Commonly asked questions for the dermatology applicant

Step 1

What do I need to score on Step 1?

Looking at the 2017 NMRP Match Data for U.S. allopathic seniors and international medical graduates (IMGs), the mean USMLE Step 1 score needed to match was 249 for U.S. seniors and 236 for all IMGs. For U.S. seniors, scoring 220 puts you at a 50% match rate, with each 10 point increase bumping your chances up by 10%.

The inflection point at ~230 suggests that scores above this range start to have diminishing returns aka each point increase starts having less and less of an impact on your overall chances.
For U.S. IMGs, the match rate hovers around 20-30% regardless of Step 1 score.

What if I didn’t do that well on Step 1?

I’ve heard that Step 1 scores are used mainly as a screening tool. Some programs have a “cut-off” score around 220 (the highest cut-off I’ve heard was 230). Otherwise, it appears if you score anywhere above 230, your chances are >50%, with marginal returns the higher you score. So scoring 240-260s should put you on equal playing field with the majority of candidates.

That being said, I know people who have matched <220. But, you’ll need to stand out in other ways (ie., strong letters, research experience, unique background, etc). If you do really well on Step 2 CK, that can definitely help compensate for a weaker Step 1 score. Check out my Step 1 and Step 2 study aids if you need help preparing!

Step 2 

When should I take Step 2?

I think the consensus is if you scored well on Step 1, the Step 2 exam matters less. You just don’t want to score significantly lower than your Step 1 score. If you didn’t score well on Step 1, try to take it earlier in the year (before September), so you can tell programs if you did really well. However, many programs are now requesting Step 2 scores for interviews, so it might be a good idea to just take it earlier and get it over with.


Help! I didn’t get honors in X clerkship.

It’s okay! Seriously, very few individuals have perfect grades. I would aim for honors in everything of course, but getting a high pass here and there, or even a pass is NOT the end of the world. I know people who have matched with a pass in medicine, so it’s very possible. Once again, think holistic picture.

Do I need to be AOA?

Nope, but it can’t hurt. 52.8% of matched applicants were part of the Alpha Omega Alpha (AOA) Honor Medical Society. That means almost half of the other matched applicants weren’t AOA. AOA is an imperfect system and some schools don’t even have it. It’s an honor if you do get it, and it will definitely strengthen your application. Just don’t obsess over it.


Do I need to take a year off?

Yes and no. I think this really depends on what region you’re applying from and how much research you have done during medical school. I would say the vast majority of applicants from New York took a year off. BUT, a few did not and matched! I think the ones who did NOT take a research year and matched were prolific during their time in school and were able to publish case reports and reviews on the side, or did some smaller research projects during their summer/research blocks. But once again, this is very region-specific so I would ask what the students at your school have historically done in the past.

Who is a good research mentor?

Good research mentors have mentored students before and have a good track record of getting their research fellows into dermatology residencies. Period.

When you’re looking for positions, make sure to ask how past fellows are doing. It’s an even better sign if their former research fellows have matched at the same research institution, because it shows that the mentors have influence within the department. Personality-wise, find research mentors who are invested and really care about their mentees. They should be willing to write you a personal and powerful letter of recommendation and be your biggest advocate.

Where do I find a research position?

Research positions are generally spread by word-of-mouth. I think the best way is to ask upperclassmen or current derm residents about their research experiences and mentors. I know at my school, we try to connect rising 4th years with our former mentors. Otherwise, cold-emailing can also work. Be polite, succinct, and offer to attach your CV if they respond. Another reminder one week later is okay, but after that you’ll probably come off as annoying (which is the kiss of death). Most probably will not respond, but the ones who do would probably make good mentors anyway, so it’s a win-win situation!

Is it better to work with someone well-known but super busy, or someone who has plenty of time but is less-established?

It doesn’t really matter. I’ll repeat: good research mentors have mentored students before and have a good track record of getting their research fellows into dermatology residencies.

Since dermatology is such a small field, who you know really matters. If your mentor has a few well-established connections at other institutions, that will definitely work in your favor during interview season. Obviously, the more well-liked and respected your mentor is, the more connected they are. That being said, less-established mentors earlier in their career tend to be more prolific, so you might have a more productive research year.

How many publications do I need?

You should have at least one publication in dermatology, even if it was just submitted. Different program directors will have their own preferences undoubtedly. Some may like a long list of publications, even if it’s just case reports. Others want to see that you have done original research in the field, even if it didn’t result in a paper. Not everyone will have 10+ publications, and that’s okay. Just have something to show that you’re remotely interested in the field. Having zero publications/presentations in dermatology is a huge red flag.

Away Rotations

Should I do one? Two? Three? Zero?

If your school has no home dermatology program, absolutely do them. Do at least 3 to secure enough letters of recommendation. I met some students without home programs who did 5, which might be a lot, but could help you secure more interviews.

I personally think an away rotation can only help you. I think most of the students I met did 2-3 away rotations. If you do well, you might get a letter and interview invite! If you don’t do well (or don’t stand out), you don’t get an interview invite. No harm no foul (unless you’re horribly abrasive, and the program director warns other programs about you). I personally felt way more at ease during interview day at programs I rotated at, because I already knew the residents and faculty members.

Only do zero rotations if 1) you think you’re really awkward or 2) your school discourages it.

When should I schedule away rotations?

It depends. If you need a letter from your rotation, schedule it before September so they have time to submit a letter on your behalf before October (or September 15 if you want to be strict with deadlines, but even your dean’s letter won’t be submitted until October 1st). If you don’t need a letter, you can always rotate later in the season (Oct-Nov) so they remember you come interview season.

Don’t schedule any rigorous rotations during the months of December and January because that’s when derm interviews are!

How do I pick my away rotations?

Away rotations DO NOT guarantee interviews. Plenty of programs have more rotators than interview spots.

So make it worth your while by picking programs you’re (a) interested in, (b) in cities/regions you’d like to match in, or (c) have a connection to. (A) is self-explanatory. If you really like a program, do a rotation there! (B) helps if you’re going to ask for a letter from that rotation. Having a letter from a particular geographic region might help you secure other interviews in that city/region. (C) helps if you’re trying to increase your chances of interviewing there. Connections mean faculty or mentor connections to a particular program (e.g., your mentor is friends with the program director, you wrote a case report with a faculty member, the chair trained at your home department, etc).

I cover away rotations more in-depth here and here.

Letters of Recommendation (LOR)

How many do I need?

You can send a maximum of FOUR letters to each program, but three is generally okay.

What kinds of letters do I need?

Dermatology programs: Derm programs want DERM letters. Do NOT send a LOR from your psych rotation (however glowing it may be) to a derm program. Some may choose to send a medicine LOR from their sub-internship as one of the four letters, but three or four strong derm letters goes a long way.

Preliminary/TY programs: You can either use the same four derm letters for these programs, or replace one or two with a medicine letter if you’re looking at really academic programs. Derm applicants generally don’t have a problem matching in prelim/TY programs, so prioritize getting those derm letters!

Who should I ask?

If you have a home derm department, you should definitely have a chair letter. Derm is a small field, so letters from well-known chairs or attendings go a long way. I’ve heard dermatologists tell me that they go to the LOR section on a student’s application FIRST to see who wrote them. If it’s from someone they know and trust, they’ll pay close attention to the content. Otherwise, if it’s from someone unknown, they might not care as much or disregard it completely regardless of how strong the letter is. Harsh right?

I will try to update this as more questions come in.

Stay tuned for tips about interview season!

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