Dermatology Match Trends From 2022-2025 Using the Texas Seeking Transparency in Application to Residency Database

Dermatology is one of the most competitive residency specialties in the United States. In 2022, the United States Medical Licensing Examination (USMLE) Step 1 transitioned from numerical scoring to pass/fail. Additional changes, including preference signaling and interview caps, were introduced during this period. This study analyzes dermatology residency application trends from 2022-2025 using the Texas Seeking Transparency in Application to Residency (STAR) database.

A retrospective database analysis was conducted using the Texas STAR dataset, a national, multi-institutional repository of self-reported residency application metrics. Dermatology applicants from participating U.S. medical schools between 2018 and 2025 were included, with particular focus on the 2022-2025 application cycles surrounding the transition of the USMLE Step 1 to pass/fail scoring. Applicant characteristics were analyzed across multiple domains, including the number of programs applied to, USMLE Step 2 Clinical Knowledge (CK) scores, research experiences, peer-reviewed publications, leadership activities, clerkship honors, and participation in a dedicated research year. Descriptive statistics were used to summarize these variables. Comparisons across application cycles were performed to assess changes over time. Continuous variables were analyzed using Wilcoxon rank-sum tests, while categorical variables were compared using chi-square tests. Statistical significance was defined as a p-value less than 0.05.

Applications per applicant declined substantially after 2023, with mean applications decreasing from approximately 82 in 2022-2023 to 45 in 2024 and 29 in 2025 (p < 0.01). Step 2 CK scores remained stable across all cycles with no significant differences (p = 0.62). Research productivity showed a modest decline following 2023. Mean peer-reviewed publications decreased from 7.77 in 2023 to 5.55 in 2024 (p < 0.01), and leadership experiences declined from 5.57 to 3.69 during the same period (p < 0.01). Research year participation remained stable across cycles (p = 0.76). Clerkship honors showed no significant differences between years (p = 0.52).

Recent dermatology applicants appear to be submitting fewer applications and reporting fewer research and leadership experiences while maintaining stable academic performance. These trends likely reflect structural changes in the residency application process, including preference signaling and efforts to reduce application inflation following the Step 1 pass/fail transition. Despite these shifts, core academic metrics such as Step 2 CK scores and clerkship honors remain consistent, suggesting continued emphasis on academic performance in dermatology residency selection.