Not matching can be a very devastating experience. After working hard for 4 years of medical school, it is tough to open an email during Match Week and see that you have not matched. However, there is hope! It happens. Sometimes there is no good reason for it besides the fact that there are too many good applicants and not enough spots. This is very true for dermatology and other highly competitive fields. The typical dermatology applicant has high board scores, a ton of clinical honors, lots of research experience, publications, oral presentations and poster presentations. A number of these perfect applicants go unmatched each year. So, what do you do if you do not match? There are some different options that will be outlined below. A lot of people don’t like to think about backup plans but you just never know and it’s good to start thinking about options ahead of time.
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Proceed with a preliminary medicine, preliminary surgery or transitional year.
Some applicants choose to go this route. Dermatology residency is an “advanced” residency starting PGY-2 which means typically you will apply to and separately interview for PGY-1 intern positions. These can be either in medicine, surgery or a combination of both (transitional year). Although some dermatology programs have the PGY-1 year included, there are not very many of them so you will probably still interview separately for intern years. When it comes time to make your rank list, you can list combinations of dermatology programs and intern years first and if you want to proceed with an intern year even if you do not match dermatology, you can rank intern years at the end of your list. Some people will proceed with an intern year and reapply. If they do not match the second time, they commonly undertake a research fellowship position and apply again the following cycle.
If you go this route, sometimes (although you cannot rely on this) spots get added or open up in residency programs and you are among a smaller pool of applicants eligible if a program has an unexpected upcoming PGY-2 spot available.
- Do a research year immediately after graduating (or extend graduation*).
Research years are wonderful opportunities for applicants to competitive specialties, dermatology included. They are helpful to get to know a department, make connections in the field and gain valuable research experience. This is especially helpful if you do not have a home dermatology department. However, doing one prior to completing an intern year is less likely to be paid. As mentioned above, some people will take on research fellowships following an intern year. These fellowships are typically paid because you can apply for licensing after intern year.
*this is on a case-by-case basis and varies by school but some schools will allow you to extend graduation by a year without paying tuition in order to accommodate a research year. This allows you to apply as a US medical student rather than as a graduate.
- Proceed with a different specialty.
Sometimes people will choose to complete another residency (usually family medicine, internal medicine, or pediatrics) before going back and applying for dermatology. Especially if you feel like you are a weaker applicant, this guarantees that you will have a job and then you can go back and pursue dermatology in the future. However, this is tricky. Not all programs will be able to take someone who has had prior training because they will not get funding again from Medicare and the institution will have to pay for the resident themselves. It’s more difficult but again, not impossible! It’s been done before.
Matching dermatology can be a tough journey. People sometimes apply multiple times, take on multiple research years, and sometimes even completely finish another specialty and come back to dermatology. But where there is a will, there is a way. Don’t lose hope and keep going for what you love!
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