Dermatology Program Research Articles

Examining dermatology residency applicant profiles for the 2023-2024 cycle: a cross-sectional analysis.

Dermatology remains highly competitive, with strong USMLE Step 1 scores traditionally crucial for securing residency positions. The 2023-2024 cycle introduced significant changes, including pass/fail USMLE Step 1 score reports and an expanded program signaling system. This study explores dermatology residency applicant profiles within this new context. A survey of 2023-2024 dermatology applicants was conducted via social media to gather demographic and application data. A total of 63 survey responses were collected: 74.6% matched and 25.4% unmatched. The racial distribution was 54% White/Caucasian, 25.4% Asian/Pacific Islander, 9.5% Black/African American, 4.8% Hispanic/Latino, and 6.3% other. The median USMLE Step 2 score was 257 (215-277). Racial differences in USMLE Step 2 scores were significant (P = 0.031), but did not affect match rates (P = 0.116). Letters of recommendation from dermatology program directors were linked to lower match rates (P = 0.036). A positive correlation was found between the number of audition rotations completed and matching at such programs (r²=0.817). Of all matched respondents, 46.8% matched to a program they did not signal; of these, 50.0% matched to a program at which they completed an audition rotation and 40.9% to their home dermatology program affiliation. The mean number of interviews was 8.02, with matched applicants receiving more invitations than unmatched applicants (9.02 vs. 5.06, P = 0.002). The shift to pass/fail USMLE Step 1 scores and expanded program signaling did not notably affect the median USMLE Step 2 score from prior years or match rates among underrepresented minorities. Success in matching continues to depend on a holistic evaluation.

Patient safety and quality improvement education in dermatology residency programs: a nationwide survey of program directors.

Patient Safety and Quality Improvement (PSQI) are key components of graduate medical training, as detailed by the Accreditation Council for Graduate Medical Education (ACGME), with specific requirements that residents participate in experiential learning in PSQI during residency training. This study aimed to analyze the breadth of available and required PSQI educational experiences across dermatology residency programs in the United States. The objective of this study was to characterize the scope of PSQI educational experiences across dermatology residency programs. We electronically surveyed program directors of all ACGME-accredited dermatology residency programs from September 2023 to March 2024. Responses to the survey were anonymously collected with Research Electronic Data Capture (REDCap). Of the 145 dermatology programs surveyed, 37 program directors responded (25.5%). 89.2% of programs reported requiring residents to participate in PSQI educational experiences, with the most common being participation in a resident-led QI project (70.3%), which was also the most commonly available experience (91.2%). The least common required experience was observed simulated patient safety events and analyses. 83.8% of programs reported formal mechanisms to assess residents' competency in QI. This study highlights variation in PSQI experiences within dermatology residency programs across the United States. More than 10% of surveyed programs reported no required QI experiences during residency training despite ACGME program requirements. Additional gaps include variation in assessment of resident PSQI competencies. This study provides insight on the current landscape of PSQI education across dermatology residency programs and identifies opportunities to strengthen dermatology programs' PSQI educational offerings.

Penn Academy for Skin Health (PASH): An Experiential Pipeline Program in Skin Biology and Dermatology for High-School Students

Penn Academy for Skin Health (PASH): An Experiential Pipeline Program in Skin Biology and Dermatology for High-School Students

Dermatology Program Coordinators’ Role and Insight in the Resident Selection Process

Dermatology Program Coordinators’ Role and Insight in the Resident Selection Process

How to develop entrustable professional activities in a training dermatology program; practical tips for dermatology educators.

Entrustable professional activities (EPAs) are units of professional practice that could be observed, assessed, monitored, documented, and entrusted. EPAs when entrusted, outline the physician's qualifications, and shape the scope of practice. This insight highlights the importance of development of EPAs in all medical specialties including dermatology to ensure the best standards for patient's care. Development of EPAs-based training program is considered a challenge for clinical educators. In this paper, we describe practical tips and reflections on our experience in developing EPAs in dermatology doctoral training program that could be a guide for dermatology educators to implement EPAs in dermatology training programs.

Perspectives Regarding Virtual Interviewing for Dermatology Residency in the United States: A Survey of Applicants, Residents, Faculty, and Program Directors in the 2022-2023 Application Cycle

Background: Despite the widespread adoption of virtual interviewing for dermatology residency in the United States (US), there are limited data on the perspectives of those affected. Objectives: Characterize the viewpoints regarding virtual interviewing of applicants, residents, and faculty who participated in the 2022-2023 US dermatology residency application cycle. Methods: Two anonymized surveys were created: one for applicants and the other for programs (residents, program directors, and other faculty). The program survey was distributed through the US Dermatology Program Director listserv in January 2023. The applicant survey was distributed through email in April 2023. Results: There were 336 respondents: 135 applicants, 63 program directors, 77 other faculty, and 61 residents. Overall, the largest proportion favored virtual-only interviewing (39%), followed by some combination of in-person and virtual interviews (28%) and in-person–only interviewing (20%). There was no significant difference between preferences of applicants and program directors (P=0.13). The respondents’ most supported changes for future application cycles were limiting the number of programs to which an applicant can apply (34%), limiting the number of interviews an applicant can accept (30%), and providing funding for applicants with demonstrated need (13%). Limitations: Our study may be limited by the response rates, estimated to be 21% for applicants and 45% for program directors. Conclusion: Given the range of preferences, we would not advocate for requiring virtual-only interviewing at this time for our specialty. Instead, reforms should prioritize the respondents’ most supported changes for future application cycles.

Dermatology resident comfort level treating hair conditions related to patients with skin of color.

Although recent studies demonstrated resident satisfaction in the treatment of skin of color (SOC) related disease, comfort levels treating hair specific to populations within the SOC spectrum is unclear. The purpose of this study is to assess dermatology residents comfort level in recognizing and treating various common hair conditions with a focus on those specific to SOC. An Institutional Review Board-approved survey was distributed to United States residents of Accreditation Council for Graduate Medical Education-accredited dermatology programs. Data pertaining to hair care knowledge and treatment comfort levels were collected. Analysis was completed using equal variance 2-sample t tests and analysis of variance F tests, P < .05. Dermatology residents were relatively comfortable with common conditions such as androgenetic alopecia and alopecia areata, but uncomfortable with creating healthy hair regimens, discussing natural hair care products, and treating trichorrhexis nodosa. Resident self-identification as underrepresented in medicine significantly impacted resident knowledge of hair care and treatment in patients with SOC. This study was limited due to small sample size and potential recall bias. This study highlights knowledge gaps in understanding hair-related care for patients with SOC, affirming the continued importance of diversifying dermatology programs as well as hair-specific training for residents.

A cross-sectional analysis of specialty clinics and subspecialty training among dermatology programs

A cross-sectional analysis of specialty clinics and subspecialty training among dermatology programs

Evaluating Participation in Gender-Affirming Care: Cross-Sectional Analysis of Dermatology Program Websites in the United States.

Evaluating Participation in Gender-Affirming Care: Cross-Sectional Analysis of Dermatology Program Websites in the United States.

Using the RE-AIM framework to assess national teledermatology expansion.

Teledermatology has been utilized in the United States Department of Veterans Affairs (VA) for decades but continues to have incomplete penetration. VA has funded an initiative to enhance access to dermatology services since 2017 to support asynchronous teledermatology for Veterans living in rural areas. As part of an ongoing evaluation of this program, we assessed the teledermatology activity between the fiscal years 2020 and 2022. We focused on the second cohort of the initiative, comprising six VA facilities and their 54 referral clinics. We studied teledermatology programs at cohort facilities using the reach, effectiveness, adoption, implementation, and maintenance framework. We used a mixed-methods design including annual online reports completed by participating facilities and VA administrative data. When possible, we compared the data from the 3 years of teledermatology funding with the baseline year prior to the start of funding. Reach: Compared with the baseline year, there was a 100% increase in encounters and a 62% increase in patients seen at the funded facilities. Over 500 clinicians and support staff members were trained. Effectiveness: In FY 2022, primary or specialty care clinics affiliated with the funded facilities had more dermatology programs than primary or specialty care clinics across the VA (83% vs. 71% of sites). Adoption: By the end of the funding period, teledermatology constituted 16% of dermatology encounters at the funded facilities compared with 12% nationally. This reflected an increase from 9.2% at the funded facilities and 10.3% nationally prior to the funding period. Implementation: The continued funding for staff and equipment facilitated the expansion to rural areas. Maintenance: By the end of the funding period, all facilities indicated that they had fully implemented their program for patients of targeted primary care providers. The Program Sustainability Index scores generally increased during the funding period. Targeted funding to support asynchronous teledermatology implementation for rural Veterans increased its reach, adoption, and implementation, ultimately improving access. Providing program guidance with staffing and training resources can increase the impact of these programs. Ongoing efforts to maintain and increase communication between primary care and dermatology will be needed to sustain success.

Israeli pediatricians' confidence level in diagnosing and treating children with skin disorders: a cross-sectional questionnaire pilot study.

Pediatricians daily see large numbers of patients with skin disorders. However, they encounter limited guidance as a result of a marked deficiency in pediatric dermatologists. Hence, reevaluation of training opportunities during pediatric residency has become essential. Our aim was to evaluate the confidence level of pediatric residents and specialists in diagnosing and treating skin disorders in children and to determine career and training-related characteristics that influence it. Conducted as a cross-sectional study, we administered a questionnaire to 171 pediatricians across Israel. We assessed respondents' self-efficacy about their ability to diagnose and treat skin disorders and collected data regarding their previous dermatology training and preferred training methods. 77.8% of respondents reported below or average self-efficacy scores in diagnosing and managing children with skin disorders. Older age (>40 years old; OR = 5.51, p = 0.019), treating a higher number of patients with skin disorders (OR = 2.96, p = 0.032), and having any training in dermatology, either during medical school or residency (OR = 7.16, p = 0.031, OR = 11.14, p = 0.003 respectively), were all significant parameters involved in pediatricians reporting high self-efficacy in skin disorder management. Most pediatric residents and pediatricians have average or below-average confidence in managing pediatric skin disorders. We suggest incorporating dermatology rotations during pediatric residency to improve young pediatricians' self-efficacy in managing skin disorders and ultimately help pediatricians provide better care for patients presenting with dermatological conditions. These findings can ultimately help refine a pilot program in dermatology that might be implemented during pediatric residency.

Pediatricians' confidence level in diagnosing and treating children with atopic dermatitis in Israel, based on a self-efficacy survey.

Atopic dermatitis (AD) is one of childhood's most common skin conditions. Although pediatricians often diagnose and manage it, more than half refer even mild cases to dermatologists. In this study, we aimed toevaluate pediatric residents' and pediatricians' self-confidence regarding their ability to diagnose and manage AD. A cross-sectional questionnaire study was conducted with Israeli pediatric residents and pediatricians in 2022. The questionnaire was designed to distinguish participants with high vs. low self-confidence characteristics regarding their ability to diagnose and treat AD. In total, 171 participants completed the questionnaire (59.4% women; age, 41.1 ± 10.6years); 39.1% of the participants were residents, while 60.9% were board-certified pediatricians. Overall, 64.4% of the responders reported below or average confidence (score ≤ 3, on a scale of 1-5) in diagnosing and treating AD in children. The group with higher self-confidence was significantly older (44.39 vs. 39.14years, P = 0.003), had more years of experience in evaluating pediatric AD (P = 0.004), had trained in dermatology during their residency (P = 0.02) with a longer training period (P = 0.01), and with more than three training methods (P = 0.009). Multivariable logistic regression analysis showed that high self-confidence was associated with age older than 40years and training in dermatology during residency (odds ratios = 5.63 [P = 0.04] and 3.36 [P = 0.05], respectively). Conclusion: Most pediatric residents and pediatricians were not particularly confident in treating children with AD. Those with high self-confidence were older, had been exposed to more patients, and had been trained in dermatology during their residency with various methods and for longer periods. Therefore, we encourage the implementation of a training program in dermatology during pediatric residency programs. What is Known: • Atopic dermatitis (AD) is one of childhood's most common skin conditions and often presents to pediatricians for diagnosis and management. • Many pediatricians refer children with even mild cases of AD to dermatologists. What is New: • Most pediatric residents and pediatricians report low confidence in diagnosing and treating pediatric AD. • Physicians with high self- confidence were older, exposed to more AD patients, and had been trained in dermatology during their residency with various methods and for longer periods.Therefore, theimplementation of a training program in dermatology during pediatric residency programs is warranted.

Results From the First Annual Association of Professors of Dermatology Program Directors Survey.

The first annual Association of Professors of Dermatology (APD) program director (PD) survey was distributed in November 2022 and included 53 respondents from individual Accreditation Council for Graduate Medical Education (ACGME) programs. This survey included 137 in-depth questions to identify similarities and differences among programs regarding 12 broad categories: program characteristics; PD demographics; impact of the COVID-19 pandemic on residency training; available resources; quality improvement; clinical instruction; didactic instruction; research content; diversity, equity, and inclusion; wellness; evaluation systems; and graduation outcomes of postgraduate year (PGY) 4 residents. The survey provided preliminary insight to similarities and differences between programs, such as varying academic time and research resources, while also challenging norms seen in areas of diversity, equity, and inclusion. As future surveys are optimized to obtain greater response rates, these metrics can be captured in a centralized database accessible to PDs to reflect trends and identify strengths and weaknesses of dermatology residency programs.

Guidelines on Away Rotations in Dermatology Programs.

The Association of Professors of Dermatology (APD) recently announced recommendations for away rotations for medical students. In this column, we provide an overview of the importance of away rotations, discuss the Organization of Program Director Associations (OPDA) recommendations for away rotations, and outline the guidelines set forth by the APD. This work on providing guidelines and transparency is ongoing and collaborative among specialties in line with the reforms to the application process to create a more sustainable and equitable system.

479 Correlation of chair’s gender with gender diversity of leadership and faculty in american academic dermatology programs

479 Correlation of chair’s gender with gender diversity of leadership and faculty in american academic dermatology programs

Perspectives of Dermatology Program Directors on the Impact of Step 1 Pass/Fail.

The shift of Step 1 to Pass/Fail has generated several questions and concerns about obtaining residency positions among allopathic and osteopathic students alike. Determining the perspectives of Dermatology Program Directors in regards to post-Step 1 Pass/Fail is critical for students to better prepare for matching into dermatology. After receiving Institutional Review Board (IRB) exemption status, the program directors were chosen from 144 Accreditation Council for Graduate Medical Education (ACGME) and 27 American Osteopathic Association (AOA) Dermatology programs using contact information from their respective online website databases. An eight-item survey was constructed on a three-point Likert scale, one free text response, and four demographic questions. The anonymous survey was sent out over the course of three weeks with weekly individualized reminder requests for participation. A total of 54.54% of responders had "Letters of Recommendation" in their top 3. Forty-five percentof responders had "Completed Audition Rotation at Program" in their top 3. And, 38.09% of responders had "USMLE Step 2 CK Scores" in their top 3. Approximately 50% of responders agreed that all medical students will have more difficulty matching dermatology. Based on the survey study, Dermatology program directors want to focus more on letters of recommendation, audition rotations, and Step 2 CK scores. Because each field seems to prioritize different aspects of an application, students should attempt to gain as much exposure to different fields such as through research and shadowing to narrow down their ideal specialties. Consequently, the student will have more time to tailor their applications to what residency admissions are looking for.

Website mission statements of dermatology residency programs: a cross-sectional study.

Recent calls for increased transparency from dermatology residency programs have revealed important opportunities, particularly including information on program websites. One piece of information that may especially benefit applicants assessing potential training programs is the program's mission statement. From August 9, 2022, to August 21, 2022, the websites of all ACGME-accredited dermatology residencies were examined to investigate the use and content of mission statements. Statements were categorized based on inclusion of mission, vision, virtue/value, aims, and goals. A total of 133 out of 143 dermatology programs (93.0%) were included. Overall, 46.15% of programs used at least one of the five mission statement categories on their websites, while 53.85% used none. Programs used the category "mission" (39.85%) most, and "vision" (3.01%) least. There was overlap in word choice across categories. The word "care" was among the top four words used in every category. Other words to appear frequently across multiple categories included "dermatology" (4/5), "residents" (3/5), "knowledge" (2/5), and "provide" (2/5). Other top words included "clinical" in the mission category, "advanced" and "leaders" in the vision category, "excellence" and "diversity" in the value/virtue category, and "patient" and "professional" in the objective category. Explicitly stating residency program missions may not only help programs plan more effectively, but also help applicants who may be undecided about which programs best align with their career goals.

The USMLE Step 1 Transitions to Pass/Fail Scoring: Perceptions of Dermatology Residents

Background: The USMLE Step 1 exam has been a critical objective tool for residency applications, and given the recent score change to a binary pass/fail system it is essential for programs and future residency applicants to understand the implications of this score change.&#x0D; Methods: A survey containing 21 items was dispensed through REDCap utilizing an established email list of all dermatology program directors (PDs) who then distributed the survey to residents in their programs in December 2021. 132 residents completed the survey. Perceptions regarding the USMLE Step 1 scoring change were probed.&#x0D; Results: Out of the 132 residents surveyed, the highest proportion of respondents were PGY2 (36.4% [48/132]) and PGY3 (25.8% [34/132]). Of that group, most of them (74.2% [98/132]) achieved a self-reported score of 240 or higher on their USMLE Step 1 exam and most (69.7% [92/132]) disagreed with Step 1 changing to a pass/fail scoring system. Similarly, 65% (86/131) opposed Step 2 CK also going pass/fail. The majority of respondents agreed that there will be increased emphasis placed on research (90.0% [118/131]), extracurricular involvement (76.5% [101/132]) and the Step 2 CK score (96.21% [127/132]). Further, 82.3% (107/130) of respondents agreed that more students pursuing a dermatology residency will need to take a gap year.&#x0D; Conclusion: According to current dermatology residents, the USMLE Step 1 exam score change to a binary scoring system will lead to more emphasis being placed on the Step 2CK exam, research, and extracurricular activities.

Dermatology Core Curriculum in Medical School and its Association in the Selection of Dermatology as a Future Career: A Nationwide Cross-sectional Study

Abstract Background: The shortfall of dermatology curricula during medical school greatly impacts the knowledge about common skin diseases and clinical skills. The lack of exposure to dermatology hampers the decision for students to consider pursuing dermatology and their preparation for matching. Purpose: The aims of this study were to assess the current state of dermatology curricula in medical school and to determine the relation of those factors to the selection of dermatology as a career. Methods: A nationwide cross-sectional study was conducted between September 2020 and May 2021 using a previously published questionnaire distributed to 25 universities across all regions of the Kingdom of Saudi Arabia. Results: Out of 1411 participants, around half reported having only 1–4 h of basic and clinical dermatology lectures. Forty-four percent were required to rotate in dermatology. Half of the respondents were expected to treat acne, sexually transmitted diseases, herpes, and candidiasis after finishing the dermatology course. Students in clinical years (odds ratio [OR] = 0.6 and confidence interval [CI] = 0.39–0.92) and interns (OR = 0.54 and CI = 0.30–0.94) were more likely to consider dermatology as their future career. Having a dermatology program in their university tended to generate interest in dermatology as a career choice (OR = 2.24 and CI = 1.55–3.24). Compared to students who did not complete a core dermatology course, students who completed core dermatology courses were twice as likely to be interested in dermatology as a future career (OR = 1.91 and CI = 1.35–2.70). Conclusion: Including core dermatology topics in the medical curriculum can help address community health needs and give students needed clinical experience and a basis for considering dermatology as a career path.

Chief resident selection in US dermatology residency programs.

Chief residents are typically selected as leaders from the senior-most residents in a residency program. The definition of the role likely varies widely between various residency programs. We aimed to gain a better understanding of responsibilities of chief residents in dermatology programs and to identify selection methods. After institutional review board review, we created a Qualtrics survey distributed through a listserv of program directors (PDs) from US dermatology residency programs. Of 51 survey responses, 100% had chief residents, and 35.3% had all senior residents designated as chief residents. The majority of programs used several selection processes, but most frequently PD selection (n=20). Programs (76%) reported other leadership opportunities for seniors. The most important attribute in selecting a chief resident was helpfulness, and PDs rated their perceived resident satisfaction with the selection process as an 8.24 out of 10, with 10 being most satisfied. Additional benefits for chief residents were reported at 86.9% (n=40) of programs. Most programs select chief residents based on merit. There is perceived satisfaction of residents regarding this process, and most programs report additional benefits for their chief residents.