out on top of their own letters, chooses an applicant whose dad owns a company involved in allergic contact dermatitis and patch testing which is the area of the PD's expertise and with whom the PD has directly worked with. All of that applicant's pubs are in that area coauthored with his dad and his brother.

None of these people were AOA.

Has Derm really gotten to where family connections and nepotism matter much more to getting a derm spot than actual academics? Everytime I keep hearing about how grades, board scores, and research are so pivotal and important for Derm and yet here you have people who get to skip all those hoops, no questions asked.

It seems magnified in derm (and perhaps it is), but connections and nepotism will get your further in life in whatever field you look at.

For those of us without those connections, we can only focus on what we can control: our grades, board scores, research, etc

 

[charmiedermie]

It seems magnified in derm (and perhaps it is), but connections and nepotism will get your further in life in whatever field you look at.

For those of us without those connections, we can only focus on what we can control: our grades, board scores, research, etc

But the reason it is magnified in derm is bc there are so few derm spots to begin with and it's not like u get interviews at every place u apply to prove yourself.

Just hypocritical for academic faculty to say how those things are so important but won't blink an eye to take others with open arms just bc they are a fiancee, son or daughter of someone on faculty.

 

[asmallchild]

But the reason it is magnified in derm is bc there are so few derm spots to begin with and it's not like u get interviews at every place u apply to prove yourself.

Just hypocritical for academic faculty to say how those things are so important but won't blink an eye to take others with open arms just bc they are a fiancee, son or daughter of someone on faculty.

I don't disagree, but that's just the way it is. No real solution other than to stay in academics and try to change the culture yourself. I will confess it was eye opening to witness this first hand as a resident during the application/interview process. But hey, who ever promised life would be fair?

 

[The Derminator]

Wow, I had no idea, and I interviewed at some of those places. Thanks for posting that, charmie. I think things like that should be out in the open.

 

[anonperson]

It's unfortunate but this is pretty common in medicine and just about any other field. For us "regular folks", grades, board scores, and good LORs are all we can depend on.

In the OB field, one of the residents at OU is related to one of the GYN ONC faculty. And don't be surprised if this relation comes in handy when it comes time for a Gyn Onc fellowship (where the match rate is like 50% and there are maybe 40 spots in the country). When I interviewed at Loyola, their one lone DO intern just happened to be the son of a OB GYN who practiced extensively out of the hospital. You'll hear similar stories in just about every specialty.

Academic faculty in any specialty are huge blowhards so take anything they say with a grain of salt.

Very few residents/physicians become game changers in their chosen field and program directors will choose students who will not make waves and pass their boards, so if they end up choosing a resident as a favor to a faculty member or some company bigwig they publish with, they do not give two $hits about the "fairness" of the situation to the med students who don't have connections.

But this also underscores the fact that the various fields of medicine are not that difficult and most med students will go on to be competent physicians and derm is no exception to this.

 

[charmiedermie]

I don't disagree, but that's just the way it is. No real solution other than to stay in academics and try to change the culture yourself. I will confess it was eye opening to witness this first hand as a resident during the application/interview process. But hey, who ever promised life would be fair?

I know it isn't fair and neither is life. Just very disillusioning when the rest of us have to be top of the class at everything and one slip up or any perceived deficiency/omission can leave us unmatched in Derm.

Meanwhile ones like the examples above can just waltz into a spot and it doesn't matter what their grades, scores, or research is.

 

[charmiedermie]

Wow, I had no idea, and I interviewed at some of those places. Thanks for posting that, charmie. I think things like that should be out in the open.

I think I lost complete faith esp. with OSU since the person is very involved with derm resident medical education on a national level. He's supposed to be one of the good guys. His standardized LOR was supposed to make it fairer and easier to compare 2 applicants - something he obviously doesn't follow for his own program.

At least in rads, anes, etc. There are tons of other programs to match, while in derm it seems like if u dont have aoa or go to a top 10 school your total # of interviews go down dramatically.

At least we would know with certain programs not to waste our time interviewing there if there was a conflict of interview dates.

 

[charmiedermie]

Very few residents/physicians become game changers in their chosen field and program directors will choose students who will not make waves and pass their boards, so if they end up choosing a resident as a favor to a faculty member or some company bigwig they publish with, they do not give two $hits about the "fairness" of the situation to the med students who don't have connections.

But this also underscores the fact that the various fields of medicine are not that difficult and most med students will go on to be competent physicians and derm is no exception to this.

I'm just surprised in Derm that it is being done when there are so few people in the specialty where everyone knows everyone. Let those people get their spot outside the match so they don't waste interview spots in places others would have liked to go.

 

[IlDestriero]

Looking at the senior faculty that have older children, it is obvious that their faculty affiliation impacts admission to my highly competitive university for undergraduate eduction. They all have at least one child that attended, some have several. Is that fair. Sure. If you're reasonably competitive why not, and the tuition benefit is very substantial. It's more of a faculty benefit than a nepotism concern.
How it much it affects graduate school admissions isn't clear to me, but several sent their kids to graduate school here as well.
If one of my children wants to pursue my specialty, I don't see why I shouldn't be able to train them. If they are reasonably competitive and interested, wouldn't my many years of service earn me that right? I should think so. In fact if they didn't select them, I would view that as an unrecoverable slight and start looking into other opportunities.
Derm may be very competitive, but someone with a 225 on the USMLE can learn the material just as well as someone with a 255. It's competitive for many reasons, but mastery doesn't require one to be in the 98th percentile, that's a side effects of the competitiveness of the field. If the reimbursement was cut to Peds levels, the average score would undoubtedly drop and there would still be competent dermatologists being turned out year after year.

 

[HalladayWeekend]

There are too many qualified derm applicants and the best applicants don't always match (or match at their top choices). There are a lot more examples of what you describe above, but the people who make these choices have the right to choose whoever they want,so this is life. I do agree it's totally ridiculous, but it happens in all fields and walks of life.

The student in my class who got far more derm interviews then everyone else had the lowest Step 1 score, but his dad has many connections in the field. It is what it is.

Besides, when you do get in on your own merits, it makes it all the more rewarding.

 

[Dral]

Hey, that Cleveland Clinic big Derm helped me get my fellowship spot. I know you are venting, but you don't know the whole story about any of those people. For all you know, they all have 270 board scores and found cures for Melanoma.

There is no outside the match anymore.

The person going to Cleveland clinic interviewed and ranked places fair and square. Just because they ended up at Cleveland Clinic, doesn't mean some special favor went down.

 

[HalladayWeekend]

I don't think this is fair if someone with better credentials wants to go to the school and the spot is taken by a faculty members kid, but this is not how the world works. In selection processes, the most qualified people do not always get chosen. Just because we have to accept that stuff like this happens does not make it fair.

 

[charmiedermie]

Derm may be very competitive, but someone with a 225 on the USMLE can learn the material just as well as someone with a 255. It's competitive for many reasons, but mastery doesn't require one to be in the 98th percentile, that's a side effects of the competitiveness of the field. If the reimbursement was cut to Peds levels, the average score would undoubtedly drop and there would still be competent dermatologists being turned out year after year.

Well, derm faculty feel very differently than you. None of them feel someone with a 225 can learn it just as well as someone with a 255.

Hey, that Cleveland Clinic big Derm helped me get my fellowship spot. I know you are venting, but you don't know the whole story about any of those people. For all you know, they all have 270 board scores and found cures for Melanoma.

There is no outside the match anymore.

The person going to Cleveland clinic interviewed and ranked places fair and square. Just because they ended up at Cleveland Clinic, doesn't mean some special favor went down.

I didn't say her father is at the Cleveland Clinic now - I said he did his fellowship there. She had 4 publications all of them with her Dad most of them reviews in low impact journals - so doubt she discovered a cure for melanoma. She wasnt AOA at her new school so doubt she had a 270.

What i said was people with those connections SHOULD just get their spots outside the match and not waste other interviews jut to interview.

All those people above had 270 board scores and found the cure for melanoma? Their familial connections had no role at all?

 

[Dral]

Well, derm faculty feel very differently than you. None of them feel someone with a 225 can learn it just as well as someone with a 255.

I didn't say her father is at the Cleveland Clinic now - I said he did his fellowship there. She had 4 publications all of them with her Dad most of them reviews in low impact journals - so doubt she discovered a cure for melanoma. She wasnt AOA at her new school so doubt she had a 270.

What i said was people with those connections SHOULD just get their spots outside the match and not waste other interviews jut to interview.

All those people above had 270 board scores and found the cure for melanoma? Their familial connections had no role at all?

I meant the one who trained at Cleveland clinic for dermpath...the one who is at Ackerman Academy now. Yes. I know him well. I trained under him for the last two and a half years. He was also president of the AAD last year. You forgot that.

He is quite an amazing clinician, diagnostician, and teacher. One would get the impression that his daughter likely isn't some screw up. Not everyone needs 270s and melanoma cures. I'll bet she had good credentials when applying though.

I think you should probably stop posting things about her pubs and AOA status and such.

And again, there is no 'outside the match'. That is illegal unless a program does 'all out'. I don't think a Derm program would do that.

 

[IlDestriero]

Programs don't have an obligation to train anyone and there is a precedent of training ones children to follow in their footsteps that dates back to around the dawn of time. I'm not sure someone beating them by 20 points on step one means that has to be put aside.

 

[charmiedermie]

I meant the one who trained at Cleveland clinic for dermpath...the one who is at Ackerman Academy now. Yes. I know him well. I trained under him for the last two and a half years. He was also president of the AAD last year. You forgot that.

He is quite an amazing clinician, diagnostician, and teacher. One would get the impression that his daughter likely isn't some screw up. Not everyone needs 270s and melanoma cures. I'll bet she had good credentials when applying though.

I think you should probably stop posting things about her pubs and AOA status and such.

And again, there is no 'outside the match'. That is illegal unless a program does 'all out'. I don't think a Derm program would do that.

I left that out for obvious reasons but it proves my point even further. I understand u have to defend someone who got you a dermpath fellowship but it has nothing to do w/this. Chill.

You initially said for all i know they got a 270 on the boards and found the cure for melanoma which is maybe why they matched. I addressed those things as not being very likely, and posted to that effect. If you hadn't made that scenario, i wouldnt have posted anything. I never said she was a screwup. But being his daughter definitely helped - not being AOA at a newly started med school with no Derm for miles would leave most applicants unmatched for Derm.

I know there are no 'outside the match' spots. I'm just saying if Derm is going to do this game it should be brought back so those people can get their spots and the rest of the interview spots can be taken by those of us who aren't offspring of derms or marrying a derm.

 

[Dral]

I am chill. Thank you.

I'm defending him and his daughter because you can't assume something just because her med school had no Derm program, was new, etc. maybe she did an away at CC and knocked their socks off. Family connection help, probably. If you had them, you wouldn't have made this thread I'm guessing.

My point isn't about numbers. It's about you not knowing the full story about these people. I don't either, but at least I'm giving them the benefit of the doubt. I guess it's easy for me to do that since I don't have to play the match game anymore...but trust me, it wasn't an easy play for me.

 

[charmiedermie]

Programs don't have an obligation to train anyone and there is a precedent of training ones children to follow in their footsteps that dates back to around the dawn of time. I'm not sure someone beating them by 20 points on step one means that has to be put aside.

I didnt say they had an obligation to train anyone or that Step 1 score alone justifies taking someone. There are applicants every year who did all the right things for 4 years to try to match derm and didnt match derm.

 

[charmiedermie]

I am chill. Thank you.

I'm defending him and his daughter because you can't assume something just because her med school had no Derm program, was new, etc. maybe she did an away at CC and knocked their socks off. Family connection help, probably. If you had them, you wouldn't have made this thread I'm guessing.

My point isn't about numbers. It's about you not knowing the full story about these people. I don't either, but at least I'm giving them the benefit of the doubt. I guess it's easy for me to do that since I don't have to play the match game anymore...but trust me, it wasn't an easy play for me.

Many students do audition rotations at the Cleveland Clinic. We all do audition rotations. People who are unmatched on match day did audition rotations. This isnt just 1 example either. Instead of saying it looks bad, you're defending the practice and say that they should be given the benefit of the doubt anyways.

You're correct it is easy for u to say now that you're finishing residency.

 

[anonperson]

I am chill. Thank you.

I'm defending him and his daughter because you can't assume something just because her med school had no Derm program, was new, etc. maybe she did an away at CC and knocked their socks off. Family connection help, probably. If you had them, you wouldn't have made this thread I'm guessing.

My point isn't about numbers. It's about you not knowing the full story about these people. I don't either, but at least I'm giving them the benefit of the doubt. I guess it's easy for me to do that since I don't have to play the match game anymore...but trust me, it wasn't an easy play for me.

So a med student from a brand new medical school with no prominent derm faculty just happens to match at the program that a parent (who is a prominent player in the field and who completed a fellowship)? You think that's just a coincidence? You think maybe, just maybe, having the same last name didn't have any benefit?

I'm sure you got to where you're at by pulling yourself by your bootstraps, etc etc etc, but the reality is clear, nepotism is alive and well in medicine. Some applicants get lucky in that regard. But don't try to deny that the OPs claims are without merit because anyone with an ounce of sense could see that even with a few sentence descriptions, the scenarios are a bit shady.

 

[anonperson]

Programs don't have an obligation to train anyone and there is a precedent of training ones children to follow in their footsteps that dates back to around the dawn of time. I'm not sure someone beating them by 20 points on step one means that has to be put aside.

Speaking as someone who's in a field not even completely related to derm, I agree with the sentiment that logically, you could take two students, one with a 230 on Step 1 and the other with a 250 on Step 1 and churn out the exact same dermatologist (this goes for nearly all medical specialties). But derm PDs have a hard on for high step 1 scores.

 

[FIREitUP]

 

[Dral]

Many students do audition rotations at the Cleveland Clinic. We all do audition rotations. People who are unmatched on match day did audition rotations. This isnt just 1 example either. Instead of saying it looks bad, you're defending the practice and say that they should be given the benefit of the doubt anyways.

You're correct it is easy for u to say now that you're finishing residency.

And people know other people and those connections get people training spots. It's just as much a part of the process as anything else. I don't think it looks bad, I think it's a valid part of the process. Sorry, not everyone gets a trophy....even the ones who train hard.

And I said an away rotation where she knocked their socks off. It's of course foolish to think just doing a rotation lands a spot. Not everyone can rock away rotations.

I wish you the best in the match. Hopefully your connections help with getting you a spot as well.

 

[charmiedermie]

And people know other people and those connections get people training spots. It's just as much a part of the process as anything else. I don't think it looks bad, I think it's a valid part of the process. Sorry, not everyone gets a trophy....even the ones who train hard.

So u think doing audition rotations, working on a research project with an unrelated faculty member who gets to know you, meeting people at other programs in presenting your research, etc. is no different or analogous to being the son/daughter/significant other of a derm attending and the latter is a valid part of the process? I know you don't honestly believe that.

I'm not talking about participation trophies. Don't worry, none of my 'connections' are related to me, but i think ill do fine.

 

[charmiedermie]

So a med student from a brand new medical school with no prominent derm faculty just happens to match at the program that a parent (who is a prominent player in the field and who completed a fellowship)? You think that's just a coincidence? You think maybe, just maybe, having the same last name didn't have any benefit?

I'm sure you got to where you're at by pulling yourself by your bootstraps, etc etc etc, but the reality is clear, nepotism is alive and well in medicine. Some applicants get lucky in that regard. But don't try to deny that the OPs claims are without merit because anyone with an ounce of sense could see that even with a few sentence descriptions, the scenarios are a bit shady.

No, it just means you don't know the full story and the person most likely knocked their socks off on their audition rotation. Bc no other med students do that apparently.

And doing it the non-family pathway is apparently also "connections".

 

[Dral]

No, it just means you don't know the full story and the person most likely knocked their socks off on their audition rotation. Bc no other med students do that apparently.

And doing it the non-family pathway is apparently also "connections".

I'm not saying other students don't do that but if one does, it's probably enough to give them a good shot where they rotate even if they might not have the best stats. But that's subjective.

And yes, connections are so important, family or not. You know that.

If you had a relative on faculty at say, San Francisco, would you not ask them for their help? Of course you would. I would have. It would have saved me tons of heartache.

What do you expect these candidates to do? Of course they are going to do what it takes to get a spot. As Ildesterio pointed out, nobody owes anyone a spot.

You are of course allowed to vent/complain about it, but when you do that on a public forum, it makes you come off as maybe that future resident who is going to complain that "Sara got one less call day than I. That's not fair!" Programs don't like dealing with that kind of thing. I hope you are sufficiently incognito on this forum for that reason.

Personality and fit go a long way in what many programs look for, not just academics. Who better to vouch for someone than a relative?...yes yes, there is definitely bias involved, I'm not denying that.

I'm not saying the family connections don't mean anything. Of course they do, it means a lot. But I do think, again, that we should give those candidates the benefit of the doubt that they put in the academic work as well. Maybe they aren't superstars, but I hope they just didn't drop the ball and just rely on family connections. Maybe some did, who knows? I hope that's not the case. Again, it comes down to giving them the benefit of doubt.

I never claimed the family thing didn't have to do with getting a spot. I just don't believe it's totally valid to assume the candidates don't put in a decent amount of academic work and instead totally rely on family connections.

 

[FranzLO]

If one of my children wants to pursue my specialty, I don't see why I shouldn't be able to train them. If they are reasonably competitive and interested, wouldn't my many years of service earn me that right? I should think so. In fact if they didn't select them, I would view that as an unrecoverable slight and start looking into other opportunities.

Unless this is sarcasm, this is incredibly disappointing to read. Where does one draw the line with "reasonably competitive?" What does that even mean? They have a medical degree? Maybe the time should be taken to tell applicants not to waste as much money by applying there. But that would be ethical.

If you are serious, no, it doesn't earn you the right. You should have picked a career less based on actual merit, ability, and motivation. But maybe I am missing something, because I am almost getting nauseous reading this.

 

[IlDestriero]

Residency is a job, specifically on the job training.
Private practice x is a job.
Union stone mason is a job.
Starbucks barista is a job.
The people doing the hiring can hire anyone they want. We don't rank applicants for fellowship or partnership based on numbers. That's a screening tool. Who gets offered positions is much more complex than that.
Sorry if that's new information.

 

[doc MD]

Has Derm really gotten to where family connections and nepotism matter much more to getting a derm spot than actual academics? Everytime I keep hearing about how grades, board scores, and research are so pivotal and important for Derm and yet here you have people who get to skip all those hoops, no questions asked.

this is the real world and not limited to derm. yes, you need the grades, research, publications, LOR, phone calls. etc. And yes, it is easier not to have it b/c of a connection, family connection, hell, maybe even a sexual connection. It is no different than having to get in b/c married to a resident, or attending, or someone that is very powerful in the field or any other field for that matter. All of those exist currently in many of the programs and have for many years and will for many years.

The world is not fair, even if you have everything in place to get in. That is just the way it is and will not change.

 

[FIREitUP]

this is the real world and not limited to derm. yes, you need the grades, research, publications, LOR, phone calls. etc. And yes, it is easier not to have it b/c of a connection, family connection, hell, maybe even a sexual connection. It is no different than having to get in b/c married to a resident, or attending, or someone that is very powerful in the field or any other field for that matter. All of those exist currently in many of the programs and have for many years and will for many years.

The world is not fair, even if you have everything in place to get in. That is just the way it is and will not change.

I think when we are taught in medical school that we as physicians we are held to a higher standard, to the naiive, it makes it seem like situations such as what the OP is describing do not happen. The OP just came to the realization that med school =/= the real world and who you know is more often more important than what you know.

OP: we feel you, it sucks, we get it, move on.

 

[anonperson]

Personality and fit go a long way in what many programs look for, not just academics. Who better to vouch for someone than a relative?...yes yes, there is definitely bias involved, I'm not denying that.

I'm not saying the family connections don't mean anything. Of course they do, it means a lot. But I do think, again, that we should give those candidates the benefit of the doubt that they put in the academic work as well.

I'd argue that family members would be least able to objectively grade/measure/vouch someone. Why else is it recommended that physicians don't take care of family members? Why else is it, if an attending has a pre existing relationship with a resident, the program will generally not put the two on service together?

I just find the dermatology situation amusing because the specialty in general is so nuts about super high Step 1 scores, AOA status, and having the "perfect" applicant that they drive potential applicants insane with the requirements, but blowhard PDs won't bat an eye about "giving" a spot as a favor. The OSU PD (is it still Zirwas?) is particularly laughable because he waxes on and on about being able to choose the right resident including the use of personality tests etc, when he can really just simplify it and say unless your relative is on faculty or your mom/dad co published with me, get in in line.

 

[charmiedermie]

this is the real world and not limited to derm. yes, you need the grades, research, publications, LOR, phone calls. etc. And yes, it is easier not to have it b/c of a connection, family connection, hell, maybe even a sexual connection. It is no different than having to get in b/c married to a resident, or attending, or someone that is very powerful in the field or any other field for that matter. All of those exist currently in many of the programs and have for many years and will for many years.

The world is not fair, even if you have everything in place to get in. That is just the way it is and will not change.

Again, I understand life is not fair. It doesn't mean it shouldn't be pointed out. Dral believes nepotism is a 'valid' part of the process no different and is on par with doing research or acing an audition elective. So then the field's company line shouldnt say grades, board scores, AOA, are vital for Derm.

I'm not saying other students don't do that but if one does, it's probably enough to give them a good shot where they rotate even if they might not have the best stats. But that's subjective.

And yes, connections are so important, family or not. You know that.

If you had a relative on faculty at say, San Francisco, would you not ask them for their help? Of course you would. I would have. It would have saved me tons of heartache.

What do you expect these candidates to do? Of course they are going to do what it takes to get a spot. As Ildesterio pointed out, nobody owes anyone a spot.

You are of course allowed to vent/complain about it, but when you do that on a public forum, it makes you come off as maybe that future resident who is going to complain that "Sara got one less call day than I. That's not fair!" Programs don't like dealing with that kind of thing. I hope you are sufficiently incognito on this forum for that reason.

Personality and fit go a long way in what many programs look for, not just academics. Who better to vouch for someone than a relative?...yes yes, there is definitely bias involved, I'm not denying that.

I'm not saying the family connections don't mean anything. Of course they do, it means a lot. But I do think, again, that we should give those candidates the benefit of the doubt that they put in the academic work as well. Maybe they aren't superstars, but I hope they just didn't drop the ball and just rely on family connections. Maybe some did, who knows? I hope that's not the case. Again, it comes down to giving them the benefit of doubt.

I never claimed the family thing didn't have to do with getting a spot. I just don't believe it's totally valid to assume the candidates don't put in a decent amount of academic work and instead totally rely on family connections.

We get it. Her father helped you get a Dermpath spot. Nothing wrong with that but you have a conflict of interest in this hence your rush to give the benefit of the doubt. Anonperson, in his response to u summed it up regarding her situation.

For someone who is so quick to give the benefit of the doubt, you're quick to say that a person will most likely complain about an extra day of call. Again, chill.

 

[Dral]

I'm not at all worked up...never have been.

 

[charmiedermie]

I just find the dermatology situation amusing because the specialty in general is so nuts about super high Step 1 scores, AOA status, and having the "perfect" applicant that they drive potential applicants insane with the requirements, but blowhard PDs won't bat an eye about "giving" a spot as a favor. The OSU PD (is it still Zirwas?) is particularly laughable because he waxes on and on about being able to choose the right resident including the use of personality tests etc, when he can really just simplify it and say unless your relative is on faculty or your mom/dad co published with me, get in in line.

And has even published papers in the JAAD correlating Step 1, med school exam scores, clinical grades, and being AOA to predicting residency performance which is just for show when it comes to selecting residents for his own program.

The hypocrisy is wanting a near perfect applicant bc derm says those attributes are necessary to be a competent dermatologist, except when it comes to the right offspring, and then those factors suddenly aren't necessary.

 

[Dral]

I do get where you're coming from, but it just seems you're spinning it as too black and white. There is a lot that goes into it.

I guess like others have stated, residency is more like a job than continuing school. It's less merit driven and more who you know. I saw that first hand. I didn't play the game interviewing for residency and it cost me.

I hate seeing it happen, but it's just how things work.

 

[charmiedermie]

I think when we are taught in medical school that we as physicians we are held to a higher standard, to the naiive, it makes it seem like situations such as what the OP is describing do not happen. The OP just came to the realization that med school =/= the real world and who you know is more often more important than what you know.

OP: we feel you, it sucks, we get it, move on.

Are u even in the match this year?

 

[charmiedermie]

I do get where you're coming from, but it just seems you're spinning it as too black and white. There is a lot that goes into it.

I guess like others have stated, residency is more like a job than continuing school. It's less merit driven and more who you know. I saw that first hand. I didn't play the game interviewing for residency and it cost me.

I hate seeing it happen, but it's just how things work.

I'm not trying to attack you. I know you've been thru the same journey. But for the applicant who has 2 conflicting interviews and has to give up one, you don't think its helpful info to know to be able to go with the program that doesnt pull this stuff and has a higher chance to match there?

Demand for certain scores, grades, etc. are all driven from the top. Applicants aren't the ones doing it.

 

[asmallchild]

I think when we are taught in medical school that we as physicians we are held to a higher standard, to the naiive, it makes it seem like situations such as what the OP is describing do not happen. The OP just came to the realization that med school =/= the real world and who you know is more often more important than what you know.

OP: we feel you, it sucks, we get it, move on.

This. It happens every year. This isn't the first year. It won't be the last year.

The best applicants (and the sanest ones) focus on what they can actually control. If you are going to nitpick every unfair aspect of the application process, you will drive yourself crazy.

If you don't like it, I encourage you to be among the few who stay in academics to change the system. We hear the same complaints every year and there seems to be no shortage of residents fleeing academia (myself included, I'm no saint) for the "greener" pastures of private practice. If this really bothers you that much, I encourage you to stay behind and fix it. Although I think you would be lying to yourself that you wouldn't afford your child the same opportunities/privileges current day attendings are providing to their children.

 

[charmiedermie]

This. It happens every year. This isn't the first year. It won't be the last year.

The best applicants (and the sanest ones) focus on what they can actually control. If you are going to nitpick every unfair aspect of the application process, you will drive yourself crazy.

If you don't like it, I encourage you to be among the few who stay in academics to change the system. We hear the same complaints every year and there seems to be no shortage of residents fleeing academia (myself included, I'm no saint) for the "greener" pastures of private practice. If this really bothers you that much, I encourage you to stay behind and fix it. Although I think you would be lying to yourself that you wouldn't afford your child the same opportunities/privileges current day attendings are providing to their children.

If i was a derm pd and wanted to play that card, i also wouldnt put my name on academic papers concluding how essential board scores, grades, AOA are to derm. I would be embarrassed if colleagues knew i did that for a son/daughter while lecturing to others on how those things are so essential to being a competent dermatologist.

I realize as a group, derm applicants have to be painstakingly risk-averse, but i do think applicants as a whole should know the programs that do it. Finding the weaknesses of each derm program is hard enough. Just see the thread.

 

[HatsAnd Sunscreen]

Of course connections play a role, but it seems pretty condescending to assume these individuals are less qualified than you are due to their medical school not having a home program or because they related to another dermatologist.

Yes, board scores, research, AOA, ect are important to be able sort through the deluge of splendid applicants that dermatology programs attract. But you can't say that these individuals did not deserve their spot because they have an intangible that you do not possess.

 

[futuredoc8788]

OP I feel you, nepotism definitely does occur and it is frustrating. However like everyone is saying, you can only worry about what you can control. I think programs rely heavily on candidates w/connects because most of the applicants in dermatology are so well qualified that sometimes it is just easier to choose the person you're more familiar with. I also agree with the others in saying that you don't really know these applicants qualifications either. Alot of these people are well qualified, they just happen to know some pretty dope people too. Regarding AOA, what does that really mean???? I was AOA however I will say that the membership process varies drastically across medical schools and its importance varies across programs. I suppose I'll see more of the selection process next year as I am currently an intern, but I suppose most programs look at the whole picture…for example scores, LORS, connects will get you an interview… but after that, for the most part you're on your own…. whether or not they can stand to be around you for the next 3 years seems to become of greater importance lol. People tend to feel like they get a better grasp of the latter when they know someone who knows the applicant. Ironically, I ended up matching at a program in which I have zero connects. I didn't know a single soul in the program or neighboring programs at all. I felt like I rocked the interview and I've been told I have a really good personality so I suppose that by itself was enough for them. Just your best and don't worry about the rest! Wishing you much success in the match!

 

[Slack3r]

I just find the dermatology situation amusing because the specialty in general is so nuts about super high Step 1 scores, AOA status, and having the "perfect" applicant that they drive potential applicants insane with the requirements...

There is nothing inherent to derm that requires high Step 1 scores, AOA, and everything else. It requires a "perfect" application because there are approximately 400 spots in the country, and 20,000 or so medical students. And when it comes down to it, a good majority of those students would like to work 40 hours/wk and still bank ~$300,000/year. Double the hours and halve the pay and derm would be the new child neurology. Not to say that there aren't many who would still pursue derm, but let's not kid ourselves here.

I'm not sure why you're all acting like this is something novel to dermatology; the same thing happens in ENT, plastics, and rad onc, etc. and those specialties have even FEWER spots than derm.

Btw, OP, are you weird? You sound weird. That will probably be a bigger problem for you than the invisible hand of nepotism.

 

[charmiedermie]

There is nothing inherent to derm that requires high Step 1 scores, AOA, and everything else. It requires a "perfect" application because there are approximately 400 spots in the country, and 20,000 or so medical students. And when it comes down to it, a good majority of those students would like to work 40 hours/wk and still bank ~$300,000/year. Double the hours and halve the pay and derm would be the new child neurology. Not to say that there aren't many who would still pursue derm, but let's not kid ourselves here.

I'm not sure why you're all acting like this is something novel to dermatology; the same thing happens in ENT, plastics, and rad onc, etc. and those specialties have even FEWER spots than derm.

Btw, OP, are you weird? You sound weird. That will probably be a bigger problem for you than the invisible hand of nepotism.

Aren't you going for derm? You could say that for any field but people would still pursue derm, ent, whatever.

How would you know getting thru derm residency and boards doesn't require any of those things?

 

[dermie1985]

There is nothing inherent to derm that requires high Step 1 scores, AOA, and everything else. It requires a "perfect" application because there are approximately 400 spots in the country, and 20,000 or so medical students. And when it comes down to it, a good majority of those students would like to work 40 hours/wk and still bank ~$300,000/year. Double the hours and halve the pay and derm would be the new child neurology. Not to say that there aren't many who would still pursue derm, but let's not kid ourselves here.

I'm not sure why you're all acting like this is something novel to dermatology; the same thing happens in ENT, plastics, and rad onc, etc. and those specialties have even FEWER spots than derm.

Btw, OP, are you weird? You sound weird. That will probably be a bigger problem for you than the invisible hand of nepotism.

I sort of disagree with this post. Yes, I do believe there are many derm applicants who chose dermatology for the pay and hours. Or, the self-perceived "prestige". However, I think many of these people do get eliminated during the match process. I have lower step scores and (probably) "poorer" clinical grades than some of my co-applicants from my home institution, but many more interviews than most of them. I honestly do think that programs are looking for more than step scores and grades, and honestly, do want to match people into derm who enjoy the specialty for more than the paycheck. This isn't the case everywhere, but I think those places are the exceptions rather the rule.

 

[charmiedermie]

OP I feel you, nepotism definitely does occur and it is frustrating. However like everyone is saying, you can only worry about what you can control. I think programs rely heavily on candidates w/connects because most of the applicants in dermatology are so well qualified that sometimes it is just easier to choose the person you're more familiar with. I also agree with the others in saying that you don't really know these applicants qualifications either. Alot of these people are well qualified, they just happen to know some pretty dope people too. Regarding AOA, what does that really mean???? I was AOA however I will say that the membership process varies drastically across medical schools and its importance varies across programs. I suppose I'll see more of the selection process next year as I am currently an intern, but I suppose most programs look at the whole picture…for example scores, LORS, connects will get you an interview… but after that, for the most part you're on your own…. whether or not they can stand to be around you for the next 3 years seems to become of greater importance lol. People tend to feel like they get a better grasp of the latter when they know someone who knows the applicant. Ironically, I ended up matching at a program in which I have zero connects. I didn't know a single soul in the program or neighboring programs at all. I felt like I rocked the interview and I've been told I have a really good personality so I suppose that by itself was enough for them. Just your best and don't worry about the rest! Wishing you much success in the match!

Thank you for your kind words.

While AOA induction has likely changed in some places to not just include academics, right or wrong it is still viewed as a marker for academics. Programs dont dig, I don't think, that deep on why someone got AOA. Once u have it, u have it.

You think it is just a coincidence that in a derm program, that 2 other people are AOA and that the 1 other person who isn't AOA, has less research, and shares a last name with a person on staff? That person is still well-qualified for u?

We all have connections. But there is a difference between publishing with a faculty member and getting a letter and being the offspring of a derm who can get you tons of interviews or a spot at his/her program.

Thank you for your advice. I just think Derm should admit upfront that it happens frequently and that scores, grades, AOA, research etc. either are or are not important.

Of course connections play a role, but it seems pretty condescending to assume these individuals are less qualified than you are due to their medical school not having a home program or because they related to another dermatologist.

I didnt say they are less qualified than me or that i deserve their spot.

 

[FIREitUP]

Thank you for your kind words.

While AOA induction has likely changed in some places to not just include academics, right or wrong it is still viewed as a marker for academics. Programs dont dig, I don't think, that deep on why someone got AOA. Once u have it, u have it.

You think it is just a coincidence that in a derm program, that 2 other people are AOA and that the 1 other person who isn't AOA, has less research, and shares a last name with a person on staff? That person is still well-qualified for u?

We all have connections. But there is a difference between publishing with a faculty member and getting a letter and being the offspring of a derm who can get you tons of interviews or a spot at his/her program.

Thank you for your advice. I just think Derm should admit upfront that it happens frequently and that scores, grades, AOA, research etc. either are or are not important.

I didnt say they are less qualified than me or that i deserve their spot.

So who should do this? Should the editor of JAAD (yes, I checked what you posted) publish something mentioning this? Who is the spokesperson for derm? This application process is real life. We have all learned that in real life, "it's not what you know, it's who you know". This applies to derm. No one is saying that dermatology as a field is somehow exempt from this.

 

[Over9000]

same thing happens in all fields, even mine, the unglorious barely-considered-medicine field of pathology.

we have pds selecting unqualified candidates from places like iraq or afghanistan who got their medical degrees in the eighties, because of some cultural, family or religious favor. gotta help your countrymen get ahead, right?

 

[anonperson]

There is nothing inherent to derm that requires high Step 1 scores, AOA, and everything else. It requires a "perfect" application because there are approximately 400 spots in the country, and 20,000 or so medical students. And when it comes down to it, a good majority of those students would like to work 40 hours/wk and still bank ~$300,000/year. Double the hours and halve the pay and derm would be the new child neurology. Not to say that there aren't many who would still pursue derm, but let's not kid ourselves here.

I'm not sure why you're all acting like this is something novel to dermatology; the same thing happens in ENT, plastics, and rad onc, etc. and those specialties have even FEWER spots than derm.

Btw, OP, are you weird? You sound weird. That will probably be a bigger problem for you than the invisible hand of nepotism.

You and I know, and most logical people know being a dermatologist doesn't require a super high step 1, AOA, etc in order to be a competent or even good dermatologist. That's the point but a lot of academic PDs will publicly argue otherwise, such as the OSU PD.

No ones denying it doesn't happen in other specialties. The OP just happens to be talking about dermatology specifically.

So who should do this? Should the editor of JAAD (yes, I checked what you posted) publish something mentioning this? Who is the spokesperson for derm? This application process is real life. We have all learned that in real life, "it's not what you know, it's who you know". This applies to derm. No one is saying that dermatology as a field is somehow exempt from this.

They could mention to prospective applicants that there's a candidate with a relative on faculty and let applicants decide what to do with the information if offered an interview. I'm being facetious but at least that would be fairer. When I interviewed for fellowship, one program was upfront about two internal candidates being strongly considered. It didn't affect my rank list but if someone was trying to manage multiple interviews on one day, that would probably sway them.