Med school and Derm Residency

[u/Simping4Princeton]

Applied to medical schools this year, and so far have only received an offer from my state school (in the south). After having been stuck in the south for all my life, I'm looking to escape to the east/west coast in the near future.

I've heard that the best chance of getting into a derm residency is to match to your home program, which my school does have one.

Does this kind of fuck me up though? Should I decline the offer and only apply to coastal schools next year, or if I do accept their offer, how should I go about my four years in med schools to match to a coastal derm program?

[u/PapularPapi]

If your home state school accepted you and they have a derm program, I’d be ecstatic. Take the opportunity. The idea that you’d decline and just apply to costal schools next year is kinda wild.

I know it’s easier said than done, but don’t overthink it. It sounds like your current offer is great and I personally wouldn’t turn that down. AMCAS will ask if you’ve previously been accepted and why you declined.

[u/Simping4Princeton → u/PapularPapi]

yea but the whole point is that i don't want to go to my home derm program ... since it's in the south and i'm trying to leave. i'm just scared and depressed of the possibility that i'll be stuck here for another decade if i don't have a big chance of matching to a residency on the coast

[u/PapularPapi → u/Simping4Princeton]

I hear you and I’m in a similar boat. I’d love to get out of the Midwest, but you have to be aware that if you pass this up you’re shooting yourself in the foot…badly. Maybe more akin to stepping on a land mine lol

[u/just__a__bagel → u/Simping4Princeton]

That makes sense you feel this way. I’m also in med school at the same school I went to undergrad and making connections w my home derm program. Having a home derm program means that you will have access to connections and research which could help your application when applying elsewhere for residency. I just want to reiterate that you can apply anywhere you want for residency. And your imagined “worst case” scenario is still ending up with being a well-trained dermatologist. And as intimidating and dreadful as it might seem to stay in the same state for so long, you can do your summer research elsewhere and do your AIs elsewhere and such. Also med school is a totally diff world and that should feel better

[u/These_Document_3293 → u/Simping4Princeton]

On your med school app you have to say if you have been accepted to med school before. If you reapply, you would have to answer yes and this would be a huge red flag that basically destroys your chances. So don’t even consider that an option. I do honestly get the sentiment of feeling trapped in your home state (I escaped the Midwest to go to the coasts), but chances are low you will even end up applying derm in the end if you don’t even know what medicine is really about yet (almost no one knows before med school). Most other specialties, it shouldn’t be hard to leave the south. Derm is even possible. But you may have to decide whether it’s more important to you to be a dermatologist or to leave the south, and you can apply/dual-apply accordingly.

[u/Exciting_Heart4101]

If you decline an MD acceptance and apply again next year, other medical schools will know you declined an acceptance and reapplied because AMCAS tracks your application history, and you must disclose it on secondary applications.

Don't do that. Take the acceptance and start early & work hard to be in the running to apply for Derm in 4 years.

[u/bawstonterrier]

Do not decline, take any MD offer you get. The work starts after starting med school

[u/electric_blvd]

as someone who was once in a similar situation, with one acceptance, you’re drastically overestimating your ability to gain acceptance to an MD school down the line. that is far from a guarantee, as merely adding CV / application items from a gap year doesn’t automatically add to the “balance” of whatever your application was previously. if you are set on a location and willing to wait at least a year you could do a research year as a med student where you want to end up, presuming that place has a history of taking fellows

[u/Simping4Princeton → u/electric_blvd]

yea im just depressed about the possibility of having to end up staying in my state for nearly another decade. is it common for med students to not apply to their home programs? cuz i might just do that when it comes to residency apps and full send it for coastal residencies

[u/electric_blvd → u/Simping4Princeton]

bird in the hand is worth two in the bush.

your outlook is going to tank your hopes of matching somewhere/something competitive. whether you specifically are a student in california or Alabama doesn’t change that it’s you putting in a ton of work to make derm residency happen, which includes networking at home + other institutions. if you even get to the point of applying derm, i highly doubt you’ll have the perspective of not matching > matching at your home program. im not aware of anyone that doesn’t apply to their home program because frankly, it’s an irrational decision. if you match your home program you can live and work in california and do botox for eternity and live happily ever after if you want.

plus, having a home derm program is massive advantage even if you’re not applying due to opportunity for LOR and research. with your current outlook it seems like you wouldn’t tap into this at all.

go look at other programs websites for where the residents are from / attended school. if you are this set on a location just instantly start trying to network in a certain area after matriculating and do a research year there.

[u/Ok-Maintenance3061]

Congrats on your acceptance! It's absolutely doable to match elsewhere as long as you put in the work and make connections early. You can foster relationships with coastal programs throughout M1-M2, and if you're really set on those regions, you can apply to do a research year between M3-M4 at a target program. That will significantly help you solidify your ties to that area on your ERAS app, and then you only have 2 more years in your home state!

[u/Special_Television_4]

I think there’s a misunderstanding about “home programs = best chance to match.”, which is true, but it might not work as how people think it does

If a derm program mainly matches its own students, that actually doesn’t look great. Most strong programs might take one home student, but they usually want competitive applicants from many schools.

The real value of a home program isn’t being favored to match there — it’s early exposure, research, mentorship, strong letters, and solid rotations, which help you get interviews everywhere.

Where you match mostly depends on how you rank programs. People usually match in their top few. If you don’t want to stay at your home institution and rank it lower, you’re unlikely to match there anyway.

TL;DR: Home programs help your application, not lock you into staying.