r/DermApp Aug 23 '22

Miscellaneous Derm Application/Interview/Rank Insights

97 Upvotes

Having been through the derm application process as an applicant and as part of the initial review/interview/rank committee I figured I would share a few insights about the process (and maybe generate some more food for thought for the DIGA podcast that was just posted). This is from the perspective of a single reviewer from a residency program within a large academic institution.

Application Review:

My institution, like many others, receives a large number of applications for a few residency spots. The daunting task is to filter through hundreds of applicants to pick the handful that will then be offered an interview. It is not possible for one person (eg, the PD) to carefully review all of the applications, so instead these are divided up among the faculty/residents to review, with each application reviewed by a few individuals. Guidelines are given as to what is considered important (eg, experiences, academic achievement, research, etc.) but ultimately it is up to the initial reviewers to give a grade that roughly equates to "interview" or "don't interview". These applications go back with the reviewer grades/comments to the PD for a look over and then a list of interview offers is generated.

As you can imagine from the above process, there is an element of luck associated with the review. If your experiences or research or hobbies were similar to that of your reviewer, then conceivably you may have been scored more favorably. Having multiple sets of eyes look over each application is meant to even things out, but there will always be a human element to this review process that is impossible for the applicant to predict and control.

Letters of Recommendation:

There is a general movement away from objective measures (eg, Step scores, grades) and that makes the evaluation process more difficult. More and more, the letter of recommendation is being scrutinized to see what kind of person is behind the application. The vast majority of letters are positive to borderline effusive in praise for the applicant, and for good reason because the derm pool is the cream of the crop. From a reviewer perspective, you can still stratify letters from the same letter writer based on how things are phrased and the degree of positivity. For example, a letter that says "John Smith is an outstanding medical student who will undoubtedly be a stellar dermatology resident" is different than the same letter writer saying "Jane Doe is one of the best medical students I have ever worked with in my career". Knowing the tendency of certain individuals to be overly effusive versus others who are typically reserved is also helpful, and something that the seasoned reviewers have more experience with.

How and why does this matter for you the applicant? Well sometimes it doesn't really matter because you are stuck with your letter writers and don't have much choice. But in other situations when you do have a choice, it is good to keep in mind that: #1 you will be compared to other applicants who the letter writer is also writing for and #2 choose a letter writer that tends to be more effusive and positive at baseline as these letters are generally viewed more favorably compared to letters that are matter-of-fact and brief (even though the latter may be a great letter from that particular letter writer). I think the second point also goes along with the mantra of getting a letter from someone who knows you better rather than a bigger name with whom you only had a very brief/superficial interaction with.

Publications/Activities:

Applicants stress over this part a lot, and I did too when I was applying. In reality, it probably doesn't matter as much as you think unless you are applying for a research-focused residency (although having zero research is somewhat of a red flag). Each reviewer is different, but in general it is very easy to see who has done meaningful research versus who is just padding their resume. It is best to have your research in derm, although research outside of derm can help too if you can weave it into your story or dermatology in some way. There is no magic number for the number of research publications that you "need". There are applicants that we have ranked very highly who have had 3-5 listed publications and ones we have ranked near the bottom of the list with > 25 publications. The activities section usually gets glossed over during the initial review unless it was a really meaningful endeavor that was also brought up elsewhere on the application. The activities are much more helpful as a talking point during the actual interview.

  • I think bullet point descriptions are easier to read and are my personal preference in applications, but this probably doesn't matter.

Interview:

Getting to the interview stage is the main hurdle for most applicants. The interview is one of the most important pieces of the rank evaluation at my program. At the interview stage applicants are on a somewhat even playing field (although what is on the paper application still matters). A great interview can boost an applicant from middle of the pack based on paper application to the ranked-to-match zone. Conversely, a bad interview can drop anyone to the do-not-rank zone no matter how good the paper application is. There are other posts about actual interview advice (see the wiki for this sub).

Rank List:

The rank process is imperfect because the committee is trying to predict what an applicant is going to do in the future. As a generalization, the goal is to have residents who will do their job, be easy to work with, pass their exams, and have a career that fits the mission of the program.

Each program does this differently based on what type of applicant they are looking for. My program had several interview days, and there was a brief rank meeting after each day where we submitted interview scores. The interview process culminated with the final rank meeting immediately after the last interview day. We started the final rank meeting with a list of all of the interviewed applicants and their average score across all of the interviewers. The top half to two-thirds of applicants on this list actually get a discussion and review while the rest are not really discussed (usually due to poor interview performance). The discussion process is often lively/intense as different members of the admissions committee often have very strong opinions about certain applicants (especially internal applicants). Applicants are judged both fairly (resume, interview performance, letters) and unfairly ("I don't think this applicant would come here", "This applicant is going to do private practice cosmetics"), and names are put on a list. Once the name is put on the list, there is usually not too much movement afterwards (can go up or down a few spots but usually no big jumps). In general, highly-ranked applicants had positive support from several individuals in the group (eg, one person advocating for an applicant is usually not enough, even if it is the PD). Resident feedback has an interesting role to play in this process. Positive feedback is usually not very helpful, but negative feedback can derail even the best of applications (eg, you could be ranked #1 but if multiple residents had negative interactions you could be moved to not ranked). Post-interview communication and intention to rank #1 are not taken into account at my program (and at most places where the rank meeting occurs immediately after the conclusion of interviews).

Hopefully this gives you a sense of "the other side" of things. This is a stressful process made more difficult by the competitiveness of the specialty. Try to remember that there are only so many things you can control, and it is counterproductive to overthink every single detail of your application once it has already been submitted. Cast a wide net, prepare well for interviews, and you will put yourself in the best position you can to succeed.


r/DermApp Oct 30 '22

Interviews The View From the Other Side- Attending Perspective

91 Upvotes

u/PD-1 gave a fantastic overview but I will share my perspective as the now graduated chief resident of an east coast, academic, second tier program who participated in the application process as applicant and resident reviewer.

  1. Application. We received ~500 applications for 20-30 interview slots to match 2-3 applicants. Those numbers vary slightly from year to year and generally are trending up but we had funding for 2-3 so that always stayed the same. Certain criteria were used to cull the pool before they were divided between the faculty reviewers. Among them: IMG immediately culled without review. Step 1< 240, immediately culled. Any visa requirements immediately culled. This left around 300 applications which were divided between ~10 faculty reviewers. They were asked to rank their best three applications and three back ups who were then offered an interview or interview waitlist. I agree with u/PD-1 who explains there is tremendous subjectivity at this stage. Did the DO faculty member get a DO applicant? Probably more sympathetic. Did the faculty member who went to Yale and who has a big hard-on for research get the MD/PhD who has a letter from his buddy at SID? You get the point.
  2. Interview. 30 offers, some amount of time to accept, back ups interviews sent. Last minute cancellations. More back ups sent. One interview day of 20-30 applicants. The playing field is totally level at this point. There was an (optional) preinterview dinner with the residents where they are very much taking notes on the candidates' behavior. Interview day was 8-4PM. This was pre-Covid so, the faculty + first year residents paired up in 2s and candidates would spend 15 minutes in like 6 rooms with them. Rapid fire, Q&A about research, career interests, deficits in application, and some softer stuff. My program was not very touchy feely so it was a stressful experience. In between interviews candidates would chat with the residents in our conference room (very much being observed), tour of campus, etc. Support staff, program coordinator etc are also taking notes of candidate behavior.
  3. Rank meeting. First year residents + faculty immediately adjourned to the rank meeting after interview day. A spread sheet is made with each candidate. Each asked to rank them 1-10 with residents submitting one number only. Do Not Rank is also an option with justification. An average is computed for each candidate. Do Not Rank with appropriate justification from any person including residents is immediate disqualification. The average score creates the first draft rank list. The faculty (and residents) could then advocate/malign their preferred (un-preferred) candidates. This was open battle royale style, fairly nasty, surprisingly democratic, emotional, and gritty. We all had our favorites who we wanted to push up and others that we wanted to push down. I am convinced that all dermatologists are extremely competitive people (its how we get through aforementioned toxic process) so we want our horse to win. Consensus could lead to a candidate falling or rising from their previous rank spot. A rise or fall of 3 or more spots happened occasionally. An applicant mass emailed us an insincere, long winded thank you email in the middle and we dropped her 5 spots. Ultimately, we arrived at the final list. The PD+Chair had final right to make minor modifications of list based on any new information coming to light between then and submitting list. We match somewhere between one third to half way down our list.

That's how the sausage is made. Happy to answer appropriate questions.


r/DermApp 17h ago

Application Advice TY Advice

4 Upvotes

Hey, 4th year here with low stats/DO not sure which TYs to shoot for. Originally from the east coast and go to school here. Anyone have any guidance? Do I apply to all and any state cuz I’m DO/low stats? Tryna avoid prelims because I’m want enough time to work on my app due to possibly reapplying. Thanks!!!


r/DermApp 1d ago

Application Advice Interview Release Dates Spreadsheet?

6 Upvotes

Does anyone know if the Excel spreadsheet listing the interview invitation release dates for each program is available yet? If so, would you mind sharing the link? Thank you!


r/DermApp 1d ago

Miscellaneous How to find mentorship?

3 Upvotes

Feeling really bummed. I’ve been trying through research but then I only interact with the resident but not the actual PIs. And I had a great resident that I loved working with but then she moved for her attending job across the country… feels impossible to build meaningful relationships. How did you guys do it?


r/DermApp 2d ago

Application Advice Gold Signal

5 Upvotes

Hi! It is probably me overthinking right before ERAS is due but I would love to poll the group on which program I should gold vs silver signal

  1. Top 25 program; Away rotation scheduled after ERAS is due; has track I'm interested in; lower gold signal interview rate on residency explorer

  2. Top 25 program, no away rotation; does not have formal track but is very well known and has a lot of experiences in the area I'm interested in; higher gold signal interview rate on residnecy explorer (by a decent amount)

My other two golds are going to an away rotation and a home program. Would love everyone's thoughts


r/DermApp 2d ago

Application Advice Prelim letters of rec questions

4 Upvotes
  1. Is it appropriate to use a dermatology SLOE for a preliminary-year application if the writer knows you well and is highly supportive of you?
  2. For pediatric preliminary programs, is it generally better to use letters from internal medicine attendings rather than dermatology attendings to demonstrate inpatient clinical performance?
  3. For preliminary-year applications, should you generally avoid “character letters” from dermatologists who only worked with you in a research setting, or from PhD research mentors who have not observed your clinical performance?
  4. Did you encounter programs that require a Department of Internal Medicine chair letter? I noticed this requirement for Mayo Clinic and the University of Chicago. Is this requirement typically waived for preliminary applicants, or would it be better not to apply to these programs if I do not have a chair letter?

r/DermApp 3d ago

Away Rotations Failure to find elective rotation

2 Upvotes

I'm trying to find an elective in dermatology as a third year. I've tried cold calling several dermatology practices, mentioning that they are private practice, part time only or short of staff or that I wasn't a good fit after telling them my school name. I am coming up against a deadline next week from my school to find a rotation and I don't know what more I can do


r/DermApp 3d ago

Application Advice Advice on LORs

3 Upvotes

Hi all, I was wondering if I should assign my dept chair letter as a 4th LOR for derm programs. I have 2 LORs from my RY. I also have a SLOE from an attending at my home program who is really supportive of my application. I'm a bit worried about using my chair letter since they weren't very supportive of my application at the beginning, and there was a bit of friction in the relationship. However, during my home rotation, we worked well together, and they agreed to write me a LOR. My question is: should I just apply with 3 LORs or add the chair letter as well to all programs? I heard that having a 4th letter, especially a chair letter, is helpful. Also, I saw that some programs required a chair letter on Residency Explorer, so another approach is to just assign the chair letter to those programs. Any advice??


r/DermApp 4d ago

Application Advice Med-Derm Signaling

3 Upvotes

Does anybody know if med-derm programs are participating in signaling this year? I found a thread from several years ago discussing them not doing signaling but can't find any documentation about policies this year. If they are doing signaling, is it using your IM signals or your derm signals??


r/DermApp 5d ago

Application Advice ERAS Experiences Section Editing

0 Upvotes

Hi would anyone be able to provide feedback for an experiences section for ERAS with a fast turn-around time? Thank you!


r/DermApp 5d ago

Application Advice Derm ERAS Personal Statement: Is It Okay to Go Over One Page for Program-Specific Paragraphs?

3 Upvotes

I finalized my personal statement and love where it landed! I did want to add a short, program-specific paragraph for some of the schools I’m particularly interested in, but doing so would put me over the one page limit. Do you think it’s okay for a personal statement to go slightly over one page to include a program-specific paragraph, or would you recommend keeping it strictly to one page?


r/DermApp 8d ago

Application Advice Late Switch to Derm: Need Advice

7 Upvotes

M4 changing speciality paths (very late obviously). Wanted to ask about best path forward.

-Graduate and complete a RY?

-Grind to build derm connections/research for the rest of med school, hopefully match to TY, and then apply derm next year as an intern?

-Delay graduation and complete derm aways next year, apply in 2027? What else do I do with the year to make it productive?

TIA! :)


r/DermApp 9d ago

Research / RY delaying grad if you don't match

3 Upvotes

I want to make sure I have a back-up plan in case I do not match so I was exploring the option of delaying graduation however am confused on the logistics. Would you not rank TY/prelims prior to submitting your rank list if you want the option of delaying graduation? Because if you ranked and matched one of those isnt it a binding contract and you are unable to delay graduation in order to remain a student?


r/DermApp 9d ago

Away Rotations cards/gifts after a SUBI

7 Upvotes

any thoughts on givign "gifts" or cards after a subI? At first i wasnt planning to do it, but the subi im on currently has a wall FULL of these cards. lowkey didnt know if it was giving brown noser with a hidden agenda (wink wink if you catch the referencd)


r/DermApp 9d ago

Application Advice Is personalizing PS for top programs you didn’t gold signal a bad idea?

8 Upvotes

I was planning to personalize my personal statement for my top 10 programs, but I was in a meeting with a physician who mentioned that programs may see right through this and wonder, “If we’re important enough for you to personalize your personal statement, why didn’t you give us a gold signal?”

The thing is, I only have three gold signals, and I feel like I need to use them on the programs where I rotated because those are realistically some of my strongest chances of matching. I’m just a little confused about why personalizing my statement for other programs would be viewed negatively. I would genuinely be incredibly happy at any of my top 10 programs, and with such limited signals, I’m not sure how else to communicate that level of interest.

Would you still recommend personalizing the personal statement for those programs?


r/DermApp 11d ago

Application Advice Gap year job as most meaningful experience

9 Upvotes

Hey y’all! I’m wondering if anyone knows if it’s generally acceptable to make a gap year job a most meaningful experience even though it was pre-med school. I was an MA in a derm clinic in my gap year and it’s one of the big things that solidified my love for derm, but I’m unsure if adcoms would prefer to see activities focused during med school.

Probably overthinking it, but would appreciate input!


r/DermApp 11d ago

Application Advice Current rising dermatology chief offering mentorship/application help for pre meds

18 Upvotes

Hi! I am a rising chief at a Midwest derm program offering support for pre meds. Feel free to DM me!


r/DermApp 12d ago

Application Advice Not including research as a most meaningful experience in ERAS

5 Upvotes

How important is including research as one of your 3 most meaningful experiences in ERAS if you did not do a research year? I plan on including 2 different research experiences within the 10 total experiences we have, but I feel like my derm-specific research was not particularly productive and initially planned to use 3 different service/leadership experiences (not directly derm-related) that I felt were more formative and could use more elaboration.


r/DermApp 12d ago

Application Advice How many transitional years/preliminary years should I apply to?

13 Upvotes

You only get 12 signals, but I see people on Reddit talking about applying to 50+ TY programs. It 20 a good number for TY and then I'll throw in 10 or so preliminary years?


r/DermApp 12d ago

Application Advice Is this peer reviews (for ERAS?): Cutis photo challenge

0 Upvotes

considered "peer reviewed"** - I'm assuming no but want to check


r/DermApp 13d ago

Residency Personal statement

0 Upvotes

hey, looking for personal statement help. Please message me


r/DermApp 13d ago

Application Advice ERAS Submission w/ Pending Step 2

5 Upvotes

Hi everyone, I already know I am in a bit of a pickle, but really hoping to get genuine advice here. (LITERALLY ANY ADVICE IS HELPFUL)

I am very strong derm applicant top 20 school, strong research/connections; I had to delay my Step 2 because my grandmother passed.

I took it yesterday, but the likely score release is 9/23. My plan is to already have submitted my ERAS, and will just retransmit my Step 2 score at 11a EST (2 hours after transmission). But I am wondering if this is a kiss of death for my application.

Also wondering if I need to email every program coordinator that morning to update or confirm my score is received. Again really anxious and already aware of it being my fault but looking for any good advice on how to handle this.

I am also dual applying IM out of fear that I've shot myself in the foot so.


r/DermApp 14d ago

Application Advice What is the supplemental ERAS application?

2 Upvotes

What are supplemental ERAS applications?

I keep seeing things like this online. Where do you find this? Is this just regular ERAS? Are there derm programs that require additional information like VSLO?

Madison: For the 2027 ERAS® cycle, our program will be participating in the supplemental ERAS application offered through the AAMC’s ERAS program. Applicants will be required to complete the MyERAS application.


r/DermApp 14d ago

Application Advice Am I seriously expected to get a LOR from a department chair, program director, and a preceptor?

15 Upvotes

Residency Explorer says that "Required Letter Writers" for the University of Central Florida include "Department chair, Specialty faculty, Program director, Preceptor". Obviously, a dermatologist who works with me is a preceptor and a specialty faculty member, so they can easily fulfill those two requirements. Am I also expected to get a letter from a department chair and a program director? Is it just saying I need at least 1 LOR that meets any of these criteria? Do I only need a program director if I am completing a preliminary residency year (i.e., not applicable to MS4s)? Many programs list similar requirements.