While there are some programs that will not interview applicants who previously did not match, failure to match does not prevent candidates from reapplying in the future. Many excellent dermatologists did not match the first time. Reapplicants should seek to overcome previous weaknesses and further build their application. The dermatology program director/chair at your current institution is a great resource for individualized advice.
Programs notice the applicant’s graduation date whether one previously applied or not. Some advisors favor addressing/mentioning a previous failure to match while other do not. If addressed, the personal statement should include your experiences/motivation for reapplying (including gaps, plans for next year, etc), but this, perhaps, should not be the primary thesis/focus of the personal statement. It may also be helpful if letters of recommendation address this issue and attest that the individual’s qualifications and character.
If an elective can be arranged before November during your internship, a more meaningful interaction may occur with faculty at your “home” program. Try to publish a case report or two with them. In addition, for those completing a preliminary year, it is important to let preliminary year faculty know of your interest. They can provide assistance in scheduling, meaningful letters, etc.
If you reapply a second time and don’t match, you may want to consider completing an Internal Medicine (IM) residency or pursuing a Dermatology Research Fellowship. Please note, some programs will favor mature candidates who have completed an IM residency, while other programs will eliminate such candidates from consideration due to funding restrictions.
Importance of USMLE Step 3 scores in applying:
An excellent score is always helpful, but it is considered with the other strengths and weaknesses of the application. As most programs focus on the Step 1 +/- Step 2, the Step 3 score is unlikely to provide helpful additional information to the program unless previous Step scores were poor. Unmatched applicants should meet with their program director/chair to ask for feedback regarding their application and ways it could be improved.
Should I complete an externship at a program of interest even if I received a interview rejection letter for the previous year?
The selection of candidates for interviews is very complex process that varies from program to program. There are certainly many more interesting candidates than available interview slots. Faculty, committee members, and program directors are human beings subject to the usual psychology that drives decision making no matter how objective we try to be. For that reason, a known candidate stands a better chance of getting noticed when compared to an unknown applicant. A good performance during the externship can lead to an interview slot or for a research fellowship position if you do not match.
Switching medical fields in residency:
In the personal statement, a short commentary reporting the reason the other specialty was chosen and the factors that led you to go another direction should probably be included. You do not want to be stigmatized by any consideration that you were asked to leave the other specialty for issues related to professionalism.