So Confused...Please give me your advice

[NewDermie]

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Hey everyone...

I am new to the forum and really need some help and advice from anyone who would be willing to help me out.

I apologize ahead of time for asking a "what are my chances thread" but I think my situation is a little unique...

Okay here is my situation:
*Went to a DO school and transferred to an MD program after my first yr. Entered MD program as an MSII (without losing any of my coursework)
*Med school is a small state school (pretty much a no name school)
*Step I 240
*Will probably be at least top 25% of class (my first yr grades don't count towards my class ranking 🙁
*Clinical grades - A's in all rotations so far (Surg, peds, neuro, and psych)
*no AOA
*Research - Undergrad research - basic science and minimally derm related (publication only in Univesrity journal)
Some research 3rd yr - no publication; not derm related
Case report - hopefully completed by the end of 3rd yr and will
publish thereafter (partially derm related)

Another problem is that my med school does not have a derm department (actually no derm faculty either).
I have contacted my Dean and she has helped me find a local Dermatologist who graduated from my med school and I am in the process of contacting her to work with her in my free time.
Other than that, my Dean was not very helpful. She stated that recommends I do away rotations early on. She says that I have done well on clinical rotations and have a good personality and my best chance would be to do aways, work hard and hopefully that will be my chance. She kind of recommended I apply to both derm and a plan B specialty.

I KNOW that what I have done so far is NOT enough for DERM. I have read numerous threads (between SDN and DermBoard) and know that I need to have much more on my application to increase my chances of matching.
I know that I will need to do a significant amount of research...at a bigger institution. I just don't know whether or not I should do this between my 3rd and 4th yr of med school...or do a Research yr after my Intern yr. I rather do the latter because I do not want to have to move away and come back to the town my med school.

Also, do you think getting a high score on Step II (like 250 or 260) would help?

PLEASE PLEASE PLEASE PROVIDE ME WITH ANY ADVICE. I really want honest opinions because I am at a loss of what to do...and because my school does not have much support it makes the situation much more difficult.

Thanks in advance for all your help.

 

[cdql]

why not apply anyway and just do the research year after your internship year if you fail to match?

i would agree there are some weaknesses but you have good clinical grades

step 2 isn't very important for derm

 

[scumbagderm]

This is a more difficult situation so i don't have an easy answer for you. I think you have an uphill battle (no AOA, no derm-department) but many others are facing the same issues.
I don't have all the answers and all I can say is what I would do in your situation. I would consider the research year before applying. The reason being that applying is very expensive and emotionally draining. I imagine its even more horrible if you aren't truly confident you have a chance at matching. Its just one year and you could really get some pubs started, get a great letter, and demonstrate that you are more than just a run-of-the-mill-i-want-to-do-botox-fourth-year. A bigger institution would be better but to be honest I have no formal experience in that because my school has a department and there are plenty of research opportunities.
But don't lose heart!! You have done A LOT to get yourself into derm already. Your 240 is a testament to your hard work and it legitamizes you as a M.D candidate. Having come from a DO school with different curriculum (aimed at preparing you for COMLEX, I'm sure), I would expect the USMLE to be harder for you. On the contrary, you have done very well--better than most M.D students who started as M.D from the beginning. Your board score will help you make most cut-offs. It won't get you tons of extra interviews (I think most derm folks have ~240) but it shouldn't disqualify you automatically.
You also seem to be acing your clinical rotations. This tells me you are easy to get along with. Nobody honors a rotation being a douche or by being lazy. Congrats on doing so well and keep it up!

 

[Dermguy]

Ok. I'll throw in my 2 cents.

If you are REALLY dedicated to derm, you could consider trying for a Doris Duke fellowship or similar between 3rd and 4th year or in between 4th year and applying. This would give you great exposure to research and could get you some publications that would get you noticed.

If I were in your shoes, though, I would not go that route, although there are some in my school who have taken that route. Here's what I would do:

1. everything obvious (grades, work hard for awesome Step 2--honestly, I'd consider taking it fairly early in your case, research as much as you can--go for quantity of articles as well as quality of articles)
2. do as many away rotations as possible at BIG programs and try to get noticed. I know some people say, "big programs mean you will not get noticed," but there are exceptions I think. For example, Henry Ford does not have regularly rotating med students, and I think an away there would get you a lot. Do these early in case you are able to get a letter and try your best to be a STUD at these (and try not to piss anyone off).
3. apply everywhere (essentially, at least)
4. consider a concomitant back-up application to something else

This is what I would tell you if you were my little brother/sister in all sincerity. If you don't match, which happens A LOT obviously, you just have to believe that it really is NOT the end of the world. If you want you can apply again, you can do research, you can switch careers, etc.

No one should ever feel 100% confident about matching. There is always some non-zero probability of failing to match, and so I think you just have to see if you're willing to go for it or not. My advice? Just do your best and organize a bunch of away rotations (get on this NOW, by the way), and see where it takes you. Good luck!

Also, I think the "what are my chances" threads are useful because everyone really is unique, as demonstrated by this OP.

 

[Ignite hardcore]

Are you sure you are out of the running for AOA? I thought most school elect towards the end of 3rd year for senoir AOA and it sounds like you will have a good chance of being asked to submit a CV.

I would also advise apply this year. If you do 2-3 aways starting in July and get some solid letters, I think you'll have a good shot at matching. Good luck with whatever you decide on.

 

[DermMatch]

Do the research year before you graduate. You will give yourself more lead time to get articles published than if you do a research year after your internship.

Try to land a one-year research funded by a prestige grant, and do it in a derm department. Doesn't have to be big name, but with someone who will be a good mentor (and try to find a topic you like because it'll be a long year if you are bored to tears).

If you don't match, then you can do a fellowship year after your intern year, thus adding two years of research under your belt, which makes you a heavier hitter come rematch time.

I never understood candidates who were, say, marginal, but who insisted on pulling the match trigger as 4th years, rather than give themselves more breathing room to strengthen their apps. Reapplying is not pleasant.

 

[scumbagderm]

👍

Do the research year before you graduate. You will give yourself more lead time to get articles published than if you do a research year after your internship.

Try to land a one-year research funded by a prestige grant, and do it in a derm department. Doesn't have to be big name, but with someone who will be a good mentor (and try to find a topic you like because it'll be a long year if you are bored to tears).

If you don't match, then you can do a fellowship year after your intern year, thus adding two years of research under your belt, which makes you a heavier hitter come rematch time.

I never understood candidates who were, say, marginal, but who insisted on pulling the match trigger as 4th years, rather than give themselves more breathing room to strengthen their apps. Reapplying is not pleasant.

👍👍 from the horse's mouth

 

[NewDermie]

I want to thank everyone for all their honest advice.

As of right now I am pretty sure that I will take a year off to do some research. I really want to apply as a strong applicant...and hopefully some research and away rotations and good letters will help me with that.

I have one more questions. What are your opinions on taking a year off for research after I graduate (like after 4th yr). Is that better or would you advise that I complete my intern year and then take a year off for research.

Thanks again and good luck to EVERYONE this coming week. I wish the best for you guys!!!!