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I'm in my second year of med school, and I recently developed a strong interest in Dermatology. I enjoy so many things about dermatology: visual pattern recognition; an array of differential diagnoses to consider from many systemic diseases; large emphasis on oncology, pathology and immunology; breakthrough treatments; etc. I did an observership recently and have realized this is what I'd love to do. This also scares me now knowing that I'm gunning for a very competitive specialty...

I'm also interested in Pediatrics (which was my #1 choice before considering Derm). Now my plan is to apply for both Derm and Pediatrics since I could be happy in either specialty. I could tailor a career in Pediatrics around Derm (Allergy & Immunology, Rheumatology and/or Infectious Diseases) and vice-versa (Pediatric Dermatology).

 

My question is regarding the competitiveness of Dermatology applications. I am trying to set up additional observerships and  find ways to get some research in Derm before clerkship begins next year. However, being realistic, I'm not sure if I'll find many opportunities in that time frame. I have Pediatric research that I'm presenting at conferences this year, and it should be published by next year. Ironically, there are some dermatology findings in that research project, but they're not a major component by any means. My questions is whether missing out on research would put me largely out of the running for Derm.

 

Any thoughts or suggestions from Dermatology residents or upper year med students would be very appreciated.

Thanks!

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So yes, Derm is extremely competitive. Research is practically required. The odd candidate who is otherwise exceptional in all other capacities might have a shot, but it's a chance that's not worth taking. Having some relevant Peds research will help, but getting a Derm-focused project should be a priority. If Derm is your goal now, get whatever you can and make as many contacts as possible within the field. For better or worse, Derm is a dive-in-head-first field, you have to fight a bit for those opportunities.

 

Backing up with Pediatrics is a bit of a risky proposition. Not impossible, but not much of a safety net either. Peds is reasonably competitive on its own and not a common back-up choice. It would be very difficult to make yourself competitive for both Derm and Peds simultaneously - through your elective choices, you're likely to take yourself out of the running for one anyway. Even if you somehow were able to give yourself a decent shot at both, Derm has about a 50% match rate, Peds about 70% - on stats alone, that's about a 15% chance of going unmatched entirely. It's fine to keep both of those as considerations for now, but as you start going through 3rd year, I would strongly recommend picking one or the other. When people back up after applying to Derm, it's typically backing up into FM.

 

Lastly, keep in mind that Pediatric Dermatologists are not common - there's maybe a dozen or two in the entire country. There are more people in Peds ID, Rheum, and Allergy/Immunology, but it's still a fairly specialized field. Those super-specialized career paths come with their own challenges that may not be apparent early on in training. Just make sure you explore what those career paths entail and see if you'd be happy with the more likely alternatives after matching into Derm/Peds - namely, becoming a general Dermatologist or Pediatrician.

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So yes, Derm is extremely competitive. Research is practically required. The odd candidate who is otherwise exceptional in all other capacities might have a shot, but it's a chance that's not worth taking. Having some relevant Peds research will help, but getting a Derm-focused project should be a priority. If Derm is your goal now, get whatever you can and make as many contacts as possible within the field. For better or worse, Derm is a dive-in-head-first field, you have to fight a bit for those opportunities.

 

Backing up with Pediatrics is a bit of a risky proposition. Not impossible, but not much of a safety net either. Peds is reasonably competitive on its own and not a common back-up choice. It would be very difficult to make yourself competitive for both Derm and Peds simultaneously - through your elective choices, you're likely to take yourself out of the running for one anyway. Even if you somehow were able to give yourself a decent shot at both, Derm has about a 50% match rate, Peds about 70% - on stats alone, that's about a 15% chance of going unmatched entirely. It's fine to keep both of those as considerations for now, but as you start going through 3rd year, I would strongly recommend picking one or the other. When people back up after applying to Derm, it's typically backing up into FM.

 

Lastly, keep in mind that Pediatric Dermatologists are not common - there's maybe a dozen or two in the entire country. There are more people in Peds ID, Rheum, and Allergy/Immunology, but it's still a fairly specialized field. Those super-specialized career paths come with their own challenges that may not be apparent early on in training. Just make sure you explore what those career paths entail and see if you'd be happy with the more likely alternatives after matching into Derm/Peds - namely, becoming a general Dermatologist or Pediatrician.

Thanks for the reply! It's quite challenging to fight for those opportunities, so hopefully some will come through this year.

 

I agree that logistics once selecting electives will be hard to coordinate if aiming for both Dermatology and Pediatrics. However, based on my experiences so far, I know I'll have a strong case for Pediatrics so long as I do well on rotations and get a few electives across the country. It's Dermatology that will be much harder to stand out in. Furthermore, while pursuing a specialized career is more difficult, I can try booking Pediatric Derm (which there are many more of than 12 across the country haha...), Allergy, ID, and/or Rheum electives during CaRMS to show balanced interests.

I'm also very flexible in terms of my specific career following CaRMS. I was just making a point how, if I did aim for both, that I could tailor my interests to either specialty. Clerkship will help me figure out more what I want to do, but right now I can't picture myself doing anything other than Dermatology or Pediatrics (and I have explored many avenues already).

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I went into CaRMS applying to dermatology with paediatrics as my backup. I had multiple interviews in both, so it is not an impossible feat (and I am not a big researcher). If you can't find dermatology observerships before clerkship that will be ok. Just work hard to get derm electives across the country and put in the effort while you are on service. 

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I went into CaRMS applying to dermatology with paediatrics as my backup. I had multiple interviews in both, so it is not an impossible feat (and I am not a big researcher). If you can't find dermatology observerships before clerkship that will be ok. Just work hard to get derm electives across the country and put in the effort while you are on service. 

 

That's a tough line to walk! I know several Peds programs that would not look favourably on a candidate with the number of Derm electives necessary to be competitive for that specialty, even with a few good Peds electives. Out of interest - and hopefully relevant for the OP - what was your breakdown of electives?

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Thanks for the reply! It's quite challenging to fight for those opportunities, so hopefully some will come through this year.

 

I agree that logistics once selecting electives will be hard to coordinate if aiming for both Dermatology and Pediatrics. However, based on my experiences so far, I know I'll have a strong case for Pediatrics so long as I do well on rotations and get a few electives across the country. It's Dermatology that will be much harder to stand out in. Furthermore, while pursuing a specialized career is more difficult, I can try booking Pediatric Derm (which there are many more of than 12 across the country haha...), Allergy, ID, and/or Rheum electives during CaRMS to show balanced interests.

I'm also very flexible in terms of my specific career following CaRMS. I was just making a point how, if I did aim for both, that I could tailor my interests to either specialty. Clerkship will help me figure out more what I want to do, but right now I can't picture myself doing anything other than Dermatology or Pediatrics (and I have explored many avenues already).

I would argue this is the exact opposite of balanced interest. Combine these with 3-4 derm electives and your application spells Derm Gunner, or in your words: "I can't picture myself doing anything other than Dermatology." Not sure what the best approach is, but my thought is who cares what your non-derm electives are in. Do what you like. Whether you do a rheum/ID/allergy elective vs en ER vs a psych vs a peds vs surgery etc is not going to make you match - research/CV, letters on derm service and interview will be what counts. For the same reasons, if rheum/ID/allergy is what you like then by all means do them. I just think the non derm electives don't really matter and should be more for your interest than anything else. 

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I would argue this is the exact opposite of balanced interest. Combine these with 3-4 derm electives and your application spells Derm Gunner, or in your words: "I can't picture myself doing anything other than Dermatology." Not sure what the best approach is, but my thought is who cares what your non-derm electives are in. Do what you like. Whether you do a rheum/ID/allergy elective vs en ER vs a psych vs a peds vs surgery etc is not going to make you match - research/CV, letters on derm service and interview will be what counts. For the same reasons, if rheum/ID/allergy is what you like then by all means do them. I just think the non derm electives don't really matter and should be more for your interest than anything else. 

Very true that those choices could make me misconstrued as a sole Derm gunner. However, my plan is to aim for both Derm and Ped's (i could see myself happy in either career even if Derm is my #1 choice), so I could do Ped's Rheum/ID/Allergy electives and Ped's Derm electives to support my interests in both areas (while also doing a couple other electives in General Ped's and/or Derm). However, these decisions are premature and largely depend on what selection will even be available across the country...

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That's a tough line to walk! I know several Peds programs that would not look favourably on a candidate with the number of Derm electives necessary to be competitive for that specialty, even with a few good Peds electives. Out of interest - and hopefully relevant for the OP - what was your breakdown of electives?

 

peds respirology

peds ID

peds derm (4 weeks)

 

adult allergy/immunology

 

7 weeks of adult derm

 

I was surprised at how many interviews I got in peds (10!), if you apply broadly in both fields it can be a reasonable choice. 

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peds respirology

peds ID

peds derm (4 weeks)

 

adult allergy/immunology

 

7 weeks of adult derm

 

I was surprised at how many interviews I got in peds (10!), if you apply broadly in both fields it can be a reasonable choice. 

Did you do a lot of research derm related?

In your opinion, would McGill, in this current cycle consider candidates with a similar elective history such as yours?

(I'm not interested in Derm, just asking for my own curiosity)

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Did you do a lot of research derm related?

In your opinion, would McGill, in this current cycle consider candidates with a similar elective history such as yours?

(I'm not interested in Derm, just asking for my own curiosity)

 

I did a bit of research, nothing to write home about and nothing to stand out compared to some of the applicants

McGill tends to choose people they want to work with and have as colleagues, so electives are much more important 

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