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IM and derm exam


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Hi everyone. I am currently finishing my first year of IM, which I matched into after not matching into my first choice desired speciality - Derm. I still love derm lots, tried to transfer but was declined funding by the PGME. 
 

My question is a bit complicated. If I pursue a 5 year GIM and do a bunch of dermatology as part of those 2 years of fellowship, can I theoretically write the Dermatology Royal College exam and specialize in Derm that way? I looked at the Royal College requirements and their only two criteria for being RC certified is successfully writing the exam and “meeting the Dermatology portfolio”, which is really geared towards mirroring a typical Derm residency program; but it came across vague and the takeaway message was “demonstrated competency and training in Dermatology”. 
 

I have previously heard of people writing Royal College exams in specialties they didn’t directly train in. I understand this is extraordinarily difficult. I’m wondering if this is theoretically possible. Thank you in advance! 

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7 hours ago, peony1357 said:

“meeting the Dermatology portfolio”, which is really geared towards mirroring a typical Derm residency program

It does mention specific training experiences, some of which might be  challenging to obtain without being a derm or affiliated resident (i.e dermatopathology, derm surgery). It also has surgical and pediatric requirements in basic clinical year. There will also be the challenge of competing for derm electives (yes, even in residency, some are hard to get) as derm residents are prioritized (anecdotal). You may also have limits of the number of OOP electives you can do to seek electives outside of your province.

UBC does have a derm re-entry program that starts at PGY-3, with the requirement of finishing a prior residency program and then practicing for 1 year. Maybe it would be easier to graduate your program, do 1 year as an internist / do 1 more year for GIM + 1 year of practice and apply for that?

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Looking at it the Derm portfolio is ALL EPAs across the entire residency. I don't have any insight into your question directly but I can't see a Derm program willing to condense 5 years of Derm training into the typical amount of elective time available in a GIM residency (let's say 12 blocks very charitably), and a bunch of the EPAs in there are longitudinal. That would be the equivalent of the Derm residency essentially saying Derm residency should only be 1 year of actual Derm. 

Anedotal, but I worked with a 4 year who did a bunch of acne because "I'm interested in it" so you might be able to do some limited Derm scope stuff as a outpatient focused IM. 

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9 hours ago, peony1357 said:

Hi everyone. I am currently finishing my first year of IM, which I matched into after not matching into my first choice desired speciality - Derm. I still love derm lots, tried to transfer but was declined funding by the PGME. 
 

My question is a bit complicated. If I pursue a 5 year GIM and do a bunch of dermatology as part of those 2 years of fellowship, can I theoretically write the Dermatology Royal College exam and specialize in Derm that way? I looked at the Royal College requirements and their only two criteria for being RC certified is successfully writing the exam and “meeting the Dermatology portfolio”, which is really geared towards mirroring a typical Derm residency program; but it came across vague and the takeaway message was “demonstrated competency and training in Dermatology”. 
 

I have previously heard of people writing Royal College exams in specialties they didn’t directly train in. I understand this is extraordinarily difficult. I’m wondering if this is theoretically possible. Thank you in advance! 

I would be *shocked* if this was allowed in any way by derm (they are very very good at protecting their turf). Unfortunately I don't think this is possible.

If you truly want to still pursue derm there are a couple of avenues:

1. finish residency and practice for 1 year and then try via the provinces re-entry/training pathway. This still depends on funding from PGME, and don't think it would be easy to do for a specialty like derm

2. Go to the U.S. (which again will be uber competitive), or other out of country options.

if you want my two cents and are willing to do more a medical derm practice: do GIM, potentially the 5 year, do all your electives/selectives in derm and related derm specialities (Rheum, ID, Plastics, Path?) and maybe find a pseudo fellowship training to get very comfortable/proficient with derm. Enter practice and focus your practice on this area (derm and specifically medical dermatology). You wont be a dermatologist, or as experienced/proficient as one, but no one will stop you from doing this, and you will still get *tons* of referrals/cases (there is a shortage of derm)

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