Abstract

Abstract It was exactly 10 years ago, in Liverpool, that the ‘BAD medical student app’ was launched. At a time when digital learning was becoming popular, a platform that is accessible globally, on your phone, which provides evidenced-based information to aid medical students’ educational needs in undergraduate dermatology, was born. In the wake of the need for promoting fair medical education, the General Medical Council, in their ‘2021–25 corporate strategy’, stipulated a requirement for an increased focus on equality, diversity and inclusion in medical education. Furthermore, medical students lack training on how skin disease presents differently in patients who have darker skin tones (Adelekun A. Skin color in dermatology textbooks: an updated evaluation and analysis. J Am Acad Dermatol 2021; 84:194–6). A 2018 study of general medicine texts found that < 5% of images included dark skin tones. Louie and Wilkes (Louie P, Wilkes R. Representations of race and skin tone in medical textbook imagery. Soc Sci Med 2018; 202:38–42) discovered that in general medicine texts commonly used by medical students, < 5% of the images included darker skin tones. The effects of the COVID-19 pandemic and the semipermanent transition to using virtual learning methods have required medical students to become more autonomous in supplementing what is learnt in lectures. Furthermore, the under-representation of skin of colour in primary medical texts will lead to students connecting diagnosis with a one-dimensional presentation and, in turn, hesitation in diagnosing skin diseases in darker skin tones. Understanding the existence of this limitation and recognizing the value of using the British Association of Dermatologists’ medical student app to reach out to medical students, we embarked upon a project to diversify education on cutaneous diseases in darker skin tones. The app, which contains didactic clinical information, as well as picture quizzes designed to challenge a student’s ability to make a spot diagnosis, has been expanded to include a larger proportion of images of darker skin tones. Where cutaneous diseases present significantly differently in lighter and darker skin tones, we have included contrasting images to illustrate this. We hope these structural changes to the app will complement higher initiatives to improve equity in skin-of-colour image representation in undergraduate medical education on cutaneous diseases.

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