Following is Part II: Advice for Medical Students Applying to Dermatology Residency, an interview with Jennifer Huang, MD - Attending Physician, Dermatology Program at Boston Children's Hospital and Assistant Professor of Dermatology, Harvard Medical School. Michael Chang, a Harvard medical school student, conducted the interview. Click here to read Part I.
dermRounds: Today we have the pleasure of featuring Dr. Jennifer Huang, the Residency Program Director of the esteemed Harvard Combined Residency Program in Dermatology. Our article will focus on advice for medical students applying to dermatology residency.
dermRounds: Dermatology has become one of the most coveted and selective residencies among medical students. Why do you think this is the case?
Dr. Jennifer Huang: There are several reasons why I think there is such a selective process in applying into dermatology. First, there are not that many spots. There are fewer than 400 residency spots every year in dermatology and by virtue of the fact that there are so few spots, it makes the process more selective.
There are also several other reasons why people are interested in dermatology. I think that people may initially think and perceive that dermatology is a lifestyle specialty. But in my mind and with my experience in mentoring students and residents, there are many more reasons why people choose dermatology. Patient care can be very rewarding because the diagnosis oftentimes can be made at the bedside. There are not a lot of specialties that allow for that these days. It’s really satisfying to come into a patient's room, evaluate the patient and give them a diagnosis in one sitting. Of course it doesn’t happen all the time and we see very complex patients, but this is an aspect of our specialty that results in real job satisfaction.
It can also be very rewarding to become a true expert in a single organ. Providing a service for patients and other providers that no one else can is really meaningful.
On the lifestyle issue, the specialty itself allows for a lot of flexibility not necessarily for your personal life but for your professional life as well. In dermatology, it is possible to adjust how much patient care you provide, and allocate time to other things that get you excited, whether it’s community service, advocacy, healthcare policy, teaching, research, etc. It is a specialty that allows for you to mold and shape your career over time.
Dr. Jennifer Huang: When a preclinical student comes and meets with me because they’re interested in dermatology, I have generally two recommendations. One is don’t make a commitment - you have so much more to expose yourself to, and you are doing yourself a disservice this early in your career when you commit to a specialty. So much inspiration comes from the faculty, patients and residents whom you are exposed to during your clinical years. Keep an open mind during this time because it is harder to change that decision once you enter a residency program. Personally, during medical I was very focused on pediatrics as a career choice and did not really explore dermatology because I wasn’t exposed to it. Making a decision too early may limit your own possibilities or your own potential.
That being said, the second piece of advice I usually give preclinical students is if there is a chance you’re interested in dermatology, since it is a competitive field, you want to make some strides even during preclinical year. The most important thing you can do is identify a mentor. This is more important than doing research or getting published. Think about why you’re interested in derm and talk to a few advisers to see if they’re interested in mentoring you. If so, establish that mentoring relationship early. As a mentee, it is your responsibility to reach out to your mentor and keep them posted on how you’re doing. Ask to meet with them - twice a year or every few months or even more frequently if working together on something. That person will also potentially provide you with opportunities as they think of them and also help you with publications or research. It’s hard to give opportunities to students that you don’t know. Establish a genuine relationship with your mentor and they’ll think of you when opportunities come about.
My advice for seeking out a mentor is that it does not always have to be someone in a leadership position - these people are the ones who tend to have the least time and have too many people reaching out to them. You may consider seeking out a mentor who is a junior faculty member since they’re closer to you in terms of having just gone through the process and may also have more time or opportunities.
Once you’ve made the decision to apply into dermatology, my strong advice is to not drop the other things you enjoy doing while you’re pursuing opportunities in dermatology. It doesn’t show commitment and does not look good. Be true to yourself and think about the things that excite you and don’t worry if it’s not dermatology related, that just makes you more interesting!
Once you are preparing your dermatology application, make sure you have someone look at your ERAS application and ask them if they have any advice about how you have described your activities or written out your publications. A faculty member who has reviewed applications before can give you good advice.
Also be sure to get advice about who should write your letters of recommendation. If you’re on a rotation and you’re not sure if you’re going to keep working with a faculty member afterwards, ask them for the letter at the end of the rotation because that’s when they’re going to know you best. It’s important who writes your letters - choose people who know you well. It is better to ask someone who knows you well than someone with an important title after their name.
Dr. Jennifer Huang: In general, we look for some standard things that are important like doing well in school, getting positive comments on your clerkships, being productive in whatever pursuits you’re excited about. In the end what we’re looking for are people who are committed to contributing to our field and have potential to become leaders in our specialty. Leaders in my mind are those who genuinely want to give back, make a difference and move our specialty forward.
When I give advice to students, I will review all of the basic things that all programs look for like your grades, board scores, publications, and all of those things that make the bulk of your application. But I will always advise them to tell a story from beginning to end. What have you done, why did you do it, and how does it relate to what you are doing now and what you want to achieve in the future. I glean all of that through their written app, achievements, personal statement, and in their interview. I am looking for someone who is authentic and really wants to give back to our specialty.
Dr. Jennifer Huang: “Necessary” is a strong word. I don’t think it’s necessary. I usually tell students that the majority of students, from my experience, take a gap year or research year. The other fact is that some people don’t do it and they still match in dermatology. My advice is to consider taking a gap year if you decided on dermatology on the later side and you have not yet identified a strong mentor, if you have not been productive in terms of dermatology focused achievements, or if you don’t feel like you had a strong performance in medical school. This is where advice from a close mentor is important. But you have to remember that you have to achieve those things during this gap year for it to make a difference. You have to be careful about who you decide to spend that year with. Make sure it’s a good relationship and someone you can connect with. I will also acknowledge that it is a huge financial sacrifice to take an extra year, as medical school is already so expensive. That’s why I wouldn’t tell everybody to take a year off and it’s completely understandable not to for personal reasons.
dermRounds: For the student who decides to apply in dermatology late in the game, what advice do you have?
Dr. Jennifer Huang: I would consider taking a year off to identify mentors, to show commitment to dermatology and to think about why you want to go into dermatology because if you decide late, it may be hard for you to express exactly what your vision is for your career. Don’t rush it if it’s possible for you to take a little bit of time - you will probably be better served doing that. If you can’t take the time, get realistic advice about your chances of matching before you proceed.
Dr. Jennifer Huang: A direct path is not always the best path. Many of us who choose medicine are trained to move directly from one step to the next, from med school to residency, to fellowship, to a job. However, I think that there are many ways to get to your final destination, and perhaps if you take some more time at your pit stops, your destination will be different than what you originally envisioned. If you don’t keep your mind open to options, then you can limit yourself. I really believe that you have to follow your passions, even if it takes you on a detour. Be creative and think big, don’t just check the boxes. Dermatology might be your passion, but the stressful process associated with getting there can bog you down. Reminding yourself of what excites you about this kind of career can keep you optimistic and hopeful even when things may feel frustrating and challenging. Burn out happens when people lose direction or meaning in what they do. Don’t let it happen to you!