Although the prevalence is still being determined, more medical students are using application consulting companies when applying to competitive residencies such as dermatology. We outline the structure of these companies, the scope of services provided, and the associated costs. We also discuss the ethical implications of using such firms in the residency application process and the impact of these practices on the candidate selection process. Finally, we offer possible solutions and measures that mitigate the impact of the use of consulting firms in residency applications.