MD What are my chances of matching into Derm?

[PrincessLolo]

Hi guys!

I just got my step 1 score and ended w/ a 251. I am content with my score and was wondering if I have a chance of matching into derm.

I attend a well respected allopathic state school, have written 2 papers (working on my third one now). Passed all of pre-clinical courses (school does P/F). I have not started MS3 yet but I am planning on working hard and doing well in my clerkships.

I guess my question is what can I do to make myself a strong applicant if my score isn't good enough for derm?Do I even have a chance?

I would greatly appreciate any advice. Thanks in advance.

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[PhillyMed777]

There's nothing to evaluate to see if you can get into derm. All we have is your step score. Almost everyone who applies also has a strong one. Your step score is good but that won't get you into derm. It will more so prevent you from being ignored. Do well in clerkship and get AOA.

You need to impress your department, do derm research, do aways successfully, acquire extremely high quality letters of recommendation from well known attendings, and interview well. That is where the majority of the game is. Students from high end research schools are given a preference. Stop focusing on step 1 so much.

Currently over 50% take a dedicated derm research year. Certain locations like nyc greatly prefer a research year. Consider doing this. The percent is only going up. Good connections can be made thru this.

You have only won one battle with step 1. The war lies ahead. Was a very mentally brutal process and felt like I was walking on thin ice every second. Good luck. It is do-able even for ordinary people like me. Do your best. Good things come at a high cost.

 

[Foot Fetish]

There's nothing to evaluate to see if you can get into derm. All we have is your step score. Almost everyone who applies also has a strong one. Your step score is good but that won't get you into derm. It will more so prevent you from being ignored. Do well in clerkship and get AOA.

You need to impress your department, do derm research, do aways successfully, acquire extremely high quality letters of recommendation from well known attendings, and interview well. That is where the majority of the game is. Students from high end research schools are given a preference. Stop focusing on step 1 so much.

Currently over 50% take a dedicated derm research year. Certain locations like nyc greatly prefer a research year. Consider doing this. The percent is only going up. Good connections can be made thru this.

You have only won one battle with step 1. The war lies ahead. Was a very mentally brutal process and felt like I was walking on thin ice every second. Good luck. It is do-able even for ordinary people like me. Do your best. Good things come at a high cost.

I agree with all of this, but I just want to add a caveat that the value of the Step 1 score is not quite so black and white. 250 is now the average for derm, so yes, in OP's case he has indeed "checked the box." However, a score of 265+, for example, would absolutely not be considered equivalent. Super-scores have inherent value beyond just checking the box. I don't care what anyone says - scoring nearly a standard deviation above the average accepted score is impressive to the people reviewing your app, and the charting outcomes prove it: in 2016, 96% of US seniors who scored 260+ on Step 1 successfully matched derm vs. 86% of those with scores between 251 and 260. Big numbers turn heads.

 

[ERDOC555]

Agree 100% with what everyone said above

A 250 only makes sure that your application gets read in dermatology. It's not the head-turner auto-in that it may have been years ago. You've cleared the first major hurdle but there remains a lot between you and matching dermatology.

The rest is entirely dependent on your research, letters, AOA, clinical grades, and rotations. Good luck, it's stressful, but it's the price we have to pay to practice in the field that we love.

 

[theonlytycrane]

Not going for Derm, but I have a question about how people going for the super competitive specialties are able to get so many pubs? Do you just take on multiple projects throughout m1/m2? I ask because I'm heading into a summer project after m1 that I'm hopeful will lead to a paper, but I'm not sure when I'll have time to pick up much else (after m2/step?)

 

[PhillyMed777]

Not going for Derm, but I have a question about how people going for the super competitive specialties are able to get so many pubs? Do you just take on multiple projects throughout m1/m2? I ask because I'm heading into a summer project after m1 that I'm hopeful will lead to a paper, but I'm not sure when I'll have time to pick up much else (after m2/step?)

Although variable the best answer to that question is a research year. Can be very productive in one year.

 

[LoGo]

Volume business in med school comes down to 3 primary factors, with two modifiers:

1. Productivity of the group you’re working with (some also refer to this as just plain luck).
2. How willing you are to take on multiple small projects (eg. Narrative reviews, cases, quick chart review etc) vs putting your time towards more major projects which will have fewer but likely higher impact papers. There are pros and cons to both options.
3. Your own work ethic - people who publish a lot are always doing research. On lunch breaks, evenings, weekends, holidays etc.

Modifier 1: Research year - obviously more time = more papers.

Modifier 2: Prior significant research experience like a PhD or MPH epidemiology such that you can effectively do things independently and only occasionally need to consult your PI.

The modifiers aren’t necessary but they certainly help if research is the main goal.

 

[Amba]

I agree with all of this, but I just want to add a caveat that the value of the Step 1 score is not quite so black and white. 250 is now the average for derm, so yes, in OP's case he has indeed "checked the box." However, a score of 265+, for example, would absolutely not be considered equivalent. Super-scores have inherent value beyond just checking the box. I don't care what anyone says - scoring nearly a standard deviation above the average accepted score is impressive to the people reviewing your app, and the charting outcomes prove it: in 2016, 96% of US seniors who scored 260+ on Step 1 successfully matched derm vs. 86% of those with scores between 251 and 260. Big numbers turn heads.

Nope, you are just reinforcing your own misguided beliefs regarding what is important for Derm. I was around 1 SD above the mean for Derm and I can assure you that it's meaningless. Overall, everyone applying for Derm does very well on Step 1, to the point where it is almost a prerequisite. I know plenty of people who did "worse" than me who matched at stronger institutions, and I know two people with "better" scores who didn't match at all.

For what it's worth, my Step 1 score was mentioned at exactly zero derm interviews (TY programs, on the other hand, definitely care about Step).

Derm is all about having the prerequisite strong, well-rounded app and then 100% after that is connections + interview.

 

[doyouhaveaflag]

Nope, you are just reinforcing your own misguided beliefs regarding what is important for Derm. I was around 1 SD above the mean for Derm and I can assure you that it's meaningless. Overall, everyone applying for Derm does very well on Step 1, to the point where it is almost a prerequisite. I know plenty of people who did "worse" than me who matched at stronger institutions, and I know two people with "better" scores who didn't match at all.

For what it's worth, my Step 1 score was mentioned at exactly zero derm interviews (TY programs, on the other hand, definitely care about Step).

Derm is all about having the prerequisite strong, well-rounded app and then 100% after that is connections + interview.

I agree. Assuming derm is similar to plastics, the importance of step 1 score is way overblown by those who haven't been through the application process yet. Yes, you have to be within a certain (very high) score range to have your application looked at, but after that you get diminishing returns for the ultra high scores I think. I had a step 1 score 15 points higher than a girl I rotated with and we got very similar interview invites. In fact, she got a handful that I didn't and really wanted (and vice versa).

Although my experience was not in derm, my step 1 score was brought up only once on interviews by someone who said it was the highest among those interviewing that day. Wasn't sure what to say in response and it was weird. Interestingly, step 2 CK was brought up on 3 occasions. 2 of them asked me how I studied for it. I was always kinda curious what their aim was in asking about it.

 

[PhillyMed777]

Nope, you are just reinforcing your own misguided beliefs regarding what is important for Derm. I was around 1 SD above the mean for Derm and I can assure you that it's meaningless. Overall, everyone applying for Derm does very well on Step 1, to the point where it is almost a prerequisite. I know plenty of people who did "worse" than me who matched at stronger institutions, and I know two people with "better" scores who didn't match at all.

For what it's worth, my Step 1 score was mentioned at exactly zero derm interviews (TY programs, on the other hand, definitely care about Step).

Derm is all about having the prerequisite strong, well-rounded app and then 100% after that is connections + interview.

Absolutely correct
Many people who did not go thru the process continue to perpetuate sterotypes. I interviewed at 18 places and seeing where people ended up can absolutely conclude step 1 doesn't turn heads like some believe. It definitely won't turn my head when I review apps in 1 yr time

 

[ERDOC555]

Not going for Derm, but I have a question about how people going for the super competitive specialties are able to get so many pubs? Do you just take on multiple projects throughout m1/m2? I ask because I'm heading into a summer project after m1 that I'm hopeful will lead to a paper, but I'm not sure when I'll have time to pick up much else (after m2/step?)

For the most part yes. I started research on pretty much day 1 of medical school and was super productive for the first 1.75 years. I've put all my projects on hold until step 1, but the first 2 years are really the only good time to do research since it's so relaxed at many schools. People can and do pump out research 3rd year but it's infinitely harder since we're often in clinic 60-80 hours per week and that's not conducive for doing much besides case reports.

I think taking a research year is so popular because very few people who decide on derm after step 1 can rack up 15 pubs/posters in the little over 1 year before ERAS goes out.

tldr; most people need to start research hardcore years 1 and 2 if they want to match derm/plastics/etc.

 

[MilkIsGood]

Currently over 50% take a dedicated derm research year. Certain locations like nyc greatly prefer a research year. Consider doing this. The percent is only going up. Good connections can be made thru this.

is it really over 50% now? yikes

 

[PhillyMed777]

is it really over 50% now? yikes

Sadly...and I don't think it even includes phds, etc

 

[Foot Fetish]

Nope, you are just reinforcing your own misguided beliefs regarding what is important for Derm. I was around 1 SD above the mean for Derm and I can assure you that it's meaningless. Overall, everyone applying for Derm does very well on Step 1, to the point where it is almost a prerequisite. I know plenty of people who did "worse" than me who matched at stronger institutions, and I know two people with "better" scores who didn't match at all.

For what it's worth, my Step 1 score was mentioned at exactly zero derm interviews (TY programs, on the other hand, definitely care about Step).

Derm is all about having the prerequisite strong, well-rounded app and then 100% after that is connections + interview.

We don't have multivariable models to prove that Step 1 score >260 is an independent predictor of matching derm, but the 96% vs. 86% match rate is pretty compelling. Everyone who has argued otherwise in this thread has only given anecdotal evidence from their own experiences on the interview trail. There are plenty of anecdotes out there saying just the opposite, i.e. people with tons of research and stellar letters getting turned down for applicants with otherwise unremarkable apps but huge Step 1 scores. In the absence of any substantive evidence to the contrary, I will continue believing the null hypothesis (based on charting outcomes and residency director surveys) that Step 1 is the most important factor. Furthermore, I think this is in agreement with common sense -- everyone knows how easy it is to pump out case reports or chart reviews. Given enough time, anyone could do it. But most med students probably couldn't crack 270 on Step 1 if their life depended on it. Is a 250 plus a first author publication in Nature more impressive than a 275? Absolutely. But if we're being honest, a large portion of the research being put out by med students is very low quality and probably shouldn't have been published in the first place.

 

[doyouhaveaflag]

We don't have multivariable models to prove that Step 1 score >260 is an independent predictor of matching derm, but the 96% vs. 86% match rate is pretty compelling. Everyone who has argued otherwise in this thread has only given anecdotal evidence from their own experiences on the interview trail. There are plenty of anecdotes out there saying just the opposite, i.e. people with tons of research and stellar letters getting turned down for applicants with otherwise unremarkable apps but huge Step 1 scores. In the absence of any substantive evidence to the contrary, I will continue believing the null hypothesis (based on charting outcomes and residency director surveys) that Step 1 is the most important factor. Furthermore, I think this is in agreement with common sense -- everyone knows how easy it is to pump out case reports or chart reviews. Given enough time, anyone could do it. But most med students probably couldn't crack 270 on Step 1 if their life depended on it. Is a 250 plus a first author publication in Nature more impressive than a 275? Absolutely. But if we're being honest, a large portion of the research being put out by med students is very low quality and probably shouldn't have been published in the first place.

I'm not sure we can necessarily draw the conclusion that the difference in match rate between score >260 and 250-260 is due to step score alone (as was probably your point in mentioning lack of multivariable analyses). Too many potential confounders (perhaps those with >260 are also the people who published the most, go to the top schools, have the most connections, etc).

However, if you look at the Program Director's survey, while step 1 score is the factor most cited as being a factor in selection to interview (though here it doesn't specify that higher is better above a certain threshold), it's importance in interview selection is rated lower than letters of recommendation in the specialty, perceived commitment to specialty (and I think research fits here), and your performance at an away at that program.

After you interview, the top four most important factors in your rank at a program, and therefore your chances of matching there, are interactions with faculty during visit, interpersonal skills, interactions with house staff during visit, and feedback from current resident. All to do with personality and fit. Your step 1 score is way down the list of things that are important when PDs go to rank you.

http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

 

[ERDOC555]

Sure, I think that one can make a very valid argument for step scores being of minor importance after the interview, ie. No one is going to pick a 265 that they felt mediocre about at the interview over a 250 who really hit it off well with the faculty.

However, it's hard to argue that the odds of getting interviews in general don't go up with higher step scores. The only people I've ever met with 15+ interviews have had 260s, Most low 250s are sitting around 10, and most 240s are getting very few (again this is limited data from anecdotal experience). I'm sure there are 240s from top schools with research years that are mopping up 15+ interviews, but there are other factors at play there.

I would highly suspect that if you controlled for research output and other variables, 260s would get more interviews than 250s. It would be an interesting study to conduct, although I'm not sure how anyone could collect that data.

My hypothesis would be that with all things equal, applicants with 260+ step one would have significantly more interviews that those in the 250-254 range.

 

[LoGo]

Sadly...and I don't think it even includes phds, etc

Agree. The PhDs I know who matched did not do an extra research year. Probably fair to assume this is just the cost of doing business in derm. Most surgeons do fellowships, most dermatologists do a research year (or graduate degrees).

I also tend to agree with posters Re step 1 score. There’s a minimum score needed to be taken seriously and play ball, but probably not considered super heavily after that unless it’s an absurd score. There’s probably confounding factors like research that students with high step also have that obscure the interpretation of the data. Nonetheless, getting as high a step score as possible is obviously useful.

 

[doyouhaveaflag]

My hypothesis would be that with all things equal, applicants with 260+ step one would have significantly more interviews that those in the 250-254 range.

Well, yeah, 100% agree with this. If everything else is equal then step 1 would sway people to invite one applicant over another.

I guess what I was trying to articulate above is that PDs look at applications as a whole and consider more than just one number. I believe that the weight assigned to that one number is less than many people believe it to be when applications are reviewed, given that it's above a certain threshold.

I'm not a derm PD though, so I'm certainly no expert.

 

[Silvertear]

Sure, I think that one can make a very valid argument for step scores being of minor importance after the interview, ie. No one is going to pick a 265 that they felt mediocre about at the interview over a 250 who really hit it off well with the faculty.

However, it's hard to argue that the odds of getting interviews in general don't go up with higher step scores. The only people I've ever met with 15+ interviews have had 260s, Most low 250s are sitting around 10, and most 240s are getting very few (again this is limited data from anecdotal experience). I'm sure there are 240s from top schools with research years that are mopping up 15+ interviews, but there are other factors at play there.

I would highly suspect that if you controlled for research output and other variables, 260s would get more interviews than 250s. It would be an interesting study to conduct, although I'm not sure how anyone could collect that data.

My hypothesis would be that with all things equal, applicants with 260+ step one would have significantly more interviews that those in the 250-254 range.

It was definitely not this clear cut - that low 250's sit with around 10 interviews, 15+ going to 260's, etc. I went through the derm application process with a step score in the mid 250's but due to research and LoR's was able to get more than 20 interviews and match at a doximity top 10. In talking with many faculty, residents, and applicants, it does seem like step score these days is more of a "getting your foot in the door" vs wowing anyone. I know of at least two people who matched at what may be considered the "best" programs (UCSF, NYU) who scored in the 240's but were obv great in other aspects. In my experience, the people killing it with the number of interviews was not solely because of their step score. I'm not so sure you'd find a significant difference between someone scoring a 255 vs a 265, all things being equal - but there is virtually never a case where "all things are equal"

 

[ERDOC555]

It was definitely not this clear cut - that low 250's sit with around 10 interviews, 15+ going to 260's, etc. I went through the derm application process with a step score in the mid 250's but due to research and LoR's was able to get more than 20 interviews and match at a doximity top 10. In talking with many faculty, residents, and applicants, it does seem like step score these days is more of a "getting your foot in the door" vs wowing anyone. I know of at least two people who matched at what may be considered the "best" programs (UCSF, NYU) who scored in the 240's but were obv great in other aspects. In my experience, the people killing it with the number of interviews was not solely because of their step score. I'm not so sure you'd find a significant difference between someone scoring a 255 vs a 265, all things being equal - but there is virtually never a case where "all things are equal"

I feel like you may be misrepresenting my argument. I am not at all making hard guidelines or cutoffs as to how Step 1 correlates with interviews. I noted myself that really strong candidates with 240s can absolutely match very well and get many interviews. I was posting about my experiences around very average middle of the road candidates who are all pretty similar in terms of research and ECs, and saying that step 1 could be very important in separating these individuals.

I'm not trying to discount the other aspects of applications. In fact, school reputation, research output, letters, connections, etc play massive roles. I'm not saying they don't. Clearly a 242 with a solid research year at a good institution will get lots of interviews. In fact probably more than a 255 with average or below average research.

I'm not trying to over-simply anything. The only point that I'm trying to make is that a higher step 1 score likely increases the odds of matching for many candidates.