Evaluating dermatology curricula in US medical schools

Abstract

To the Editor: The last comprehensive description of dermatology curricula in US medical schools found that responding programs offered an average of 16.3 hours of dermatology instruction and 8% required no dermatology instruction.1McCleskey P.E. Gilson R.T. DeVillez R.L. Medical student core curiculumin dermatology Survey.J Am Acad Dermatol. 2009; 6: 30-35Abstract Full Text Full Text PDF Scopus (55) Google Scholar A decade later, our study sought to characterize the current state of dermatology curricula in US medical schools. Medical school curriculum leaders at the 151 US allopathic medical schools holding accreditation status by the Liaison Committee on Medical Education on June 28, 2018, were e-mailed invitations for participation in a survey assessing their school's dermatology curriculum via the Research Electronic Data Capture system.2Liaison Committee on Medical EducationAccredited MD programs in the United States.http://lcme.org/directory/accredited-u-s-programs/Date accessed: July 24, 2018Google Scholar Survey responses were received from 79 of 151 medical schools (52%). Schools reporting total hours greater than 3 standard deviations from the mean were contacted to confirm the accuracy of their data. Among the responding schools, 97.4% had a required dermatology curriculum and 62 of 79 (78.5%) were associated with a dermatology department. Most schools incorporated lectures (97.4%) or small group instruction (74.7%) as part of their required dermatology curriculum. Three schools required clinical hours of instruction in dermatology. Although 79 schools responded to the survey, only 69 completed fields indicating the number of hours of dermatology instruction. The mean hours of dermatology instruction were 12.6 hours of lecture (median, 10; range 0-34) and 4.9 hours of small group instruction (median, 4; range, 0-33) over all 4 years of medical school. Total instruction, including lecture and small group instruction, averaged 17.5 hours (median, 14; range, 0-42) over 4 years, indicating approximately 1 additional hour of dermatology instruction compared with the average in 2009. Many responding schools offered optional clinical hours in dermatology (68.6%), and 97.5% offered optional dermatology electives. Schools without required dermatology curricula cited limited time and status as elective. In all, 11 respondents indicated that instruction was inadequate owing to limited time and administrative emphasis on subjects other than dermatology. The reliability of this survey was limited by the 52% response rate, as response bias in schools with strong dermatology curricula may have led to an overestimate of the mean number of dermatology instructional hours. In addition, the study relied on self-reported data and self-reported identification of respondents to confirm that an appropriate recipient had filled out the survey. Given the burden of dermatologic disease in primary care,3Lowell B.A. Froelich C.W. Federman D.G. Kirsner R.S. Dermatology in primary care: prevalence and patient disposition.J Am Acad Dermatol. 2001; 45: 250-255Abstract Full Text Full Text PDF PubMed Scopus (102) Google Scholar, 4Fleischer A.B. Herbert C.R. Feldman S.R. O'Brien F. Diagnosis of skin disease by nondermatologists.Am J Manag Care. 2000; 6: 1149-1156PubMed Google Scholar it is reasonable to suggest a minimum standard for the dermatology curriculum during medical school to adequately prepare future clinicians to treat dermatologic disease. Our study identified competition for curriculum time as a barrier to additional dermatology instruction for some schools. Prioritizing clinical exposure to dermatologic diseases in medical school and utilizing standardized educational modules may be strategies to improve dermatology education in a time-efficient but effective manner.