Resident Corner

Resident Application Q&A with Dr. Sacharitha Bowers

Do you have questions about the upcoming Resident Application Cycle? The Next Steps in Derm sister site, Derm In-Review has been hosting a fabulous series of interviews with Program Directors and faculty.  Derm In-Review Advisory Council member, Cula Dautriche asks all the questions that incoming residents want to know!  One recent interview featured Dr. Sacharitha Bowers, from Southern Illinois University School of Medicine, who discussed questions and concerns regarding this upcoming residency application cycle.   You can find those questions and answers below.  You can also head over to the Derm In-Review Instagram Channel to watch the full interview!

What step 1 score are PDs looking for? and what other qualities are program looking forms?

It really depends on the program. The average Step 1 score of the dermatology applicant has hovered around 250, however more and more programs are realizing the limitations of Step 1 and the inherent bias and inequity built into standardized exams. The USMLE has clearly been aware of this as well and we know Step 1 is going pass/fail.

Other qualities really center around a few key aspects: how will you be with patients, how will you be with your teammates, and what are you looking for in your residency program?

How will you care for patients – will you advocate for them, go the extra mile, work in the patient that needs to be seen and needs our help? Even if we don’t know how to help the patient, are you willing to learn and give it your best? Will you be the doctor that you’d want caring for your own family? Caring for patient in an empathic and compassionate manner, with the lens of cultural sensitivity, openness, and willingness to learn from them is so important.

How will you be with your teammates? Can they count on you to help them when they are running behind? Will you be able to help them if they are struggling, or cheer them on with their wins? Can you cover for them when they need you? Will you be receptive to feedback in the interest of self-improvement and lifelong learning?

What are you looking for in a residency program? Do you want to be at a big urban medical center with multiple specialty clinics and research opportunities? Are you looking for a smaller program with a more community focus? Or do you just want to get solid clinical training and a strong educational foundation? Almost every residency can provide you this, so how do you choose after that?

Many people pick based on the city they want to live in – don’t do this!!! You have your whole life to live in the city you want. Certainly other factors sometimes come into play, but remember that residency is a very busy time and picking a program based solely on the city it is in (not considering that there may be other considerations, such as family) takes away from you having a better fit at another program.

What are your thoughts on Step 1 being pass/fail? How will it affect future matches?

My personal thoughts are that this is a step in the right direction when it comes to increased equity in the match process as well as using meaningful selection criteria. The Step 1 exam was never meant as a residency selection tool – rather it was meant for licensing requirements. Now, how it will affect future matches remains to be seen. I know there are valid points on either side. Will it make the application process for IMGs or students from lesser known schools more challenging? These aren’t straightforward yes or no questions because the criteria used to determine residency interviews and ranking are so complex and vary from program to program and even year to year.

What advice do you have for a derm applicant without a home derm program?

I really feel for these students, especially this year. A few options include trying to spend time in local dermatology clinics, participating in virtual elective offering (check out the national dermatology interest group site for this), checking out meet and greet virtual open houses, and just getting the most of the medical school rotations and experiences you have. As PDs, we are sensitive to applicants who don’t have home programs, and when and if you are emailing programs about virtual electives, mention that you don’t have a home program.

What things have stood out to you in applicants from previous cycles?

I really appreciate when applicants are honest about their past struggles or challenges they have faced and are willing to have a conversation about how this may have affected them or even how they have learned and grown from these experiences. We are all human, we make mistakes, life throws us unexpected curve balls and truth be told I think the windy curvy path is much more interesting than the straight linear one! Sometimes we stumble/fail, but these experiences don’t define us and they should not limit our potential. I think medicine could do a lot better with more sharing of these vulnerable moments!

Would you rather a less personal LOR from a well-known derm or a detailed LOR from a less-known person?

This is easy – hands down I value a more detailed LOR from a lesser known person. It doesn’t matter to me WHO the letter writer is, what matters is their content.

Are scores being reviewed differently this cycle?

I do think that programs are approaching this cycle more with a holistic lens, even if they don’t’ necessarily participate in an official holistic review process.  Some programs may even decide to implement the pass/fail approach earlier, many programs are blinding scores or not using score cutoffs. I think no matter what, most programs are realizing that this pandemic has thrown us all a huge hurdle but we can use it as an opportunity to rethink our processes.

What are your thoughts on applicants emailing letter of interest to programs?

There’s no rule barring applicants from expressing their interest to programs and I believe the more transparency there is during the application process, the better. What will serve applicants and programs well is ensuring better fit and more transparency helps to achieve this. It’s always very helpful to know if a student is highly interested in your program, especially when you are making the hard decisions on where to rank applicants.

Do you think applicants should bring up their weaknesses during an interview?

I think they should be prepared to answer anything that is on their application, from failed tests, missed time, or experiences related on the PS. Not everyone asks about “weaknesses” per se, but it’s always good to have an idea of what you think you want to work on in regards to growth and self-improvement. “Red flags” should be prepared to be discussed.

Is non-derm research still valuable?

YES!! I think the best research is meaningful research. Research that you want to engage in and were able to put significant effort into is what I consider meaningful. It doesn’t matter if it is derm-related or not, in my opinion. Not everybody has access to dermatology research and not all dermatology programs have research. Find research opportunities that are meaningful and interesting to you and that you can make contributions to that will add to your skill set.  No matter what field the research is in, you can learn similar valuable skills in and around scholarly activity.

What is the appropriate time to tell a program that they are your number 1?

IF you really think they are your number 1, you can tell them they are your number 1! cWait until after you have finished all your interviews! I don’t recommend telling programs on the day of the interview because it may not be viewed as genuine and also, how can you be sure?

How can DO applicants improve their chances on matching derm?

SO much of this rests on programs being more inclusive to DO applicants.  Our DO students learn everything our MD students do and more, and dermatology can benefit from an integrative approach.  I would advise DO students interested in dermatology connect with the national dermatology interest group if they can and be part of the conversation and get as involved with the process as our medical students.

What do you look for in IMGs? What component could help IMGs stand out?

I truly feel for our IMG applicants because I think there is truly a barrier placed in front of them with the limited number of dermatology slots that puts them in a position of relative competition with US applicants. In my mind, anyone who has a passion for a particular field and is willing to work hard to learn about this field, genuinely wants to take care of these patients and help our communities should be able to train in the field of their choice. There is so much inequity in healthcare and so many disparities, and our application process often keeps these disparities thriving. Dermatology is the 2nd least diverse specialty in medicine and our patients need more diverse and inclusive representation in their physicians. Inherent biases in the application process maintain these disparities and we need to critically examine the ways academic medicine contributes to this inequity. I believe academic medicine can be a beacon of increasing health equity and an integral part of this working towards equitable residency selection processes. I also believe there is inherent bias against our IMG applicants regarding their medical training, and this does a disservice to physicians who could make important contributions to medicine and healthcare in America. To answer your question, I look for the same characteristics no matter the applicant, but given the barriers that exist for IMG applicants, it helps for them to reach out programs and communicate their interest and showcase their unique strengths and contributions.  You never know when it will strike a chord with a particular program.  Bottom line, I think as a specialty we have much work to do in regards to our DO and IMG applicants to ensure they have equitable and inclusive representation in dermatology.