Abstract
To the Editor: The COVID-19 pandemic has affected medical education dramatically, and medical students are anxious for guidance on the upcoming residency application process. Students interested in dermatology are in an unprecedented position. Most have limited exposure to dermatology during the first years of medical school, and many will not be able to complete dermatology subinternships until right before the application deadlines.1McCleskey P.E. Gilson R.T. DeVillez R.L. Medical student core curriculum in dermatology survey.J Am Acad Dermatol. 2009; 61: 30-35Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar Traditionally, away rotations were critical for developing connections with faculty and obtaining letters of recommendation. With these clinical experiences delayed or cancelled, many students are concerned that they will be at a disadvantage for matching into a residency program. In response to the COVID-19 pandemic, dermatology residency program directors released a consensus statement recommending a more holistic review process [p 1], highlighting that away rotations should not be “perceived as required” [p 2], the absence of a step 2 score should not prevent students from applying [p 3], and “lack of opportunity for students with smaller home programs or in areas more affected by the crisis” would be taken into consideration [p 4].2AAMC. Dermatology Residency Program Director Consensus Statement on 2020-21 Application Cycle. Available at: https://aamc-orange.global.ssl.fastly.net/production/media/filer_public/0f/7b/0f7b547e-65b5-4d93-8247-951206e7f726/updated_dermatology_program_director_statement_on_2020-21_application_cycle_.pdf. Accessed June 29, 2020.Google Scholar Although dermatology was 1 of the first 2 specialties to release a statement, 6 other specialty consensus statements have been released as of May 15, 2020, all recommending no or limited away rotations with letters of recommendation written by home program faculty.3Association of American Medical Colleges AAMC. Specialty Responses to COVID-19. Available at: https://students-residents.aamc.org/applying-residency/article/specialty-response-covid-19/. Accessed June 29, 2020.Google Scholar Many specialties have recommended that students without home programs complete rotations at the nearest institution. Although the recommendations put forth thus far are a welcome first step, additional measures are necessary to ensure a safe and equitable experience for medical students applying for dermatology residencies. We strongly urge academic departments to restrict away rotations. Such a recommendation will help equilibrate the application process, such that applicants from areas most affected by COVID-19 are not unduly disadvantaged compared to peers who participate in away electives. Exceptions should be made only for students without home programs who could rotate at the closest Accreditation Council for Graduate Medical Education (ACGME)-accredited department. Furthermore, opportunities should be made available for students to participate in virtual didactics and grand rounds. Student participation would be encouraged using the chat feature in online video platforms for questions. Dermatology faculty and/or residents could lead virtual small group sessions with medical students to discuss material and provide opportunities for questions and feedback for students who are not comfortable raising questions in a larger group. The American Academy of Dermatology's standardized online curriculum should also be used to provide basic dermatology education, coupled with resident-led teaching sessions to answer questions and provide insight into dermatology residency.4Cipriano S.D. Dybbro E. Boscardin C.K. Shinkai K. Berger T.G. Online learning in a dermatology clerkship: piloting the new American Academy of Dermatology Medical Student Core Curriculum.J Am Acad Dermatol. 2013; 69: 267-272Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar Offering these experiences to students will offer opportunities to interact with a diverse group of dermatology faculty. Our specialty is in a unique position to rethink the professional experiences we deem necessary for prospective residents. By being creative in our responses to the changes necessitated by the COVID-19 pandemic, students will have opportunities to be safely and adequately prepared to begin dermatology residency while also gaining a resilience and flexibility developed by weathering this uncertain time.
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