I would do a research year if I were you. << know students like you wo home program, no research year, rotate at safety programs wo research year like downstate and you are more likely to do well << Is there really such a thing as a "safety program" in derm? << Yes, tons, especially your home program and aways, all the midtier programs or crappy locations are safety programs. If you noticed from this year, there are only like 30 programs that everyone loves and then everyone settles for the other 100. Just look at the rank list tab <this is such a cocky statement. "all the midtier programs" are safety schools? thats rediculous. dermatology is really competitive and not everyone has the luxury of picking only among top tier programs -- Yeah 75% of us don't get that luxury but the lucky 25% do. It sucks but that's life, you still get to be a dermatologist just not at the "dream" program/location.

How did you get good letters and pubs without a home program??

Once I learned that acgme only pays for one residency I knew I wouldn’t dual apply. If you would honestly do an internal med or whatever else residency before reapplying then fine, dual apply. But if it’s derm or bust then don’t waste your time and energy dual applying.