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The ups and downs in my path to dermatology

I went into medical school determined to be an ophthalmologist. A close family friend of mine is a great ophthalmologist and loves his job, which I found inspiring. A part of me also felt pressured to choose a field early on, because I worried that I couldn’t get into a competitive one unless I started doing research, volunteering, getting to know the faculty, etc. In retrospect, this is silly, because exploring different fields to find out what you like is probably the most important thing you can do as a medical student. But I thought I knew, and so I threw myself into my research on mouse retinas and time at the free eye clinic. I enjoyed working with my amazing mentor and PI, but fast forward to the end of third year, after I did two months of ophtho rotations, I realized that I didn’t love the clinical work.

Major uh-oh, as I was three months away from residency applications.

I did some quick and frantic soul searching and reached out to several mentors. One of my early mentors from undergrad suggested that I try a dermatology rotation. Crazy, I thought to myself at the time. I had been interested in dermatology as a first-year medical student, but after hearing about the insanely high board scores, the intense type-A pre-derm students who were at the top of their medical school classes, and the crazy number of publications you needed to get in, I was completely scared away from the field. My mentor told me to try anyways, and I listened.

At the end of my third year, I switched into a four-week dermatology rotation. I think I was actually half hoping that I wouldn’t fall in love with the field, so that I didn’t have to go through the grueling application process. But I completely fell head over heels.

Dermatology combined what I loved about internal medicine (the actual thinking about the medicine!) with super interesting visual diagnoses. I loved the mix of procedures and clinic, the continuity of care I got with patients, and the huge overlap between dermatology and other fields like rheumatology, cancer biology, immunology, etc. In short, I liked it more than any other clerkship I had done and I could really see myself in this field. So I decided to go for it.

It was two months before residency applications were due, and I didn’t know the faculty well and I had very little to show in terms of dermatology research. My board scores were nowhere near the quoted average needed to be a “successful applicant.” I emailed all the faculty to see if anyone had a short-term research project, and  I ended up working on and presenting a case report of graft vs. host disease with an amazing young attending named Bernice Kwong, MD, in the Stanford dermatology department. I also did a special rotation with Toby Maurer, MD, the chief of dermatology at SF General Hospital who is the leader in global health dermatology (another huge interest of mine).

Fast forward to that November. Everyone in my class had gotten interview invitations, but my inbox stayed quiet. Then… the floodgates opened, and not in a good way. I had applied to around 85 dermatology programs, and every day I got rejection after rejection after rejection. I remember getting twelve rejections in a day once, and then, the cherry on top, I got rejected from one of my top programs. I had just gotten off the Muni (public bus in San Francisco) and it was pouring rain, and I just stood there on the street holding my umbrella and broke into tears. I had never felt so insecure, so unsure of myself and my accomplishments, and I felt like I had no future in medicine.

Eventually I did get some interviews, and most were surprisingly at excellent programs I felt very lucky to be visiting. What I soon realized was that it didn’t matter that I wasn’t pre-derm from the start or that I didn’t have the highest board scores or number of publications. Every school I visited was really interested in my global health and media background and the gap year I had spent working in medical journalism! I had something different in my application, and even though it was nontraditional, it helped me stand out and gave me another skill set to bring to the department.

NYU Dermatology really stuck out in my mind on interview day; I clicked with the faculty and the residents who I met, and I loved the facilities and specialty clinics there. I never thought that I would actually match there, but I’ll never forget the feeling that shot through me when I opened my red envelope at Stanford Match Day and read “NYU Dermatology.” I’m halfway through my first year of derm here at NYU, and I still pinch myself sometimes because this training program is amazing, and I am so impressed by my co-residents.

Ultimately, one of the main points I want to get across here is that the whole application process is an unpredictable free for all. There’s no way to say whether one person or another who will definitely get into dermatology residency because it’s a totally SUBJECTIVE process. If you are passionate about something that can be related to dermatology in some way, that can make you stand out, so show it in your application! Don’t freak out comparing yourself to other applicants because chances are even the most confident appearing ones have moments of insecurity too. You’re all in the same boatAlso, don’t let the fear of failing stop you from trying. If I had let my worries of embarrassing myself stop me, I would not be a derm resident today. Most importantly, don’t let the application process define you and affect how you think of yourself. Any medical student has already worked so hard to make it this far, and no matter what happens, you will be more than fine.

Joyce Park is a resident in dermatology at NYU Langone Medical Center who received her MD and BA at Stanford. A longer version of this piece originally appeared on her blog, TeaWithMD.

Photo by bairli1

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