Dermatology Residency Programs Research Articles

Beyond graduation: a survey study exploring drivers of alumni contributions to dermatology residencies.

Philanthropic donations are an increasingly important funding source for academic medical centers. Minimal published data is available about factors that influence alumni donations to residency programs. We performed a cross-sectional analysis of a single-site dermatology and combined internal medicine-dermatology residency programs to assess factors impacting alumni donations. Donors tended to have graduated less recently (only 20% graduating after 2010) and practice in the same region of their alma mater (50%). Respondents preferred funds be allocated to resident needs over needs of medical students. Strategically engaging senior alumni and offering fund allocation opportunities could increase philanthropy, with alumni perceptions of the residency program warranting further investigation for their impact on donation decisions.

Considerations for Artificial Intelligence (AI) Use in the Dermatology Residency Application Process.

Artificial intelligence (AI) has gained traction in the field of dermatology, but the role of AI in the dermatology residency application process has been minimally explored. We encourage dermatology residency programs to proactively set guidelines to applicants and letter writers on the use of AI tools. Further, programs should consider implementing natural language processing models in reviewing residency applications to promote principles of diversifying the dermatology workforce.

Dermatopathology Trends in African Americans: A Retrospective Analysis of Biopsies.

In a retrospective analysis of biopsies from January 1, 2019 to December 31, 2020, at University Hospitals Cleveland Medical Center, we aimed to determine the frequency of dermatologic conditions biopsied in African Americans (AA). Given that AAs constitute 13.4% of the US population, understanding the skin disease profile within this significant demographic is crucial. From a total of 1701 biopsies collected from 1442 AA patients, benign neoplasms emerged as the most common diagnosis, accounting for 26.7%, predominantly in females. Notably, cutaneous T-cell lymphoma was the most frequently biopsied malignancy, whereas pigmentary disorders were the least common at 1.4%. The study highlighted the higher occurrence of squamous cell carcinoma compared with basal cell carcinoma in AA, contrasting trends in other racial demographics. Moreover, recognizing the unique presentations of skin disorders in different racial backgrounds is essential, especially because disparities have been reported in skin of color training among dermatology residency programs. Understanding these racial differences in skin diseases can assist clinicians in refining their diagnostic approach. Future research could further explore the potential gaps between clinical expectations and histologic findings, improving diagnostic accuracy.

Geomapping of pediatric dermatologists: A tool to promote diversity and equity in dermatology.

There is a lack of racial and ethnic diversity across the field of dermatology, including the subspecialty of pediatric dermatology. Residency programs are improving recruitment and mentorship of medical students who identify with racial or ethnic minority communities (underrepresented in medicine [URiM]) to dermatology overall, a goal similarly held by our subspecialty. The objectives of this study were to create an online mapping tool to visually centralize the list of 142 dermatology residency programs, 105 with practicing pediatric dermatologists on faculty and 51 that offer financial scholarships for URiM visiting medical students completing away rotations. With this tool, we hope that prospective students may not only identify potential pediatric dermatology mentors for virtual and in-person activities, but that they may also build connections with and increase their chance of matching at prospective residency programs with demonstrable commitment to diversity, equity, and inclusion.

42832 Ethics training in dermatology residency programs: a survey study assessing residency program directors and assistant/associate program directors

42832 Ethics training in dermatology residency programs: a survey study assessing residency program directors and assistant/associate program directors

41843 Website Mission Statements of Dermatology Residency Programs: A Cross-Sectional Study

41843 Website Mission Statements of Dermatology Residency Programs: A Cross-Sectional Study

41202 Availability and Content of Diversity Equity and Inclusion Information on Dermatology Residency Program Websites

41202 Availability and Content of Diversity Equity and Inclusion Information on Dermatology Residency Program Websites

Website diversity, equity, and inclusion statements and initiatives of dermatology residency programs: a cross-sectional study.

Website diversity, equity, and inclusion statements and initiatives of dermatology residency programs: a cross-sectional study.

Characteristics of Dermatology Residency Program Morbidity and Mortality Conferences: A Survey of Program Directors.

Characteristics of Dermatology Residency Program Morbidity and Mortality Conferences: A Survey of Program Directors.

Understanding the Factors Associated with US Dermatology Resident Trainees' Diagnostic Confidence and Skill for Skin of Color Pathology

Background: Inequities in dermatologic health outcomes translate to worsened clinical outcomes for minority groups. For example, despite a lower incidence of skin cancer overall, African Americans are diagnosed at later stages with greater degrees of lymph node involvement. This has been shown to lead to disproportionate mortality when compared to lighter skinned individuals. Medical education materials contain a significantly lower percentage of skin of color (SOC) images than of lighter skin and research has indicated lower diagnostic accuracy of dermatologic conditions in darker skin by U.S. medical students. The objective of this study was to explore U.S. resident dermatologists’ ability to accurately identify skin pathology among SOC patients verus lighter skin to potentially identify gaps in training that may contribute to this disproportionate morbidity and mortality. Methods: A cross-sectional electronic REDCap survey open to all U.S. dermatology residents asked participants their basic demographics (e.g., level of training, racial and ethnic identity) and program characteristics (e.g., geographical location, proportion of patients by Fitzpatrick type, presence of a dedicated SOC clinic). This data was correlated with participant visual diagnostic accuracy on a 22-item multiple choice quiz (images selected by a senior academic dermatologist) of characteristic nonmalignant and malignant conditions in lighter skin and SOC. Results: Residents preferentially misdiagnosed malignant lesions in SOC over lighter skin (p <.0001) and preferentially misdiagnosed malignant lesions in SOC over nonmalignant lesions in SOC (p <.001). None of the residents’ basic demographic or program characteristic variables had significant relationships with any assessment of performance. Conclusion: Dermatologists should maintain a high clinical suspicion for malignant conditions in patients with darker skin types, given that these lesions are the most preferentially misdiagnosed and the fact that these lesions carry higher risks for morbidity and mortality. Dermatology residency programs should instill efforts to emphasize correct detection of malignant lesions amongst those with skin of color.

REGULATING TEACHING AND PRACTICE OF AESTHETIC MEDICINE AND SURGERY

The practice of Aesthetic medicine and surgery sits across the divide of different specialties; Dermatolo­gy and Plastic Surgery in particular. Besides these two specialties Maxillofacial surgery, Ophthalmology, and Otolaryngology also practice aesthetic medicine and surgery. Aesthetic Medicine is evolving as a Specialty in itself globally, and in Pakistan. There is a growing demand for minimally invasive cosmetic procedures (MICPs) including Botox, fillers, chemical peels, and lasers. In 2018, 15.9 million MICPs were performed in the United States, an increase of 228 percent in com­parison to the year 2000.1 However, the exact data pertaining to these procedures is lacking in Pakistan. Dermatologists, and to an extent plastic surgeons, are considered more appropriately trained to address the growing demands of a population with aesthetic con­cerns.2 Besides these two specialties, other special­ties and non-medical providers such as aestheticians, nurse practitioners, and physician assistants are pro­viding these services the world over and locally. Accreditation Council for Graduate Medical Educa­tion (ACGME) has categorized Dermatologic surgery education into 3 categories: competency, significant exposure, and education. Though competency requires direct training, significant exposure may be achieved through direct observation or assistance, whereas edu­cation is defined as available educational material with­out direct exposure.3 There is no data pertaining to the satisfaction of residents regarding training in Cosmetic Dermatology and aesthetics during residency. However, studies from the West point towards a lack of satisfac­tion in training.4 Dermatology residency programs in Pakistan of­fered by the College of Physicians and Surgeons have incorporated mandatory rotations in Lasers and logging of cases at level 2 or observer status. A survey con­ducted by Asher et. al. amongst Dermatology residents working across Pakistan reported that 65 percent of the participants of the survey wanted to take up Der­matologic Surgery as a subspecialty after completing their fellowship in Dermatology.5 A survey reported that 70% of Canadian residents plan to offer aesthetic ser­vices in the future.6 In order, to bridge the gap and train doctors in aes­thetic medicine and surgery, there has been a mush­room growth of academies that conduct certificate courses charging the doctors heavily. On top of it, the practice of Aesthetics is costly and mostly conducted in private setups, with minimal regulations. Moreover, there has been a huge unregulated influx of allied healthcare professionals and nonphysician operators (NPOs’), in aesthetic medicine.7 Complications are more common in invasive proce­dures performed by cosmetic technicians, estheticians, and employees of medical and dental healthcare pro­viders who are not trained for these procedures and there is little or no physician supervision as compared to facilities run by dermatologists Unfortunately, most of institutes imparting education/training in aesthetic medicine offer a short course Thus, after attending a one-day training course, they start performing medi­cal procedures on patients without baseline knowledge and training. The College of Physicians and Surgeons Pakistan recently introduced Fellowship in Paediatric Dermatology as a subspecialty of Dermatology as well as Paediatrics. With the increase in the demand for Aesthetic procedures and practice by multiple special­ties, CPSP may introduce a subspecialty in Aesthetics or Cosmetic Dermatology which is under consideration by the Faculty of Dermatology of CPSP. It is the responsibility of various medical and pro­fessional associations of relevant specialties, in partic­ular dermatology and plastic surgery, to bridge the gap in teaching for their members in order to regulate the cost and quality of training. The College of Physicians and Surgeons on its part need to expedite the sub­specialty programs to address the needs of specialists aspiring to adopt Aesthetic medicine and surgery as a profession. Pakistan Medical and Dental Council (PMDC) should devise regulations pertaining to education as well as the practice of aesthetics in consultation with the College of Physicians and Surgeons and Public sector Universities. The rules and regulations adopted by the PMDC, be­ing the regulatory body, should be adopted by Provincial Healthcare regulatory bodies responsible for overseeing licensing and registration of both public and private sector healthcare establishments to ensure quality, efficiency, and safety in healthcare.

Dermoscopy in Selected Latin American Countries: A Preliminary Look into Current Trends and Future Opportunities Among Dermatology Residency Programs.

Skin cancer remains a global public health burden. Dermoscopy is a useful technique that aids in early detection and increases diagnostic accuracy with adequate training. However, dermoscopy is not uniformly taught to residents worldwide. Dermoscopy training in Latin American dermatology residency programs has not been explored. To assess current dermoscopy training among dermatology residency programs in Latin America (eg training modalities, preferred/most effective modalities per residents, diseases/pathologies taught). Cross-sectional survey distributed via e-mail between March and May 2021. Chief residents from Argentina, Brazil, Colombia, Costa Rica, Chile, Ecuador, Guatemala, Mexico, Panama, and Uruguay were invited to participate. 81 chief residents completed the questionnaire (81/126, 64.2%). Seventy-two percent of programs had an established dermoscopy curriculum, with dedicated hours of training varying greatly by program. Institutions commonly utilized sessions with "unknown" dermoscopy images and direct teaching by experts in the clinical setting as supplements to lectures, also described by residents as most effective. The most commonly taught methods included pattern analysis (74.1%), the two-step algorithm (61.7%), and the ABCD rule (59.3%). Almost all respondents reported desiring additional training during residency and believe that dermoscopy training should be a requirement to graduate from residency. This study highlights a preliminary look into current landscape in dermoscopy training among selected Latin American dermatology residency programs, demonstrating room for improvement and standardization in dermoscopic education and training. Our results serve as a baseline reference and provide valuable information to guide future educational initiatives incorporating successful teaching strategies (eg. spaced education/repetition, flipped classroom model) used in dermatology and other fields.

Use of Social Media for Patient Education in Dermatology: Narrative Review.

Social media has rapidly become one of the main avenues for news and communication among those with access to technology. Nearly 60% or 4.7 billion people worldwide use social media. Different social media networks provide users with a barrage of posts, opinions, and transformations. With this noticeable uptick in physician and patient education usage of social media, exploration of the impacts of social media on patient education in dermatology is crucial. The goal of this narrative review was to evaluate existing peer-reviewed literature examining the use of social media for patient education in dermatology and to establish trends and implications. Additional attention was given to different social media sites, and potential differences in modalities of posts such as short-form videos on TikTok and Instagram Reels, long-form videos on YouTube, and infographics on Twitter, Instagram, and Facebook. PubMed, Access DermatologyDxRx, and Scopus searches of peer-reviewed publications were performed to discover articles with social media and patient education keywords in combination with other health care-relevant or dermatology-relevant keywords. Subsequently, the screening of these studies was performed by the author who has experience with education and research experience in health care, dermatology, social media, and telehealth. Ultimately, the selected articles were summarized through qualitative analysis of key points and presented for further discussion. Through this narrative review, the researcher was able to identify several publications focusing on dermatology and social media. Some common subject areas included the use of social media for the promotion of private dermatology practices, residency programs, and research journals. So long as providers, such as dermatologists, take ethical considerations into account, these platforms can provide patients with curated educational content. In addition, several publications emphasized the use of social media as a form of patient education on dermatologic conditions but also as a source of misinformation. This narrative review illuminated the use of social media as a form of patient education for dermatology, with its applications addressed across many demographics and situations. As social media platforms continue to update their algorithms, content filters, and posts, social media may become a reputable form of patient education in dermatology. Future studies and innovations should continue to explore innovations in this space, the efficacy of different modalities of posts, and longitudinal differences in patient outcomes and health literacy.

The Resident Cosmetic Clinic: An Institutional Review and Outcomes Analysis of the Loma Linda University Experience.

As the number of dermatologists offering cosmetic procedures continues to increase, so does the need for hands-on exposure to cosmetic dermatology during residency. A resident cosmetic clinic (RCC) model presents as a mutually beneficial opportunity for trainees to obtain first-hand experience, while patients have access to more affordable pricing. (1) To assess volume and variety of cosmetic dermatological procedures during residency. (2) To compare Loma Linda University (LLU) Dermatology RCC data with national residency program data. (3) To provide guidance for other dermatology residency programs who wish to incorporate cosmetic training into their educational curriculum. In this cross-sectional, retrospective, chart review study, resident training in cosmetic procedures at the LLU RCC was quantified and compared with that of national program averages, minimums, and maximums as reported by the Accreditation Council for Graduate Medication Education. LLU RCC residents performed more nonablative skin rejuvenation, intense pulsed light, and soft tissue augmentation procedures as the resident surgeon compared with other dermatology residents across the nation. Institutional review highlights an unmet need for greater exposure to and training in a variety of dermatologic cosmetic procedures during residency. Practical considerations for achieving optimal learning experiences were provided through the implementation of a resident cosmetic clinic.

How to Advise Medical Students Interested in Dermatology: A Survey of Academic Dermatology Mentors.

Dermatology residency programs are among the most competitive residencies of medical specialties. To navigate this competitive process, students seek advice from dermatology mentors who provide a range of responses depending on their experience or preferences. To consolidate this range of advice, we surveyed members of the Association of Professors of Dermatology (APD) on their responses to common questions from medical students regarding quantity of program applications, research gap year, internship year, letters of intent, away rotations, letters of recommendation (LORs), and the new Electronic Residency Application Service (ERAS) supplemental application. Although recommendations given to students remain individualized, our study describes the range of advice received and details the differences between mentor advice and common student practices throughout the application cycle. We hope these data will help mentors in advising students as well as inform organizations seeking to create standards and official recommendations regarding aspects of the application process.

Dermatology Residency Applicant Self-Reported Stressors and Coping Mechanisms by Sex, Race, and Geographic Region during the 2020-2021 Application Cycle.

Our aim was to identify self-reported stressors and coping mechanisms during the 2020-2021 application cycle by dermatology residency applicants. We hypothesized that coronavirus disease 2019 (COVID-19) would be the most reported stressor. During the 2020-2021 application season, the Mayo Clinic Florida Dermatology residency program sent a supplemental application to each applicant requesting that they describe a challenging life situation and how they handled it. Comparisons of self-reported stressors and self-expressed coping mechanisms according to sex, race, and geographic region were performed. The most common stressors reported were academic (18.4%), family crisis (17.7%), and COVID-19 (10.5%). The most frequent coping mechanisms expressed were perseverance (22.3%), seeking community (13.7%), and resilience (11.5%). The coping mechanism of diligence was observed more often in females than in males (2.8% vs 0.0%, P = 0.045). First in medicine was more often observed in Black or African American students (12.5% vs 0%, P = 0.001), immigrant experience was more often observed in Black or African American and Hispanic students (16.7% and 11.8% vs 3.1%, P = 0.021), and natural disaster was reported more often in Hispanic students (26.5% vs 0.5%, P < 0.001) as compared with White applicants. By geography, applicants in the northeastern United States were more likely to report the COVID-19 pandemic as a stressor (19.5%, P = 0.049), and the natural disaster stressor was more often reported by applicants from outside the continental United States (45.5%, P < 0.001). Stressors reported by dermatology applicants in the 2020-2021 cycle included academic, family crisis, and the COVID-19 pandemic. The type of stressor reported varied by race/ethnicity and geographic location of the applicant.

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.

Ethics training in dermatology residency programs: A survey of dermatology residency program directors and assistant/associate program directors.

Professionalism, defined as a demonstrated adherence to professional and ethical principles, is one of the six core competencies of dermatology graduate medical education. We sought to assess the current educational landscape for ethics training in dermatology residency programs by surveying dermatology residency program directors and assistant/associate program directors. A sixteen-question survey was designed and distributed to dermatology program directors and assistant/associate program directors via an email list. The estimated response rate was 43.17%. Most (54.55%) dermatology residency programs did not have an ethics curriculum. Among programs with an ethics curriculum, about three-fourths were implemented in the past ten years. The most common settings for teaching ethics were "formal didactics" (31.91%) and "ad hoc during clinical encounters and other clinical settings" (27.66%). Cited barriers to implementing and/or maintaining an ethics curriculum were "lack of time" (30.10%), "lack of faculty with expertise in ethics" (24.27%), and "lack of useful resources" (20.39%). Despite requirements for ethics training, most dermatology residency programs did not report having an ethics curriculum. This study's results highlight the need for an increased emphasis on ethics training in US dermatology residency programs.

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.

Impact of considering United States Medical Licensing Examination Step 1 pass/fail on diversity in dermatology residency recruitment.

The University of Chicago dermatology residency program considered the United States Medical Licensing Examination (USMLE) Step 1 pass/fail during the 2020-2021 application cycle with the goal of recruiting diverse dermatology residency candidates. We conducted a retrospective multiyear cross-sectional study among applicants to the dermatology residency program during the 2018-2019 and 2020-2021 application cycles, the latter excluding use of USMLE Step 1 cutoff scores as a screening tool. Of the applicants, 69.8% (n=419) and 94.5% (n=605) had their residency applications reviewed by our program during the 2018-2019 and 2020-2021 application cycles, respectively. There was a statistically significant upward trend in the number of underrepresented in medicine (URiM) applicants offered an interview from 10.4% (n=5) to 37.7% (n=20) across the application cycles. Multiple linear regression demonstrated there was a statistically significant decrease in the mean USMLE Step 1 score among applicants reviewed across application cycle and URiM status independently, and as a factor of their interaction (P=.016 and P=.001). By de-emphasizing the USMLE Step 1 score and using the test as originally intended, a marker for licensure, our program significantly increased the number of URiM applicants who were offered an interview and implemented a holistic review process focused on individual attributes and cultural competence.