From this old article on matching into derm:
http://www.studentdoctor.net/2009/10/the-successful-match-getting-into-dermatology/
"In 2007, out of 407 U.S. seniors applying to dermatology, 158 failed to match (39% of U.S. senior applicants).7 Applicants who fail to match often wish to reapply the following year. What can these applicants do to strengthen their application?
There are certainly a number of dermatology fellowships out there. It's been documented that applicants who complete these fellowships have a higher match rate the second time around. I think that's probably because you get to know the director well, and since they know how you work and how you produce results, they can write you a better letter of recommendation. I've also seen some individuals plan to do degree-producing programs, such as a Masters of Public Health, or a program with a focus in biostatistics or epidemiology.
There are certain objective measures that can't be changed. You can't change the Dean's letter, you can't change your board scores, and you can't be AOA the second time around. However, you can publish and get new letters of recommendation. These are ways to strengthen your application.
Some applicants who fail to match pursue a pre-residency dermatology fellowship. In a recent survey of fellowship directors, it was learned that 92% of past fellows (176/190) were able to match successfully following completion of the fellowship.8 How can applicants make the most of these fellowships?
Most of these fellowships are directed by individuals that are fairly well-known in their specialty. A letter of recommendation from a faculty member that spent months, or sometimes a year, with an applicant is a very valuable resource. That's going to be more information than the prior application, and the letter writer is able to be very rich in their detail about what supports the positive things that they say about the applicant. We look very closely at that.
Many fellowships are directed by some very productive members of our specialty. If the director is known for publishing, putting abstracts in meetings, and making headway in addressing different questions, then it's expected that the applicant will have participated in those results.
There may be interview questions such as "why do you think you didn't match?" There are certainly applicants who don't match who have fantastic records, and for some reason they just didn't make it. There may be cases where you cannot say that's the reason I didn't get in. But if there were an item or items that weren't so good, then you have to plan to address those. You can't change those items, but another way to address prior performance is to demonstrate in a more current job that you can do the work, and you can do it well."
Also from this article on getting into ophtho:
http://www.studentdoctor.net/2009/0...w-with-dr-andrew-lee-ophthalmology/#more-2018
"Applicants who fail to match often wonder how they should spend the year before they reapply. What recommendations can you offer to these applicants?
The best chance for a match in ophthalmology is as a first time US senior medical student. The match rate drops off precipitously after this first application. The second application needs to be better than the first application if the second time applicant is to be successful. This means demonstrating perseverance, passion, and persistence through a research year in ophthalmology (e.g., a clinical or bench project), a pre-residency fellowship (e.g., ocular pathology), or an observational fellowship combined with the above. The "brick walls" in the process are meant to keep the other people out (i.e., those who don't want it as badly or who fail to make a significant improvement in their application)."