You are realistic to have low expectations. Dermpath is the most competitive fellowship to get in pathology because they have so few spots and you are competing against Derm residents who have the most competitive applications in all of residency/fellowship. That being said it’s not impossible: somebody’s gotta fill those slots, right...why not you?
As far as finding an “in” via the hemepath route at a program that has both fellowship programs, I think the margin of return on that is next to nil. You would already have to be in the hemepath program (or at least accepted) to get any traction into parlaying that towards a potential dermpath fellowship. If you’re already in the program as a hemepath fellow, then obviously for the sake of time, you’d be doing dermpath the following academic year. At that point, the dermpath fellowship would have likely already filled their incoming dermpath slots while you are a hemepath fellow. If you theoretically were to use it as an “in”, in my opinion, for the sake of time, it would be better to get accepted into hemepath; and, then immediately contact the program and say you want to stay in the area and complement your training with another fellowship and have an interest in atypical lymphoid proliferations of the cutis. Again, the margin of return on this is minimal to nil, imo.
If I were you, since you only want to do one fellowship and avoid two if possible, I would beef up my CV as best as I could to apply for dermpath only when you’re a third year path resident. If you don’t get in, apply for hemepath as a late third year or early fourth year. At that point if you didn’t get in dermpath the first time, chances are slim you’ll get in later down the road. There’s always hemepath spots open, so you should have no problem getting in. Then as soon as you are accepted in hemepath (not already started), you can try the long-shot of contacting the program and seeing if you’re hemepath fellowship director can reach out to the dermpath director and express your interest in complementing your training. That being said, I think it’s a long-shot, but it still may be worth a shot…