Dermatology Residency Applications

u/PD-1 gave a fantastic overview but I will share my perspective as the now graduated chief resident of an east coast, academic, second tier program who participated in the application process as applicant and resident reviewer.

1. Application. We received ~500 applications for 20-30 interview slots to match 2-3 applicants. Those numbers vary slightly from year to year and generally are trending up but we had funding for 2-3 so that always stayed the same. Certain criteria were used to cull the pool before they were divided between the faculty reviewers. Among them: IMG immediately culled without review. Step 1< 240, immediately culled. Any visa requirements immediately culled. This left around 300 applications which were divided between ~10 faculty reviewers. They were asked to rank their best three applications and three back ups who were then offered an interview or interview waitlist. I agree with u/PD-1 who explains there is tremendous subjectivity at this stage. Did the DO faculty member get a DO applicant? Probably more sympathetic. Did the faculty member who went to Yale and who has a big hard-on for research get the MD/PhD who has a letter from his buddy at SID? You get the point.

2. Interview. 30 offers, some amount of time to accept, back ups interviews sent. Last minute cancellations. More back ups sent. One interview day of 20-30 applicants. The playing field is totally level at this point. There was an (optional) preinterview dinner with the residents where they are very much taking notes on the candidates' behavior. Interview day was 8-4PM. This was pre-Covid so, the faculty + first year residents paired up in 2s and candidates would spend 15 minutes in like 6 rooms with them. Rapid fire, Q&A about research, career interests, deficits in application, and some softer stuff. My program was not very touchy feely so it was a stressful experience. In between interviews candidates would chat with the residents in our conference room (very much being observed), tour of campus, etc. Support staff, program coordinator etc are also taking notes of candidate behavior.

3. Rank meeting. First year residents + faculty immediately adjourned to the rank meeting after interview day. A spread sheet is made with each candidate. Each asked to rank them 1-10 with residents submitting one number only. Do Not Rank is also an option with justification. An average is computed for each candidate. Do Not Rank with appropriate justification from any person including residents is immediate disqualification. The average score creates the first draft rank list. The faculty (and residents) could then advocate/malign their preferred (un-preferred) candidates. This was open battle royale style, fairly nasty, surprisingly democratic, emotional, and gritty. We all had our favorites who we wanted to push up and others that we wanted to push down. I am convinced that all dermatologists are extremely competitive people (its how we get through aforementioned toxic process) so we want our horse to win. Consensus could lead to a candidate falling or rising from their previous rank spot. A rise or fall of 3 or more spots happened occasionally. An applicant mass emailed us an insincere, long winded thank you email in the middle and we dropped her 5 spots. Ultimately, we arrived at the final list. The PD+Chair had final right to make minor modifications of list based on any new information coming to light between then and submitting list. We match somewhere between one third to half way down our list.

That's how the sausage is made. Happy to answer appropriate questions.