Third- and fourth-year medical students

Important updates for F2 students

  • What 3rd year clerkship program should I do? (Traditional, VALOR, MODEL, PISCES, KLIC)

    • UCSF SOM offers a variety of programs that students may choose for 3rd year clerkships. These programs provide a wonderful array of unique opportunities to work with specific communities and populations. The deadline to choose is often in the winter quarter of 2nd year. It is important to note that there is no "right" or "wrong" program for a derm applicant – different students have gone through different programs and have successfully matched. The choice of a 3rd year clerkship program is a highly personal one and should be based on your desire to work with certain communities/patient populations and how you best learn as a student.

  • Planning considerations for 3rd year:

    • Consider doing the 140.01 elective (2 week basic dermatology elective), if available/ feasible. It is strongly recommended to do this in the second half of the year, after you have more clinical experience under your belt, as you would want to perform strongly in this rotation. However, a benefit of taking it earlier (in the first half of the year) would be if you are torn between two potential future specialties and want to make a decision sooner rather than later. This would be an important point to discuss with your mentor.

  • Planning considerations for 4th year:

    • Remember, ERAS application must be completed by October 1st, which is when the dean's letter (aka MSPE) is uploaded. Oct 1 is the deadline for a majority of dermatology programs. Keep in mind that ERAS application opens September 15th which is often when a majority students submit their internal medicine application (relevant if you are applying into an internal medicine preliminary/transitional year). Thus it may be worthwhile to submit your application by September 15th. Some preliminary internal medicine programs do send out interview invitations in the time between Sept 15th and Oct 1st.
    • Try to do dermatology as early as possible. Take the 140.01 basic 2 week elective back-to-back with the 2 week 140.08 advanced elective. You will choose the focus of your 140.08 elective when you arrive for the 140.01 (as faculty schedules/ availability changes). Consider doing a 150.01 research elective during the late spring or early summer to finish up writing any manuscripts you have been working on so that you can submit them as early in the summer as possible.
    • Do your medicine sub-I in the beginning of your 4th year - late spring/early summer. It is preferable to have your medicine sub-I grade before your application is due, and this is often where some students choose to get one of their Medicine letters of recommendation.
    • Take USMLE Step 2 CK at a time so that your score will be reported on your ERAS application (ideally before September 1)
    • Plan for any away electives to be during the summer (ideally before September 1st) if you are planning to get a letter of recommendation from that rotation (see above table on letters of recommendation).
    • Do you need to do an away elective? Consider it if: you are "born, raised, schooled" exclusively in California (see #12 table above), if you have a particular program that you would like to match in (consider this an "audition" rotation), or if you have nothing to lose (i.e. you are not a strong candidate because of grades, board scores, but you would really like to try to match because you feel that your personality/clinical skills shine best in person). If you "look perfect" on paper, there are potential risks to doing an away elective and it may be in your best interest to not rotate outside of UCSF. However, doing an away elective is by no means a guarantee that you will get a letter of recommendation or an interview from that institution.
    • You do not need to do multiple away electives. Presumably, you will be a dermatologist in the future so you should instead take the necessary electives to prepare yourself for internship (i.e. how to read an EKG, radiology, procedures courses, cardiology, ID, rheumatology elective, etc).
    • Plan to take the entire month of January and possibly also December (if possible) for interviews. As it may be difficult to navigate with limited vacation time, you may consider doing a more flexible research month. Most dermatology interviews are in January and are only offered on 1 day so it is imperative that your schedule is as flexible as possible.

    An overview of highlights of the 4th year are:

    • June-mid-August: peak season for doing dermatology electives, derm research, one sub-I (preferably medicine unless you are pursuing pediatric internship year – in that case, then a pediatric sub-I is more relevant), taking Step 2 CK, and writing your personal statement
    • mid-August: recommend to take Step 2 CK before this date, as it will require approximately 4-6 weeks to get your scores posted to your ERAS file. It is strongly recommended, though not essential, to have your Step 2 CK score included on your ERAS file; it is an important data point for many programs. If you have a weak Step 1 score, it is IMPERATIVE to have your Step 2 CK score included on your ERAS file (hopefully improved). Please take Step 2 CS according to the SOM guidelines (not an important consideration for dermatology residency)
    • ERAS application opens in mid-August or early September so you can begin to work on your application online (without officially sending it to programs yet)
    • September 1: last day to ask faculty to write a letter of recommendation. This is not a firm deadline but more of a suggestion of courtesy – giving a faculty member 4 weeks to write a letter is standard and the letter is due in final form by October 1st. This means that it may be important to do any dermatology elective with a faculty member from whom you are hoping to get a letter at the latest in August.
    • September 15th: First possible day to submit your application on ERAS. This is often when a majority of internal medicine applicants submit their application. This is relevant if you are doing a preliminary/transitional internal medicine year. Some prelim programs send out interview invitations between Sept 15th and Oct 1st.
    • October 1st: MSPE (aka Dean's letter) is posted. Most programs download their apps on this day so it is essential that all of your application and letters are submitted before this date.
    • October/ November/December: preliminary year interviews
    • January >>> December: dermatology interviews
    • mid-February: rank lists are due
    • mid-March: MATCH!

General advice for application season

  • What's the most important piece of advice for a student applying into dermatology?

    • MENTORSHIP is the key to successfully matching in dermatology. If you are considering a career in dermatology, it would be worthwhile to (a) join the DIG and (b) establish a relationship with a dermatology mentor, and to do these as early as possible. Please note that it is not necessary to meet with multiple mentors (and in fact is strongly recommended against). You should have a key career mentor (which you can get through the DIG mentorship program) and perhaps also a research mentor (if you are doing research in an area outside of your career mentor). It would be worthwhile to meet with ONE of the residency program directors (currently Erin Mathes and Michael Waul), the SOM dermatology advisor (Kanade Shinkai), or the confidential dermatology advisor (Ryan "Yoshi" Arakaki) at some point when you have officially decided to apply in dermatology; please note it is only necessary to meet with ONE of them, not all four.
    • Attend as many DIG workshops/panel discussions as possible. These are HIGH-YIELD sessions and can make your mentorship meetings more individualized to discussions re: your specific career goals, needs.

    Please consult your mentor frequently to help you navigate the residency application process. Key decisions:

    1. Picking a research mentor/ research project 3rd year scheduling, choosing a 3rd year track
    2. 3rd year scheduling, choosing a 3rd year track
    3. 4th year scheduling, including away electives and whether to take a year off
    4. Which programs, how many programs to apply to
    5. Which programs, how many programs to interview at how to rank programs/ how to reach out to/ communicate with your top choice program. This is an important step following interviews and you should set up a mentor meeting to specifically discuss this.
    6. How to rank programs/ how to reach out to/ communicate with your top choice program. This is an important step following interviews and you should set up a mentor meeting to specifically discuss this.

How competitive is my application

  • How important is each of the following for admission into a competitive program?

  • What are my chances of matching? Is it too late to consider dermatology as a specialty?

    • We highly recommend that you meet with your mentor AS EARLY AS POSSIBLE to review your board scores, clinical grades, CV, and discuss your career goals. You advisor can help you estimate your chances of matching and areas of your application that you may wish to strengthen, and whether you need to take a year off to develop your commitment to dermatology. If you have any areas of grave concern (i.e. very low board score, failed a clerkship), please discuss with one of the residency program directors or the confidential dermatology advisor as they have more experience in strategies for dealing with this.
    • Is it too late? It is generally not recommended to try to apply in dermatology if you have not had any clinical or research experience in dermatology by the summer of 4th year. Why: you will not have enough experience in dermatology or connections to get strong support for your application. In these cases, it may be worth taking time off, or applying to internship only, and pursuing a clinical or research fellowship in dermatology after internship, then applying later.
    • Once you apply, you'll know a lot based on the number of interviews you get. The magic number of interviews that suggests a high likelihood of matching is around 7. If you have fewer than 4, you may want to consider a backup plan. Not matching is not a disaster; the match rate for second round applicants is still high. Most of the individuals who match on the second try do so with a notably improved application with new publications, fellowship experiences, etc – i.e. do not submit the same application as in 4th year. Third and fourth attempts to match are generally not successful.

  • What should I do if my board scores are low?

    • Electives and research experiences for students with scores lower than 225 can be key: some programs do screen applicants based on scores and if they know you, they are more likely to pull your file for an interview anyway. Some options for students with lower board scores include: taking a year off and doing a productive research project, doing a research fellowship (after internship) in clinical research, cutaneous oncology, psoriasis, hair/nail, etc.
    • A word on taking a year off between 3rd and 4th year: It is not essential but may be recommended if other components of your application are weak. However, please note that a research year must be productive and highly mentored. A year without publication or some other tangible result may hurt rather than help.
    • If you are planning to take a year off, you should contact the program director(s) of the Pathway relevant to your interests (e.g., Clinical and Translational Research, Molecular Medicine, Global Health) < http://meded.ucsf.edu/pathways/five-pathways > so that you can find out options for funding and important application deadlines. In addition to the general intramural funding within UCSF, students may be able to apply simultaneously for funding through specific programs depending on their interests. For example, students with basic science projects can apply for the Howard Hughes Medical Institute Medical Research Fellows Program (this award is highly competitive). Students with global health projects can apply for Doris Duke International Clinical Research Fellowship. Students from underrepresented in medicine backgrounds and students interested in health disparities research (regardless of background) can apply for funding through PROF-PATH (Promoting Research Opportunities Fully – Prospective Academics Transforming Health). Deadlines for these applications are relatively early. Students must meet with advisory college mentors, program directors, and mentors before submitting a letter of intent to pursue a yearlong project in October of MS3. Project proposals are initially reviewed in December, and final submissions (including multiple letters of recommendation) are due in January. The process requires significant planning, so it is advisable to identify a mentor and project as early as possible. Overall, about 70% of students applying for Pathways are funded. Additional derm-specific funding sources may be available through the American Dermatology Association, American Skin Association, North American Contact Dermatitis Society, and American Acne and Rosacea Society.

ERAS-related questions

  • Advice on personal statements?

    • It can be hard to write a statement that stands out and unfortunately many of them sound the same. You want to leave the reader with something that is memorable about you, but not too much of an outlier. Don't be afraid to be explicit about your goals and show it to some people you trust. But don't show it to too many people - it dilutes the originality and personal voice that really has to come through.
    • Though you want the statement to be personal, it is generally not recommended to describe a cutaneous condition that you have experienced (severe acne, atopic dermatitis, psoriasis, melanoma) unless you have a very unique aspect of this that you would like to discuss or explore. This is a common pitfall for students (i.e. many students write about this and thus it ends up not being very original).
    • It is generally recommended for the style to be straightforward, easy to read, and succinct. Do not attempt to be creative or artsy unless creative writing is really your forte. Be certain to not obscure the message of your qualifications and commitment to the specialty with your artistic flair.

    A general format would be:

    • Paragraph 1: I want to be a dermatologist because (ie how you decided on derm) and be clear on why you are a doctor.
    • Paragraph 2: Describe your experiences, accomplishments in dermatology. Be specific and be comfortable highlighting your successes. i.e., "I collaborated with Dr. John Smith of University to perform analysis of melanomas taken from 340 patients to determine the patterns of XYZ staining and associate the relevance of this staining pattern to patient prognosis and survivorship; this work resulted in an oral presentation at the annual AAD meeting in Denver 2014 and also a first-author publication in the JAAD." In the essay be gracious to your mentors (OK to name drop).
    • Paragraph 3: Summarize your story, your path to dermatology and indicate whether there are any particular career aspirations (ie to become a pediatric dermatologist – only state this if this is 100% certain, otherwise ok to leave this more general)

    The personal statement is a really good chance to explain any particular circumstances: low board score (because of illness, death in family), why you are switching from another specialty into dermatology, why you want to move to Chicago (because partner is being relocated there or your entire family lives there). Please seek guidance on this aspect from mentors to make sure that the circumstances you hope to describe are appropriate and properly worded.

  • What do I do if I am asked to draft my own letter of recommendation?

    • This sounds a bit awkward at first, but it turns out to be both routine and to your advantage. It saves the writer time and allows you to put in the time and effort in the areas that are really important to you. It is also a chance to emphasize thematic points that will be consistent with the rest of your application or highlight things that you want to get extra attention that might not be obvious to the writer.

    One basic outline is:

    • Paragraph 1: What is the relationship, ie How do you know each other and how long have you worked together?
    • Paragraph 2: What you have accomplished
    • Paragraph 3: Personal attributes. This is the hardest part for most people. This it is an opportunity if there are themes you want to highlight so feel free to take a stab at it.
    • Paragraph 4: Summary paragraph. Good for a line or two that is the impression you want to leave with the readers.

    To make it easy to read, keep it to one page. Put in ERAS information also - it also saves the writer time from having to look it up.

  • Should I apply into something else as a back-up plan?

    • This should be discussed with your mentor or with the confidential dermatology advisor. First, it is logistically very difficult to interview for dermatology, internship, and a 2nd specialty at the same time, unless the internship program (ie internal medicine) is the same as the 2nd specialty. You do not want to create such a hectic interview schedule that you show up to your dermatology interview(s) exhausted!
    • If you have been counseled that your chances of matching in dermatology are very low, but you still wish to apply: consider applying broadly in dermatology (plus internship) and your 2nd specialty and see where you get interviews. If you get only 1-2 dermatology interviews, then it will likely be possible to interview in both specialties, and then list dermatology at the top of your rank list. However, if you decide to rank the 2nd specialty, do so with caution. If you are even remotely a good candidate for dermatology, you will likely be a very strong candidate for a 2nd specialty and may match in that specialty. Because matching is a binding agreement, it will be very difficult to switch later. Bottom line: it is important to decide whether your priority is to match in dermatology (and risk not matching, then apply again later) or whether your priority is to match in something (then okay to rank both specialties). Please seek advice and mentorship if you are considering this.

  • What programs have been popular among UCSF applicants, or how should applicants go about considering programs?

    • The top dermatology programs in the country include UCSF, UCLA, U Penn, NYU, Harvard, Columbia, Stanford, Northwestern.
    • Applicants are strongly encouraged to apply broadly across the United States. The typical applicant will apply to 60-80 programs though an extremely strong candidate could successfully match with 30-40 applications. Research-oriented applicants to the 2+2 program would likely apply to 30-40 programs as there are fewer programs nationwide that support such research-oriented trainees.
    • Key considerations include: opportunity to see a broad variety of diseases, types of patients, opportunity to work in different clinical settings (VA, county system, upscale practice, community practice, inpatient hospital), availability of experts in different specialties (ie pediatric dermatology, hospital dermatology, dermatologic surgery, dermatopathology), the size of a program (ranges from 3-21 residents), clinical teaching faculty, didactic curriculum (is it resident-led or faculty-taught?), research opportunities (if desired), track record with developing academic careers/mentorship. Cost of living is also an important consideration for individuals applying to residency.
    • Please note that there can be a disconnect between the reputation of a medical school and the dermatology residency training (i.e. there are SUPERB dermatology residency programs at medical schools that you may have never heard of (and vice versa). It is important to review the list of programs with a mentor.

Resources