can we have an honest, respectful conversation about this "derm is derm" that comes up here every once in a while. I think derm is the only specialty where people applying to penn are also applying to larkin (no shade to larkin) just mean they are different and i'm curious why this is. Is the idea that derm is so great, it doesn't matter where you go? It is just crazy to me that 260 step students will gun for top/mid tier medicine, rads, fm, psych literally anything else but for derm, it becomes "derm is derm" i can go anywhere for derm // I mean I doubt Penn Derm applicants are applying to Larkin which mainly takes DO applicants, but that's probably a small detail in your overall point. The truth is that Derm is a seller's market, and it has been for a while (Derm 10-15 years ago heavily emphasized being the top of the medical school class, possibly AOA, stellar Step 1 scores, etc. to even be considered/still in the running to be able to match into Derm because it was just that competitive). There are fewer derm residency spots vs. the number of people applying. That's what makes it competitive. It's as simple as that. Applicants don't get to call the shots as much, and so there is a lowering of expectations and many are naturally thankful to even match into Derm (that's where the "Derm is derm" aphorism comes from). If you're not happy, programs can find someone easily (someone who didn't match and in their intern year, someone who did a RY after internship and applied again, etc. to take your residency spot in Derm). Needless to say that contributes a lot to the haughtiness in the specialty with Derm attendings (who know their specialty is competitive) although that is changing somewhat with younger Dermatology graduate attendings entering academia and are more understanding of how the process is now.