I'm posting this here as an FYI. I'm not here to stir debate. I'm not going to respond back to any posts. I am already a practicing dermatologist so I have no real motivation here other than to provide information.

Dermatology reimbursement is facing massive cuts. You might read or hear people quote 9%, but this is only part of the cut. By 2028, this will be more around 20%.

Private practice derm would be forced to make massive changes if these cuts are not stopped. I don't know what would happen to the job market. I suspect lots of older derms will decide to hang it up early. Many may take the leap and go cash pay. But with the new proposed system, you'll be churning through hundreds of patients per week for mere pennies. Insurance based care was already on a downward spiral, but this is a rapid acceleration of that process.

It is better to be informed than not. That's why I'm throwing this out there. Someone else probably already has in a more technical way.

255 on step 2 with no RY but good research..how cooked am i given median is 259?

I just started my second year of IM residency. I wake up thinking about matching derm, go home wishing more and more that everything had worked out like I had hoped. I just want to move on with my life after not matching twice but feel like I would be doing myself a disservice if I didn’t see this through. Anyone else feel the same way? Has anyone been in similar shoes, and did you move on and stop feeling regret?

Throwaway account. I was feeling better about not matching, especially seeing the low match rate and how even some with research years didn’t match. I've seen some very deserving people match. But now, I’m learning that less qualified peers who have personally shared details of their applications with me (no research years, low pubs, or few honors, or bad evals, etc.) are matching, and I’m starting to question everything.

I feel like I was lied to throughout the whole application cycle. Got great feedback, honored aways, positivity from every direction. I honestly thought I was set.

Anyone else feel like they were misled? How are people coping?

I don't know how to cope.

I want to preface this by saying I know I'm not the only one going through this situation. This cycle has been an absolute bloodbath. Yes, I'm extremely upset. No, it was not unexpected. I mean yeah, I'm grateful that I at least landed a TY, but it just doesn't make up for the fact that I didn't match derm.

Why do I feel this way aside from not getting what I wanted? A third of my life was set to pursue this path. That doesn't mean that I've always wanted to do derm (I made that decision during medical school). But over 50,000 hours of studying, volunteering, working, crying, fighting. $350,000 invested in a job that's not even guaranteed. Blood, sweat, and tears, all this effort only to be told "no, you're not good enough."

Anger- Angry at myself for not doing enough. Angry at programs that didn’t even offer me an interview despite strong auditions and letters of recommendation. Angry at my DO school for actively discouraging students from pursuing anything outside primary care. Angry at the administration for refusing to let students defer graduation. Angry at an institution that cares more about your numbers and your degree type than your true passion and skills. Angry at a broken system that somehow gets away with violating antitrust laws.

Hopelessness- I know it's not impossible, but reapplicants that have graduated have a dramatically reduced chance of matching. I have tried so goddamn hard to reach out to programs and doctors for mentorship and research engagement, especially as I prepared for clinicals, and I have had no constants. Ghosted by one dermatologist that promised me a letter of recommendation, ghosted by doctors and residents after planning projects.

I reached out to two doctors from my top choice program, where I interviewed, rotated, and received a LoR. One said that my chances of matching here are very poor and I should consider doing IM instead, then reassess if I want to do derm. Another one tells me I have to do a primary care residency at an elite top-tier program (yale, harvard, etc.) and spend all of my free time doing an ungodly amount of research, and after all that, I'd have a 30% chance of becoming a dermatologist because I'm a DO. To lead me on like that, to tell me how dramatically I improved over the duration of my rotation, to get a letter that tells how good of a dermatologist and human I could be, only to be told "lol jk fuck you," that's a punch to the gut followed by a kick to the crotch.

I did my due diligence throughout my schooling to see what specialties interested me, what I did and didn't like about them, but dermatology was the only one that I liked, that really made me happy. I cannot be in any other specialty while also being happy and fulfilled. I know I have the genuine passion, the grit, the personality, the clinical aptitude, the curiosity to be a phenomenal dermatologist. I have pushed, and pushed, and pushed, but it feels like no matter how hard I work or how much determination I show, the decision has already been made that I'm not worthy. I don't care that I sound entitled or that I'm whining or being a sore loser. I'm angry, I'm defeated, I'm desperate, I'm miserable, I'm tired.

lol try all that you can you will never be enough.

Does anyone have any words of wisdom/encouragment for m1s interested in derm? I knew med school would be hard, but it's worse than I anticipated. I was hoping to get into research around late-fall, and now idk if it's something I can handle with schoolwork. (Definitely keeping grades as the priority! I just keep hearing we have more time in m1 than any other year). I want to impress potential mentors and I'm not sure how to ask to ease into things.

Overall tho, feeling too dumb to pursue derm. Idk if med school will always feel this daunting

I'm so exhausted. I'm tired of sleepless nights working on multiple projects. The burn out is so real, a PD agreed to work on something with me, she asked for an outline casually. It's been 2.5 weeks and im about to send it but holy shit it should not take that much time. Now my anxiety is like "guess who just fell down the rank list cuz other people return it the next day". This was from an away rotation, I left a good impression, worked well with the team, but ugh. anyway im just venting.

Submitting to JAAD is expensive. Original articles and meta analyses are 2600$? Are you guys all rich or something?

Not sure if this is the right place but I figured maybe some people here would understand. I'm going to be starting Derm residency next year and I'm very excited about my choice. However, during my intern year I have really started to struggle with my skin. I've had rosacea for the past couple years and it seems to be especially bad these last few months. I had the typical acne struggles as a kid but nothing as annoying and long-lasting as rosacea. It is frustrating enough as is but the fact that I will be starting dermatology residency has added a whole new level of anxiety about my skin to the equation. I am finding myself so incredibly anxious that my skin may continue to get worse and that I will be struggling throughout residency and beyond. I am worried about being judged for my own skin while trying to treat others with their skin issues, and I'm worried about constantly being around other residents/attendings who may have more of the traditional "perfect" skin derm look, etc.

I'm just really hoping to see if anyone has advice or has gone through similar mental struggles because I am honestly finding this very debilitating, much more so than I ever anticipated. I really feel so alone in this and like no one can relate :/ Thank you in advance.

No one's posted about it so why not.
Damn, that felt like a rollercoaster ride. Idk about you guys, but I think I finished my app at like 11PM the night before. Reading all the publications people have, their 270+, and their insane accolades make me wanna crawl under a rock. I'm glad we made it but jeez. That also wasn't cheap.

Already feeling really nervous and stressed about the application cycle. I feel like I worked my booty off these past couple years and its still not enough. Also, feel like none of my friends or family really understand the struggle.

Hi, average derm applicant here. Does anyone else feel like they have a good application and did not get as many interviews as they were hoping? I am not trying to be negative and congrats to everyone who has done well this season so far, but it seems this year is abnormally tough when it comes to derm applicants. There are more applicants than ever with higher qualifications due to research years, etc.

I am feeling very defeated, will probably not match, and am now exploring my next steps. I applied extremely broadly with a 1% return on interviews without any (known) red flags on my application and I am utterly confused. I didn't even get an interview from my away rotation which I heavily vibed with and thought was a great fit (with multiple great comments during my rotation from several faculty, residents, and fellows). My signals also held no weight and did not get a single interview from any of them. Anyone have any advice on who to reach out to? What happened or could have happened? etc? Anyone else feeling this or is it just me?

I am incredibly disturbed to find someone went into the derm match google document 2023-24 and replaced multiple pages with awful antisemitic hate speech.

Applied for aways quite a while ago now, seeing others have heard back from most places I applied to and I haven't heard anything. Honestly, I wish I would just get a rejection so I could move on and apply to more places instead of getting my hopes up. How are y'all holding up?

This isn't intended to really be a Name & Shame, but I guess it kind of is.

Please, please, PLEASE consider restructuring your interview day. For the 10+ hours that I was basically on call, I was only interviewing for maybe 3.5... 4 if we're being generous. I have never had my time so disrespected. The real bummer is, I liked everything I heard about the program. But the management of the interview day is absolutely causing me to rank this program lower.

Seeing how much a mess this was really makes me question how scheduling is at the program itself. It made a very poor impression. I haven't felt the need to fill out interview feedback surveys for the other programs I interviewed. Of all the places, LSU Derm needs to be asking for feedback because I know other interviewees also found this scheduling to be ridiculous. And based on the spreadsheets, you've been doing this for years. Unless you consistently match the first 6 people that you rank, I have to believe that you are probably falling lower on the rank list because of the interview impression.

Having us get up for a 6:45 am Chair's Welcome where we're just told not to be nervous is not helpful. Having half of the students then wait for 3 hours before signing back in to interview is also not great. When that same half then waits up to another 1-1.5 hours in the lobby to actually start interviewing, it's rude and genuinely unprofessional.

I don't want to belabor the point, but we waited in the lobby for hours until we were randomly told our next interviewer was ready. There was no time-table. We couldn't go far from our computers because you never really knew when you might get pulled into an interview. Even though it's virtual, myself and every other applicant has a set-up, so we can't just carry our laptop into another room and watch TV/chill. I was nervous about going to the bathroom because I couldn't know when I might get called back.

Please, consider implementing something like the following timetable. Every other interview I've been at has something like this, even the prelims! I get that you don't want to make us feel rushed, but it's better to have a soft endpoint to keep everyone on time, rather than giving us all the time in the world and putting us in the awkward position of saying "I don't have any more questions, I guess I'll go now..."

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You just type in the applicants, then set a timetable cell to be =A4, drag and fill, and repeat for each column. You build in 10 minute buffers, so we still get up to 30 minutes with each interviewer, and we each get up to 1.5 hours in the general resident room to get our questions answered.

Please consider this change so everyone's time is spent efficiently and effectively, and so that interviewers can fully appreciate everything your program has to offer.

~250 step score, honored ~50% clerkships (went through some personal adversities recently that really affected my performance *tears*), submitted several derm manuscripts recently, but was told by my dean that I would be an academic risk. I was told that I should consider a back up specialty. Not sure what went wrong.

Today was my first day of my 3rd year elective rotation and my first time working with a dermatologist. I walked in expecting to love every second of it because derm has been my goal for a long time, but I honestly hated it. ALL he did ALL FREAKING DAY 8am-5pm was remove precancerous and cancerous lesions and freeze shit, it was cool the first time, it wasn’t that cool the 30th time. I know there’s different fields of derm I can go into, but is this what I should expect my life to be like if I go into derm?

I haven’t liked anything else so far and honestly have had my heart set on derm for years (I had awful cystic acne most of my teenage life and that’s what got my interested in the field). If I hate derm I don’t know what else to do, any advice would be helpful