Reapplying into Dermatology as a PGY-1 Intern

6 min read

This week, I’m sharing an interview with my friend who matched into an excellent dermatology program this year. I wanted to share his story because he’s also a reapplicant. Like me, he also had a disappointing outcome in the match last year. But unlike me, he “partially-matched” and moved onto his PGY-1 preliminary internship while I deferred graduation and retained my medical student status.

If you do end up partially-matching into an intern year and are also reapplying, you’re in the unfortunate position of having to balance intern year duties with the stresses of preparing for residency applications. This can be incredibly taxing. Intern year is frequently capped at 80 hours a week (and even more if residency work hours are violated, which is not uncommon), with little reprieve in terms of vacation time or weekends. It’s no surprise that many reapplicants are unsuccessful at matching during their intern year, and instead opt to reapply during a research year as a postdoctoral fellow when time is more flexible.

My friend accomplished the impressive feat of matching at an excellent dermatology program while balancing intern year. Let his success be a testament that anything is possible with the right strategy and determination.

Thanks for taking the time to share your story! Can you give us a little background about yourself as an applicant?

I graduated from a mid-tier US med school in a large city and did a derm research fellowship between my 3rd and 4th year. I had 7 interviews my first year, majority in the same geographical area as my medical school. My research fellowship was very basic science heavy, so I actually didn’t have many publications compared to many of my peers who spent a year doing clinical research. But I had some cool projects on my application. One actually resulted in a publication in a great journal right before my first interview last year. Unfortunately, I couldn’t list it as being published in my ERAS application, but I brought it up in interviews whenever I had the opportunity.

What advice would you give to someone starting intern year who didn’t match?

Tell your program director early on (within the first month or so of starting) your intention to reapply to dermatology during your intern year. As a reapplicant, I was told to have a program letter from my internship. Since program letters are typically compiled from our attending and resident evaluations, it was important that I performed well during my intern year. At the beginning of each rotation, I made sure to tell attendings my plans to reapply, and that I would be interested in using their evaluations in my application. This helped put me on their radar. Almost all of the attendings were supportive and took the extra step in writing down strong comments of support for me.

How difficult was it balancing intern year with the stresses of reapplying?

It was definitely difficult at first. There was always a sense of uncertainty of where I will be this time next year looming over my head, especially when everyone else around me knew exactly where they were going. The first few days are awkward when people ask you what specialty you’re going into. I felt like I was not as good as my other co-interns who were successful in matching. But after that, it gets better. You forget that most people are very sympathetic to your situation and want nothing but the best for you.

What letters did you use?

I used my new program letter, which I heard from interviews was strong. I asked all my old letter writers to update their letters for me, which included my research mentor, my medical school’s dermatology chairman letter, and a derm attending that I worked with at my home medical school. I removed a more generic letter written by a really famous derm attending.

Did you have issues scheduling away rotations and interviews?

I requested a backloaded schedule and I requested vacations during interview periods, and scheduled elective time towards the beginning of the year to do dermatology rotations. Balancing interviews with an intern schedule was definitely one of the most challenging aspects of this year. Only two of my interviews landed during my vacation block. I had to work with the program and find coverage for the rest. It’s not like in medical school where you can just request an extra day off for interviews. I had to find someone who was willing to cover for me for each day I was absent. I was fortunate to have a supportive intern class, but it was still stressful. Definitely have a conversation with the program early on so that they can help you coordinate coverage.

As for away rotations, the process for arranging one will most likely require GME approval. It usually takes a very long time (at least a month or two). I wasn’t able to arrange an away rotation ultimately, but I was told by my mentor that it may be useful in building a connection with a program. I ended up rotating with the dermatology department that my program was affiliated with, but I didn’t end up getting an interview there, so take it with a grain of salt. But I don’t personally regret doing the rotation as I got to meet new attendings, explain my situation, and gain valuable advice.

You mentioned you got a new interview coach. Tell me about that process.

This was one of the best investments I made this cycle. In retrospect I was underprepared for interviews. I only did a few mock interviews beforehand, and after thinking that my preliminary medicine interviews (which tend to be longer, relaxed, and conversational) went well, I felt that I was adequately prepared for dermatology interviews. I prepared for all of the standardized questions, but I didn’t realize how generic my own answers were. One feedback I got last year was having a generic answer to “Why derm?”

The interview coach was useful in helping me craft my own story. She didn’t really change my mannerisms or anything like that, but helped me hone and polish my story and delivery.

What was wrong with your “Why derm?” answer?

They told me they’ve heard my answer over and over, thousands of times. I talked about how I enjoyed the visual aspect of derm, skin manifestations of internal disease, diversity of the field, and so on (which is all true). Basically every reason you’ve ever come up with for derm, these interviewers have heard. And it ends up sounding cliched and uninspired (even if it’s true). This time, I really focused on my background, upbringing, and experiences during school and research that impacted my decision to pursue a dermatology residency. I made it personal.

So how does a coaching session work?

The first session is very casual and is mainly a fit test. It’s very conversational and is meant to get you to open up and share your story. The coaching comes later. After that first session, you’re sent a list of interview questions to look over and craft responses to. I edited mine a bit so they were more relevant to derm. I emailed back my responses and then we met to go over the delivery. We met for a few sessions, and then once before each interview just to run through the questions again. Like drill practice.

Was she a derm interview coach?

No — she actually coached people interviewing for C-level executive positions. Initially I was worried that because she was more used to working with applicants in finance and business, it might not be a good fit. And there were times where I did not agree with her feedback or suggestions. However, interviewing skills are something that translate across fields and overall I think the process was very constructive.

Would you recommend this to other applicants?

Personally I’m really glad I did it. I knew that interviewing was one of my weaker aspects of my application. The biggest benefit of interviewing coaching was that I was able to package all of my experiences into a story that I could deliver during a very short period of time. I think everyone has his or her strengths and weakness, and honestly, some people don’t need another person helping to do that. For me, by practicing and getting feedback, I felt more and more confident in my story of why I want to pursue dermatology.

Do you feel applying as a PGY-1 intern gave you more options?

I don’t know about that. I think that a lot of programs saw my status as a PGY-1 negatively, which precluded me from many interviews. On the other hand, I became eligible for physician-only positions (which have openings for PGY-2 spots the upcoming year).

What interviews did you get the second time?

I got 6 interviews, almost the same number of interviews as I did the first time. I had an even split between interviews for advanced positions and physician-only spots.

How do you think you did on interviews this time?

For the most part, better than last year. I felt especially good about the interviews at the program that I ended up matching at. I walked out of that interview room thinking I might end up there. You just have a feeling when you really click with everyone in the department.

Did you talk about being a reapplicant?

At each program I was asked at least once by an interviewer “Why do you think you did not match?” At the program that I matched at, I actually brought up the topic myself during the interview. I felt that it affected the interview positively. I didn’t try to actively hide the fact that I did not match the first time around.

Did you consider post-doctoral fellowships?

Yes. But I was also okay waiting until March to apply in case I didn’t match again. Some of the fellowships make you withdraw from the match if you get an offer. I wouldn’t have done that.

Congrats again on an amazing match!

Thank you! I definitely felt lost the same time last year trying to navigate how I was going to reapply. I hope this is helpful to anyone who is going through a similar situation.

Be sure to check out my Ultimate Guide to Surviving Medical School for your one stop shop for all things med school and residency-related, and How to (Actually) Match into Dermatology for my personal perspective of matching as a reapplicant. For additional resources about dermatology programs and research fellowships, check out my post here.