The breadth of the skin, and all its different functions is something you’ll explore in-depth in a dermatology residency. You won’t find dermatology as part of the usual curriculum at most medical schools, even though almost 30% of the US population seeks treatment for a dermatologic disease every year. In the US, a dermatology residency typically lasts three years, although all residents must complete a in an off-service specialty before doing core dermatology rotations and lectures. It is longer in Canada, where you might have to do five years, because, again, your first two years are done in other specialties, such as a or an . This article will detail things you need to know about dermatology residency in both the US and Canada, , and how to tailor your application to what residency directors are looking for in applicants.
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In a dermatology residency, you’ll learn more about how to treat the close to 3000 different diseases of the skin that are as varied and complex as the skin itself. But being a dermatologist is not only limited to the skin. As a dermatologist, you’ll be confronted with a variety of challenges related to a person’s skin, hair, and nails, and other cosmetic problems to more serious conditions that can range from blistering disorders to cancer.
- Pediatric dermatology
- Micrographic surgery
- Dermatologic oncology
These are some of the more popular subspecialties but dermatology expands to various other fields that we’ll talk about more later. A dermatology residency is a little more didactic-heavy than other medical specialties, where you start doing rotations and seeing patients in your first years. There are rounds, to be sure, but you’ll find yourself more in lectures, studying, and doing clinical work than doing rotations. This is because the nuances of skin disorders can lead to a misdiagnosis.
Non-dermatologists who try to diagnose skin disorders are wrong between 20-50% of the time, which is why many dermatology residencies focus on didactic training first. But if you are interested in surgery, especially in Mohs surgery, which is a technique used to treat skin cancers, then a dermatology residency may be an appealing choice. If you do end up doing rotations in your first years, they will most-likely be in other specialties, since dermatology is not often taught, or at least required, in or
Most dermatology residency programs in the US require a year of preliminary training before you can even apply. But there are 13 dermatology residency programs in the US that are categorical and do not require an additional year of post-graduate training. The additional year requirement is mostly because of the lack of dermatology training you get in medical school in both the US and Canada. There are a lot of reasons why dermatology, despite its relevance, is not a required rotation in medical schools, among them, the lack of time to fit it into the curriculum, and a dearth of dermatology departments that offer undergraduate medical education.
That’s why, if you are considering dermatology, you should take a few to learn more about dermatology, to prepare yourself for a dermatology residency and to demonstrate your interest in the field (but don’t overdo it, which we’ll explain later). And, if you are really set on being a dermatologist, getting outstanding grades in these electives will also make you stand out, as many residency directors look for whether you will able to excel in this highly specialized, and interdisciplinary field.
When you do finally enter the dedicated dermatology residency rotations in your second year, you’ll find that your didactics, lectures, and subspecialty clinics will come before inpatient or outpatient rounds. You will also consult on patients who have presented with skin disorders, and get a chance to practice cosmetic procedures and other critical clinical skills. As you progress, you’ll also have required rotations in some of the subspecialties related to dermatology, such as dermatopathology.
In the US, if you decide to enter any fellowship related to dermatology, you will have to be board-certified in this specialty, whether it is dermatopathology or pediatric dermatology, by the American Board of Dermatology (ABD). But other subspecialties do not require you to be board-certified, even though you can apply for a certificate in a subspecialty such as micrographic dermatologic from the ABD.
We’ve already talked about how dermatology is an ignored specialty in some medical schools, but it’s important to mention again, since this can work in your favor when you are preparing your application for a dermatology residency. Since dermatology is often overlooked by medical students, you can make an impression on dermatology residency directors simply by taking a dermatology rotation or shadowing a dermatologist during your rounds.
But, the typical application requirements to get into a dermatology residency program in the US are a little different than most programs. This is what most programs in the US ask for:
- Transitional year residency or one-year residency in another specialty (internal, emergency, pediatrics, etc.)
- Medical Student Performance Evaluation ()
- Up to 3 or 4 letters of recommendation
- Official transcripts
- and scores
Other programs may have harder requirements, such as a having a certain USMLE score or graduating in the upper third of their class, but these requirements are not universal and more program-based.
But what is it about your application that will set you apart from other dermatology residency applicants?
To answer this, we’ll first examine why applying to a dermatology residency in the US is different from a decade ago. The number of PGY-2 dermatology residency positions in the US has risen from 400 five years ago to close to 500 in the last cycle.
Why? Well, the reasons are simple: “lifestyle” and money.
Even though dermatology is not included in most required rotations at medical school, students have become privy to the supposed “benefits” of being a dermatologist – benefits for them, mostly. In the US, more than in major urban centers such as New York or Los Angeles practice in the richest neighborhoods. This has pushed many medical students into dermatology even though they are not that interested in dermatology as a science or medical specialty.
This newfound popularity has soured many dermatology residency directors on applications packed with dermatology electives in medical school and a from students who have little to no genuine interest in dermatology. So, what we are trying to say is that one of the best ways to stand out when applying to a dermatology residency is by actually being interested in dermatology.
How do you do this?
As we mentioned, taking and excelling in an elective dermatology rotation during medical school stands out more than a graduate who took a dermatology elective and got an average grade. You can also do extracurriculars that put you in contact with people with dermatologic diseases or injuries such as volunteering at a free, student-run clinic. But you can also join the Dermatology Interest Group Association (DIGA), which is a national, student-run association of medical students interested in dermatology, and if there is no chapter at your campus, then start one!
The match rates for both the PGY-1 and the PGY-2 dermatology programs in the US are near perfect, as they are regularly around 99% or 100%. As we’ve discussed, the entire field of dermatology has been rising in popularity with medical students, but even with that moderate rise of applicants, a dermatology residency is still not as popular or competitive as other high-demand residencies.
Since most dermatology residencies ask for a preliminary year in another discipline, you can either try your luck with one of the few programs in the US that offers a categorical dermatology residency, such as the , or apply directly to a PGY-2 position after you complete a transitional year residency.
Since you will have completed at least one year of residency before you enter the core dermatology rotations, once you do, your schedule will be concentrated solely on dermatology and all its subspecialties. The beginning of your dermatology residency could include basic courses in subjects such as diseases of the skin, skin infections, melanoma and sun damage and cancer. You could also spend a block or two in pediatric dermatology, dermatopathology and microscopic surgery.
Depending on the program, you may have research modules integrated into your schedule, which, in dermatology, are called “clinics” and are based around a particular area of the epidermis, such as hair and nails, or wound repair and reconstructive surgery. The dermatology residency program at has 15 different clinics that you can attend which range from the seemingly innocuous, like the Hair Loss Clinic to the more specialized like the Skin Cancer Genetics Clinic.
But, as we mentioned earlier, a lot of your training will come from the classroom, books, lectures, symposiums, and conferences that often come before you actually start doing your rounds and seeing patients. The dermatology residency program at NYU Grossman does this, where, in your first years, you are exposed mostly to dermatology case studies and reviews of articles published in dermatology journals in discussions headed by senior, , before you start rotations.
In Canada, as with most residencies, a dermatology residency lasts five years. But, since, again, dermatology is not always a rotation that medical students take, the dermatology residency programs in Canada are mostly categorical. So, your first two years will be spent rotating in other departments and specialties such as family, emergency, or internal medicine or pediatrics.
But you may also take rotations in disciplines related to dermatology such as plastic surgery or immunology. You also do more clinical rotations than in American dermatology residency programs given your preliminary training in other disciplines. So, once you enter the specific dermatology years, you’ll be immersed directly into clinical experiences, even though that time will also be shared with further didactic training.
A majority of residency programs in Canada have been switching to a new assessment model that may change the course content and structure of some dermatology residency programs, although some programs are only now implementing the program. The model, known as Competence by Design (CBD) determines whether you are ready and competent enough to advance to your next graduate year.
Similar to their American counterparts, Canadian dermatology residency directors have noticed that many more medical graduates are choosing dermatology for the same reasons: money and free-time. And the statistics bear it out. An overwhelming majority of dermatologists in Canada (79%) are in private practice with only a miniscule 13% practicing in academic or hospital-based institutions.
And, just like their American counterparts, dermatology residency directors in Canada have become wise to the ways that applicants are padding their applications with research projects and hours spent shadowing a dermatologist, even though they have little real interest in dermatology. However, that does not mean that if you are truly interested in dermatology that you should not take dermatology electives or shadow a dermatologist.
Some programs in Canada recommend that you take at least one elective in dermatology, but will be more impressed if you draw from a variety of disciplines given its interdisciplinary nature. The other things that will stand out for Canadian dermatology residency directors is your (this bears repeating) genuine interest in dermatology and the strength of your letters of recommendation, which usually, must be from practicing dermatologists or those who taught you.
But aside from these qualities, many dermatology residency programs in Canada have similar admission requirements:
Most dermatology residency programs do not even request your board examination scores, or anything similar. But having participated in significant research having to do with dermatology is also important. If you are fortunate to get to the interview stage you should be prepared to talk about why you did this research along with answering other common . Your interview, personal letter and letters of recommendation will hopefully convey your interest in dermatology, but make sure to get the experience and references that will objectively convey it as well.
According to CaRMS, there are only 28 dermatology residency positions in Canada, and all of them were filled in the most recent match. However, despite the low number (low relative to the US) of dermatology residency positions in Canada, they are not necessarily hard to get into. You can apply without having to take an additional year of residency, and have only a few electives in dermatology, while having an outstanding application to ensure you get in, although research projects and great letters of recommendation will also help.
If you’re a medical student in Canada or a recent graduate, you’ve probably heard of the new changes many residency programs, regardless of the specialty, are making to their curriculums based on the transition to Competence by Design (CBD). This transition means that many programs are in the process of adapting their curriculums to suit CBD, which means they must create new In Training Assessment of Resident (ITAR), different exams, and create new evaluations to comply with CBD.
These changes are on-going, and will eventually affect the way all residency programs, including dermatology will be structured. But, from now on, many dermatology residency programs will now include integrated research projects and clinics or required rotations in pediatric dermatology although the placement and locations may be varied (for example, no programs offer a rural rotation, although some offer an international one).
We’ve laid out the details of CBD and how it will change programs across Canada, so we won’t get too much into it here, but even though the changes are significant, the subject matter of what you will be taught remains the same; only the way you are assessed will change.
Notwithstanding the changes CBD will bring, the curriculum of many Canadian dermatology residency programs is similar to the US, in that residents also participate in clinics tied to specific dermatologic diseases, while also seeing patients in various settings (inpatient or outpatient), performing cosmetic and restorative procedures and participating in research and presenting at conferences.
Be Genuinely Interested in Dermatology
This comes straight from the mouths of countless dermatology residency directors, as well as many former and current residents. You may think that dermatology offers a fast-ride to riches and a lot of free-time, but if those are your only goals for becoming a dermatologist or a doctor for that matter, you should probably consider another profession altogether. Mostly, because there are a lot easier (and cheaper) options to becoming rich. Being a dermatologist is as important a medical profession as any other and having a real desire to be one is one of the more valuable traits to have.
Take Dermatology Electives (Within Reason)
Choosing and deciding on your electives in medical school is one part of . But if you make the mistake of thinking that only choosing dermatology for your electives is a good idea, we have news for you, it is not. The reason being that residency directors want to see variety and whether you have truly explored other fields of medicine either out of curiosity or because you feel like it would add to your residency training. It’s OK to take one or two or three (depending on how many electives you are given) but make sure you take others as well to show your foresight and versatility.
Get Great Letters of Recommendation
As in other niche residencies such as a or a , getting quality letters of recommendation is key to showing that you have the trust and endorsement of experienced, practicing dermatologists who have seen you excel in the field. Even though dermatology is growing in popularity, you still have to seek it out, in some ways, by doing dermatology-specific activities that we mentioned before, which will also get you attention, and which excellent letters of recommendation will solidify.
Put a Lot of Thought into your Personal Statement
Basically, you should use every opportunity you are given to speak or communicate (, interviews) during the residency application process to articulate why you want to be a dermatologist. And here is where you can show your genuine interest rather than letting your research projects or shadowing hours speak for you. Talk about why you want to be a dermatologist, give concrete examples and do not mention money or lifestyle.
Prepare for Your Interview
Depending on the program you are applying to in either the US or Canada, you may have different interview formats (virtual or in-person) and styles (traditional panel interview, or ), but, whatever interview format or style, you should prepare well in advance. You can read over and do mock interviews to refine your answers. If you are doing a traditional interview, this will be your chance to elaborate further on your true interest in dermatology by talking more about the experiences that pushed you toward the field. If you’re doing an MMI interview (most common in Canada), you may still be asked about your interest in the specialty, or how you would respond in certain situations, but you can read over to get an idea of how to answer during the interview.
1. Is a dermatology residency competitive?
Dermatology is becoming one of the as more students learn about it and are interested by the “lifestyle” and potential salaries. There are about 500 positions in the US and only 30 available in Canada but the number of applicants is greater than both those numbers. However, if you are truly interested in dermatology, you should not overdo it by taking too many dermatology electives and shadowing dermatologists because you think that’s how to get in. Showing a genuine interest in the field through any of the activities we mentioned will help more than showing off.
2. How can I get into a dermatology residency program?
You need to show an early interest in dermatology and take a wide variety of electives, since the skin is so multi-faceted and has connections to plastic surgery, hematology and pediatrics. You should take a few dermatology electives as well, but do non-academic things to show real interest and compassion. Volunteer where you can and work at free-clinics to show your true commitment.
3. What are the requirements to get into a dermatology residency?
You have to have obtained your medical school degree in the US or Canada, if you are an international medical graduate, you also need to have your ECFMG certification; passed your USMLE Step I, II, and III in some cases with a minimum score (try to aim for 260); you need to write a personal statement, and submit up to three letters of recommendation. You also have to have completed a year-long residency in another field before you apply or you can try to apply to the categorical programs, but there are much fewer of the latter than the former.
4. How much are the starting salaries for dermatology residents?
In the US, at some programs the starting salary is $71,864, which can go up to $85,820 in your final years. In Canada, you can expect to earn $69,867 in your first year and $91,777 in your final year.
5. How long does a dermatology residency last?
In the US, a dermatology residency could last three years, but you have to complete a one-year residency previous. In Canada, a dermatology program is categorical so you’ll spend five years in the program.
6. Is there a good work-life balance for dermatologists?
One reason that so many medical students are going into dermatology is the promise of an ideal work-life balance. The majority of dermatologist go into private or group practices where they determine their work hours and schedule, so it is much easier to achieve a work-life balance in this field than most others.
7. How can I match to a dermatology residency?
You should apply to as many programs as possible, but make sure you are truly interested in the field, which is something that residency directors will ask you about in your interview, if you make it to the interview. Other than genuine interest, you should also do extracurriculars in dermatology related fields and work in clinics that help people with dermatological problems.
8. Which dermatology residency program is the best?
You can refer to the list above for some of the best dermatology residency programs in both countries, but what you think is the best should be based on your preferences and career goals.