The path to a dermatology residency begins early, and, increasingly, includes a year off from medical school for research, residents say. Prospective dermatology residents also are advised to be flexible, earn strong clinical recommendations and consider an "audition" rotation.
Ruth Ann Vleugels, M.D., credits her success to having done research in dermatology and having strong clinical recommendations from supervisors inside and outside the specialty. She is chief resident in her third year at Harvard Medical School's dermatology training program.
"In addition to research," she says, "showing that you're dedicated to taking care of patients is really important."
For medical school students considering applying for dermatology residencies, "The trend is to try to decide by the third year," says Dr. Vleugels, who chose dermatology early in her fourth year.
"Also," she says, "most Harvard applicants who are not M.D./Ph.D.'s have taken a year off from schooling to pursue research. It's possible to match without doing this, but it's becoming more of the norm."
Indeed, Deborah Goddard, M.D., says that because she decided on dermatology shortly before her fourth year of medical school, she chose to take a year off to work in a dermatology research lab, get married and line up a four-week away rotation before her final year of medical school.
"I discovered dermatology rather late during my medical school career," says Dr. Goddard, a second-year University of California, San Francisco (UCSF) dermatology resident who planned to enter orthopedic surgery or pediatrics before she attended a camp for children with severe skin disease.
Dr. Goddard advises students who are seeking dermatology residencies - particularly those interested in matching in a certain region of the country - to consider doing audition rotations.
"But they must really think about their personality, and how they'll fare in getting to know their prospective new colleagues in a relatively short period of time," she says.
To do an away rotation successfully, Dr. Goddard says, "Candidates should have an outgoing personality that enables them to interact well with different types of people they may encounter in their desired program."
Flexibility a must
Additionally, Dr. Vleugels recommends applying to a broader spectrum of programs than applicants who apply to nondermatology programs.
In many fields, she says, medical students can feel reasonably confident that they'll match at one of their favorite programs.
"But in dermatology - especially now - that's not the case. And people who want to do dermatology can't necessarily pick the city they want to be in," she says.
Erin Mathes, M.D., targeted the first year of a combined pediatrics and dermatology residency program at UCSF. She surmises that her interest in pediatrics made her fairly unique.
However, because she chose dermatology in her fourth year of medical school, "I scrambled at the last minute to do another dermatology rotation and rearrange my schedule for my fourth year so that I could do dermatology," says Dr. Mathes, now in her fourth year of the five-year combined program.
Dr. Mathes chose dermatology, because "I found myself coming home from work during each day of my dermatology rotation thinking, 'Wouldn't it be great if I could do this for my career?' I was particularly interested in pediatric vascular malformations and birthmarks."
She also liked dermatology's visual aspect.
"Patients were concerned about their problems, because they could see them," which provides more motivation to follow doctors' recommendations than less visible ailments do, Dr. Mathes explains.
Similarly, Dr. Vleugels says, "I had an interest in autoimmunity, and dermatology seemed like an ideal field in which to pursue this interest."
Particularly in academic medicine, she says, "Dermatology is truly an evolving field. There are many areas to which one can contribute."
"Being able to take care of patients of all ages appealed to me," Dr. Goddard says.
Furthermore, she says, "Relatively few fields offer the flexibility to use both medical and surgical skills daily. And you can change the composition of your practice over the course of your career as your interests change."
Dr. Goddard says strong demand for dermatologists' services also helped draw her to the field.
"It appears that won't diminish for the course of my career," she says. "It was important to know that it wasn't a field that is waning in terms of the need for the skills and services dermatologists offer."