Resarch years are about connections, or in rarer circumstances about producing very high quality translational work that will make you more attractive to top programs. If you can form the connections without a RY then more power to you. If you are pursuing something like peds derm or even med-derm, a RY may not be as necessary since there is less competitition for these spots and more focus on the clinical interest (that being said, if you feign interest in these it is very easily spotted)