What do unmatched derm applicants usually do?

[JustSomePreMed]

I guess the idea that there are a bunch of applicants with super high Step I scores who go unmatched each year is a bit frightening to me. What are the common "outcomes" for students who fail to match the first time around in derm? I understand there are year-long research fellowships, but I feel like those things would've already had to have been in place by the time match day would roll around, no?

Sorry for such a basic question. Also, ignore my username, I made it several years ago before starting medical school.

---

Members don't see this ad.

 

[Sol Rosenberg]

I think the most common are:

1. Prelim (Usually Medicine) -> Research Fellowship -> PGY2 Derm is one path with a happy ending, and one that advisors seem to say happens very commonly (but I doubt this, maybe because I personally don't know anybody who has successfully completed this path.)

2. Prelim (Usually Medicine) -> Categorical Medicine is what I suspect happens more often.

I know some (OK just 2) people that managed to land a PGY2 Derm spot after completing a categorical IM residency, but this is rare.

 

[vicinihil]

2 students from my school didn't match last year, went on to do a Prelim Medicine year, matched PGY2 Derm this year. Not sure if it's what's common, but my advisor and student dean have echoed the same path.

PGY1 Medicine--> PGY2 Derm.

 

[smiley737]

The fellowship route does actually seem pretty successful. The last Hopkins fellow and UCSF fellow both matched at those programs

 

[JustSomePreMed]

I guess it's just very unnerving to think about so many unhappy, unmatched overachievers. I feel like it's a good idea to have a strong contingency plan when applying for derm, so that you're not left completely dumbfounded and resourceless should the unthinkable happen and you do not match.

I'm somewhat new to the world of derm (I was originally interested in a different but very competitive specialty), and I'm doing my best to get involved in some derm research and clinical activities. I'm just trying to figure out what I should be doing to ensure that, in the event I don't match, I can still have a productive year before trying again.

Any suggestions on what to be doing at this point to prepare for that? (I'm an M3). Obviously I want to be optimistic about my chances, but I've always found it a good idea to hope/expect for the best while preparing for the worst.

 

[SierraPoppa]

I guess it's just very unnerving to think about so many unhappy, unmatched overachievers. I feel like it's a good idea to have a strong contingency plan when applying for derm, so that you're not left completely dumbfounded and resourceless should the unthinkable happen and you do not match.

I'm somewhat new to the world of derm (I was originally interested in a different but very competitive specialty), and I'm doing my best to get involved in some derm research and clinical activities. I'm just trying to figure out what I should be doing to ensure that, in the event I don't match, I can still have a productive year before trying again.

Any suggestions on what to be doing at this point to prepare for that? (I'm an M3). Obviously I want to be optimistic about my chances, but I've always found it a good idea to hope/expect for the best while preparing for the worst.

If there's another specialty in which you've invested a lot of time and personal commitment and in which you're still interested, I would apply to both. I had a backup plan (a second ROAD specialty, not medicine), and while you'll probably catch some flak for it on this board it's not uncommon. Derm has one of the highest double-specialty application rates of all the residencies.

Folks like to say things about "dedication to the specialty" and how they'll try forever to get in, but that's just not practical. I don't remember what the re-applicant match rate is, but it's very low (less than 10% if I remember). Your loans will come due and you'll have an even smaller chance of getting in each successive year you apply.

Obviously, if you decide to do this, keep it to yourself. Don't mention it in interviews or you won't be ranked. Dermies are very sensitive about you having a backup. I went so far as to not tell anyone at my school, because rumors spread here faster than VD and some derm applicants are cold enough to go tell the department if they hear about it.

 

[ShaveBiopsy]

i don't think it's that bad...this is overly dramaticized...everyone that i know that didn't match in med school matched the 2nd time after doing a fellowship or just intern year

 

[FixItUp Chappie]

From this study (2006) it looks like about 21% of reapplicants matched. This highlights various characteristics that may help your chances.


Arch Dermatol. 2011 Feb;147(2):196-202. Epub 2010 Oct 18.
Factors associated with successful matching to dermatology residency programs by reapplicants and other applicants who previously graduated from medical school.

Stratman EJ, Ness RM.
Source

Department of Dermatology (4K5), Marshfield Clinic, Marshfield, WI 54449, USA. [email protected]

Abstract

OBJECTIVES:

To identify factors associated with and not associated with successful matching and matriculation (hereinafter "matching") to dermatology residency programs for applicants who previously graduated from medical school and to distinguish which factors are within applicants' control.
DESIGN:

Observational cohort study.
SETTING:

Six accredited academic dermatology residency training programs in the United States.
PARTICIPANTS:

A total of 221 residency applicants who previously graduated from medical school and who applied through standardized electronic application to 1 or more of the participating residency training programs.
MAIN OUTCOME MEASURE:

Matriculation to a dermatology residency program by August 2008 following the 2006 residency application period.
RESULTS:

Forty-six of 221 former medical school graduates included in this study matched to a dermatology residency program. Factors strongly associated with matching included United States Medical Licensing Examination Step 3 score; submission of letters written by dermatologists from institutions that train dermatology residents; completion of preliminary medicine internships rather than transitional or other internship types; listing of research experience; publishing of medical manuscripts; and completion of non-Accreditation Council for Graduate Medical Examination dermatology fellowships. Factors not associated with increased matching included volunteer work; PhD status; sex; number of posters or presentations at dermatology conferences; quality of journal publications; and first authorship. Most successful applicants limited personal statements to 1 page and did not mention previously failing to match. The study sample represented at least 86% of such nontraditional applicants who matched in 2006.
CONCLUSIONS:

For candidates seeking to match into dermatology residency programs after graduating from medical school, there are factors within their control that are associated with higher rates of match success. This study provides evidence to assist mentors who counsel such candidates.
©2011 American Medical Association. All rights reserved.

PMID: 20956631 [PubMed - indexed for MEDLINE]

 

[jiggabot]

So if I don't match and I do a Prelim (IM) year --> research fellowship,

what happens then? I apply in September of my research fellowship year and obtain a PGY-2 spot for next July (10 months later)? or is the PGY-2 spot for the July a year later (22 months)?

 

[asmallchild]

So if I don't match and I do a Prelim (IM) year --> research fellowship,

what happens then? I apply in September of my research fellowship year and obtain a PGY-2 spot for next July (10 months later)? or is the PGY-2 spot for the July a year later (22 months)?

It will be for the PGY-2 spot a year later (22 months).

So I've known people who have opted to continue research for another year (especially if it's a paid position)

For those who have the means, I've also known people to take that year off for traveling or other personal enjoyment.

And sometimes, positions will open up outside the match so taht you can start 10 months later

 

[jiggabot]

It will be for the PGY-2 spot a year later (22 months).

So I've known people who have opted to continue research for another year (especially if it's a paid position)

For those who have the means, I've also known people to take that year off for traveling or other personal enjoyment.

And sometimes, positions will open up outside the match so taht you can start 10 months later

Wouldn't I save more time just doing med school for 5 years including one year of research, instead of spending 2 years after my prelim year? Or does that significantly reduce my chances compared to doing a prelim year?

Also, I've heard varying things about reapplying, some saying that your chances are much lower, some saying that with a fellowship it is 90% +. Which is true?

 

[asmallchild]

Wouldn't I save more time just doing med school for 5 years including one year of research, instead of spending 2 years after my prelim year? Or does that significantly reduce my chances compared to doing a prelim year?

Also, I've heard varying things about reapplying, some saying that your chances are much lower, some saying that with a fellowship it is 90% +. Which is true?

My medical school dean was a huge advocate of taking 1 yr off while in medical school to avoid the potential heartbreak of not matching. Taking 1 yr off doesn't guarantee you anything but it's something special you can sport on your CV (obviously, getting publications is good but the act of taking 1 yr off for research alone may show added commitment over someone who doesn't)

In terms of reapplying, it is a mixed bag. I believe there was a JAAD article sometime in the past year talking about reapplication and I do believe the numbers show that your best chance is the 1st time while you are in medical school.

That being said, my chair does offer that # of "90%" if you do a research fellowship.

In the end, I think persistence and communicating with the right people are the keys whether you are a 1st time applicant or reapplicant.

 

[opencomedo]

The problem with doing a 5th year for research instead of graduating is that some research fellowships want an M.D. and someone who has done an intern year that way you can write for medications and things like that b/c they do lots of clinical trials (or so I've heard). Of course there's nothing to stop you from doing a 5th year, then applying, then doing the stuff noted above if you don't match.

 

[Gracile]

For those who took a year off for research during med school, did most participate in NIH/Doris Duke/HHMI? I'm considering taking a year off.

Thanks!

 

[LigamentumTeres]

For those who took a year off for research during med school, did most participate in NIH/Doris Duke/HHMI? I'm considering taking a year off.

Thanks!

Looking forward to the answer to this too!!

 

[Renova]

That being said, my chair does offer that # of "90%" if you do a research fellowship.

I had heard the 90% figure as well, but there's a paper in the Archives from February looking at factors that impact success rates among reapplicants. While they did find that doing a research fellowship does significantly increase your chance of matching, only 35% (11 out of 31) of research fellows in their cohort matched.

http://archderm.ama-assn.org/cgi/content/abstract/147/2/196

EDIT
Just saw that someone had already posted the paper.

 

[volcoff]

I'd recommend taking a year off during medical school if needed versus a research fellowship. IMO there appears to be a stigma associated with not matching (which increases the more time you reapply). I've seen individuals who have done a research fellowship and have numerous publications, decent scores, and many derm-related extracurriculars, that end up not getting as many interviews as applicants right out of med school with far fewer credentials and demonstrated interest. You really want to put your best foot forward the first time around.

 

[dermathalon]

I had heard the 90% figure as well, but there's a paper in the Archives from February looking at factors that impact success rates among reapplicants. While they did find that doing a research fellowship does significantly increase your chance of matching, only 35% (11 out of 31) of research fellows in their cohort matched.

http://archderm.ama-assn.org/cgi/content/abstract/147/2/196

EDIT
Just saw that someone had already posted the paper.

I read this paper too and IMHO it's not that great of a study if you are looking for accurate percentages. They only took six institutions into account which creates more bias in the final data. Qualitatively interesting but quantitatively not so hot.

 

[SierraPoppa]

The "5th year vs research fellowship" question overlooks the fact that most people only do a research fellowship after not matching, while the 5th year is obviously before matching.

It sounds like you're thinking about restructuring your med school timetable on the assumption that you won't match. Also, the 2 people I knew who took a year off to do research (not derm) ended up with no first-author pubs and a lot of disappointment, so I personally would not take that route. You'll also use up your grace period on your loans during that year, I believe, which is something to think about if you're a mere financial mortal like me.

Back to the research fellow question, I don't have a study or hard numbers for you, but the school where I did an away rotation had a research fellow who had failed to match 2 times AT THAT PROGRAM, AS THEIR RESEARCH FELLOW! This person just kept rolling into another year of research fellowship, hoping they'd change their mind next year. She was in year 3 when I was there, planning on a 4th if the match didn't go her way.

 

[Brachyury]

The "5th year vs research fellowship" question overlooks the fact that most people only do a research fellowship after not matching, while the 5th year is obviously before matching.

It sounds like you're thinking about restructuring your med school timetable on the assumption that you won't match. Also, the 2 people I knew who took a year off to do research (not derm) ended up with no first-author pubs and a lot of disappointment, so I personally would not take that route. You'll also use up your grace period on your loans during that year, I believe, which is something to think about if you're a mere financial mortal like me.

Back to the research fellow question, I don't have a study or hard numbers for you, but the school where I did an away rotation had a research fellow who had failed to match 2 times AT THAT PROGRAM, AS THEIR RESEARCH FELLOW! This person just kept rolling into another year of research fellowship, hoping they'd change their mind next year. She was in year 3 when I was there, planning on a 4th if the match didn't go her way.

During the year, your loans are deferred because you are still in an academic program (assuming it is through an organization like DD, NIH, or HHMI). The grace period is the time between when you finish school and before you have to start payment on your loans.

 

[SierraPoppa]

During the year, your loans are deferred because you are still in an academic program (assuming it is through an organization like DD, NIH, or HHMI). The grace period is the time between when you finish school and before you have to start payment on your loans.

You may be right about deferrment while doing research, but you're wrong about it only starting after you finish school. One of the residents in my prelim took a year off during med school for personal reasons, and that used up her grace period. Most of us who just graduated aren't paying on our loans yet, but she had to start right away.

Anyone who's thinking of doing this should definitely seek the opinion of a loan advisor or someone with intimate knowledge of the process to make sure you don't accidentally use up a grace period you need later.

 

[Brachyury]

You may be right about deferrment while doing research, but you're wrong about it only starting after you finish school. One of the residents in my prelim took a year off during med school for personal reasons, and that used up her grace period. Most of us who just graduated aren't paying on our loans yet, but she had to start right away.

Anyone who's thinking of doing this should definitely seek the opinion of a loan advisor or someone with intimate knowledge of the process to make sure you don't accidentally use up a grace period you need later.

I'm confused (sorry), but if you do a HHMI, DD, Sarnoff, etc, your loans will continue to be deferred, so the issue of a grace period should not be a problem. Besides, with federal loans, when you are in repayment (or a grace period), if you re-enter a situation where they are able to defer (such as your fourth year), once that deferrment ends, you'll re-enter a new grace period. Are you talking about a post-intern year research fellowship? Did this person do a non-HHMI, NIH, DD fellowship? Thanks!