34986 Optimizing representation of skin of color in preclinical medical curricula at two Mayo Medical School campuses

Abstract

By 2045, the US Census Bureau projects that the majority of the US population will be people of color. This study aims to provide data and a framework to evaluate and ensure equitable representation of skin of color within medical curricula images. The Mayo Clinic Alix School of Medicine Diversity, Equity, and Inclusion Curriculum Review Committee investigated the representation of skin of color in the preclinical medical curriculum on the Minnesota and Arizona campuses, evaluating all illustrations or photographs of human subjects. 2193 images in Minnesota and 805 images in Arizona were categorized based on a Fitzpatrick skin type scale graphic and compared with the national distribution using a chi-square goodness of fit. A skin type graphic was appropriate as the study purpose was to evaluate lightness/darkness of depicted skin rather than photosensitivity. Images used in the Minnesota χ2(5,12) = 1902307, P < .0001 and Arizona χ2(5, 12) = 112534, P < .0001 curricula were significantly different from the national distribution. The largest discrepancy on both campuses was the overrepresentation of Fitzpatrick type I images in preclinical curriculum. Fitzpatrick types III, VI, and IV were underrepresented at both campuses in order of descending magnitude. Postreview meetings with course directors critically examined nuance, implicit bias, and stereotype imprinting, developing attainable, high-yield interventions. The knowledge gap in dermatology education and disproportionate representation of lighter skin in teaching materials has been recently documented in the literature. To ensure accurate diagnosis and high-quality care for diverse patient populations, human imagery within medical curricula and reference material should, at a minimum, reflect population demographics.