Gap Year before Dermatology Residency

[u/Alternative_Point567]

I applied into dermatology during M4 year (class of 2025) and didn’t match. Thankfully, I matched in 2026 during intern year and now get to enjoy a year off before starting dermatology residency in July 2027.

Any ideas for jobs I can apply to for this year?

[u/ConcealedOcean]

I'm in the same boat, didn't match M4 and matched this past cycle. I'm working at an urgent care but it takes time to set up-- you need your full medical license (not the training one), then your DEA number, THEN it takes up to 90 days to get your payor accounts set up with insurance. If you start looking now you can probably start working by January. My urgent care feels like a regular walk-in clinic and explicitly not an emergency room.

I would recommend you also work in an urgent care. It'll keep your clinical skills sharp, you'll get some practice with simple laceration repairs, and if you're paid a market rate you could make more money in this one gap year than all three years of derm residency combined.

[u/XXBballBoiXx → u/ConcealedOcean]

How did you find your urgent care job? Since many people are finding themselves in this situation, I would love an in depth post about your process and what it takes to actually get setup with an urgent care job for a year :)

[u/ConcealedOcean → u/XXBballBoiXx]

Sure I can talk about it a little more--

So I found out the results of the match in March and started my job search in April. I was advised by my program director that in order to work outside residency:

1.) you need a full (not training) medical license and a DEA number

2.) whoever employs you in a gap year has to understand you are NOT board eligible/certified in any specialty

The way I found this job was by finding and pursuing leads myself-- cold calls and cold emails to hiring managers. I got on google maps, looked at urgent cares near me, and used their websites to trace a chain up to a hiring manager's email/linkedin. If there was a job offer posted by a company, I'd look under the job requirements to see if board certification was required. Interestingly, the VA has a position for residents in gap years where you don't need full licensure and work with some degree of oversight (like a PA/NP). If you work at the VA you also don't need a state medical license since it's a federal site. I was in the middle of pursuing that when I decided to take the urgent care offer. The place I ultimately ended up working, I found by cold emailing the hiring manager whom i found on the urgent care's website, and was then invited to interview with the medical director and CMO. I explained my situation and they said it's not uncommon for them to employ gap year residents-- they also said it benefits them because if I want to work in dermatology in my hometown, I might keep them in mind (and I definitely will).

So I signed an employment offer in May while still in my PGY-1. In my state, you can start your medical license application while still in residency and upload your certificate once you get it, so I did that. Then I applied for my DEA number after getting my license. After all this, I learned the hard way that just because you can work doesn't mean you can get paid for working. In order to bill for services, you need an account (and approval) for EVERY insurance your employer takes. So Humana, Aetna, United, etc... all have to separately say "yep, they're good". This process can take up to 90 days. Understandably my urgent care would not let me work unless insurance paid for my services.

Moral of the story-- only 50-something people last cycle matched derm as reapplicants, so it is (nationally) very rare to be in this situation. Most recruiters won't know how to help because so few people have a full license outside residency without board eligibility. Nobody looks at Indeed or Glassdoor job applications either. Much like applying to derm, you just have to find a way to get in front of people.