Dermatology Training Research Articles

Epidemiology of skin diseases among children attending the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State: a retrospective observational study

Background: Numerous studies have examined skin disease trends in Nigeria, revealing a shift towards increased allergic dermatoses. This research assessed the patient landscape at a clinic and satellite site in Obukpa, Nigeria. Methods: A retrospective study of patients seen in the skin clinic of the university of Nigeria teaching hospital (UNTH), Ituku Ozalla, and the rural outpost in Obukpa between November 2009 and 2018 was carried out. A total of 1851 patients' data were analyzed. Diagnosis was based on clinical findings. Results: There were more females (n=1007 [54.4%]) than males (n=844 [45.6%]). Most of the patients were of school age (6-12 years), and the most typical skin disease category was infectious disorders (32.5%), another categories/miscellaneous group (27.7%). Nearly all patients that presented to the rural outpost in Obukpa resided in the surrounding area of Nsukka (93.4%). Conclusions: Comparing the study findings with an earlier one from the same center, there is no change in pattern, with infectious disorders being the most common skin disease category. However, these are largely preventable and emphasize the need for public enlightenment campaigns and policies to discourage the over-the-counter purchase of prescription-strength corticosteroid creams and antibiotics by parents and caregivers, a prevalent practice before seeking medical attention for their children. In addition, there is an urgent need to strengthen dermatologic training in primary health care settings, especially among pediatricians in Nigeria, to improve access to care.

Findings of the British Association of Dermatologists Career Survey of Dermatologists in Training and New Consultant Dermatologists 2023.

Previous surveys of UK dermatology trainees have identified key patterns regarding future career intentions that can help to inform workforce planning as consultant vacancies continue to grow. We invited all doctors training in dermatology, as well as all dermatology doctors who have completed training between 2018-2023 to complete separate surveys over a six-week period. These surveys explored: career locations, working patterns, pull factors towards particular posts, and push factors away from NHS consultant posts. The findings of these surveys confirm persisting trends towards less than full time working, ongoing limited geographical mobility of trainees, and a reducing appetite for academic work all identified in previous surveys. This survey offers the first insight into the working lives and factors influencing these career choices of consultants who completed their dermatology training between 2018-2023.

Skin Biopsies and Diagnostic Outcomes at a Multisite Family Medicine Residency Network.

Physicians other than dermatologists evaluate nearly 60% of all skin diseases, and 22% of these physicians are family physicians. Dermatology education is therefore an important aspect of Family Medicine training. Dermatologic procedural training in Family Medicine residency is not standardized, however, so family physicians graduate with highly variable skills. This study describes the scope and diagnostic outcomes of skin biopsies performed by residents at a multisite Family Medicine residency network in comparison with those performed by attendings at a Family Medicine faculty community practice. We performed a retrospective chart review of patients evaluated at eight Family Medicine residency training sites and one Family Medicine faculty community practice within a regional academic health system between January 2020 and October 2022. Patients with a skin finding who underwent at least one skin biopsy during their visit were included in the study. Among all of the skin findings, the incidence of skin biopsy was 3.6% (258/7104) for residents and 1.8% (175/9917) for attendings (P < 0.001). Family Medicine residents performed fewer shave biopsies (57.8% vs 77.7%, P < 0.001) and more punch biopsies (25.6% vs 11.4%, P < 0.001) compared with attendings. Most biopsies performed by residents and attendings were benign, although residents biopsied significantly more benign (79.1% vs 64.6%, P < 0.001) and malignant lesions (11.2% vs 5.7%, P = 0.049). Attendings biopsied significantly more low-to-moderate-grade dysplastic (22.3% vs 5.0%, P < 0.001) and high-grade atypical lesions (4.0% vs 0.8%, P = 0.034). Family Medicine residents at this residency network receive training in a variety of skin biopsy types. Distinct skin biopsy practices and outcomes between residents and attendings may reflect differences in patient populations, clinical expertise, and dermatology referral patterns.

Knowledge, Attitudes, and Practices of Filipino Medical Interns on the Management of Superficial Cutaneous Mycoses: A Cross-sectional Study.

Superficial mycoses are one of the most common skin conditions encountered in the outpatient clinics, causing significant morbidity amongst patients. Since these are highly prevalent diseases of the skin, the general practitioner should be able to manage uncomplicated cases, with no need for evaluation by a specialist. The study aimed to determine the knowledge, attitudes, and practices of Filipino medical interns on the management of superficial cutaneous mycoses using a self-administered questionnaire. This may help identify possible gaps in knowledge, as well as obstacles these future clinicians may encounter when managing superficial mycoses. This in turn may assist in the development or improvement of dermatology training among medical students and continuing medical education programs amongst non-dermatologist physicians. This is a descriptive cross-sectional study among medical interns of the Philippine General Hospital to investigate their knowledge, attitudes, and practices regarding the management of superficial mycoses. Eligible participants were asked to complete an online self-administered survey questionnaire which assessed their capacity to recognize and manage uncomplicated superficial mycoses, and determined their attitudes regarding dermatology training in medical school. The study included 170 medical interns, with majority having only 1-4 weeks of cumulative duration of dermatology training in medical school. Many of the participants (67.1%) had inadequate overall knowledge scores, but this was not significantly associated with their cumulative duration of dermatology training, as well as with their frequency of encounters with superficial mycosis patients. Most deem dermatology training (92.4%) and learning about the management of superficial mycoses (91.2%) during medical school very important. Majority are interested in attending more courses or training in the subject. Recommendations to improve medical school training on superficial mycoses include more practical approach in dermatology modules, integration of dermatology electives in medical school, and longer duration of dermatology modules/rotations during medical school. While knowledge scores of medical interns were not significantly associated with the duration of their dermatology training during medical school as well as their encounters with patients with superficial mycoses, it is shown that they have low confidence scores regarding management of superficial mycoses. They deem that learning more about this disease and dermatology in general is vital to their medical education and are desirous of more training in this subject. Recommendations to improve medical school training on superficial mycoses include dermatology modules, rotations or electives in medical school. Additionally, better training during medical school, and formulation of clinical practice guidelines specific to cutaneous mycoses were recommended to improve healthcare delivery for patients with such diseases.

Abstract C012: Evaluation of skin cancer screening education provided by dermatologists with The Sun Bus for medical students

Abstract Introduction: Medical student curriculum is lacking in standardized training of skills for conducting the skin cancer screening examination. Dermatology is not a standard clinical rotation during medical school, and many medical students do not have much exposure to the specialty of dermatology for hands-on training in skin examinations by dermatologists. We sought to create an event in conjunction with the Sun Bus that included education about dermatology and skin examination for medical students. Objectives We sought to assess how the effects on knowledge of dermatology and skin cancer prevention and screening among participating medical students changed from participating in the educational event. Methods: The Health Education and Awareness Team of Texas Tech University Health Sciences Center El Paso collaborated with The Sun Bus to organize a training event for medical students. During this event, students had the opportunity to listen to a panel about dermatology as well as the basics of skin cancer screening from working dermatologists. Students also received a brief training on skin cancer screening provided by The Sun Bus and conducted screenings alongside dermatologists during a free skin cancer screening event. Students completed voluntary pre-event and post-event surveys. Results The vast majority of students did not feel confident in their ability to screen for skin cancer prior to attending the event. This research showed improved student confidence in providing skin cancer screenings and identifying suspicious skin lesions from the intervention. Conclusion: Medical students lack standardized training in dermatology and in the dermatologic skin cancer screening examination. This student educational event represents a meaningful intervention that improved medical students’ confidence in providing skin cancer screenings and identifying suspicious skin lesions. Bibliography The Sun Bus. https://www.thesunbus.org/about-us Accessed 11 Dec 2023. Compres E, Holzem K, Ibler E, Bierman JA, Rademaker AW, Kundu RV. A Brief Dermatology Curriculum in Skin Cancer Detection and Prevention to Improve Medical Student Knowledge and Confidence. MedEdPORTAL. 2020;16:11049. Published 2020 Dec 29. doi:10.15766/mep_2374-8265.11049 Moore MM, Geller AC, Zhang Z, et al. Skin cancer examination teaching in US medical education. Arch Dermatol. 2006;142(4):439-444. doi:10.1001/archderm.142.4.439 Ivanov NN, Swan A, Guseman EH, Whipps J, Jensen LL, Beverly EA. Medical Students' Knowledge, Attitudes, and Behaviors With Regard to Skin Cancer and Sun-Protective Behaviors. J Am Osteopath Assoc. 2018;118(7):444-454. doi:10.7556/jaoa.2018.098 Ivanov NN, Swan A, Guseman EH, Whipps J, Jensen LL, Beverly EA. Medical Students' Knowledge, Attitudes, and Behaviors With Regard to Skin Cancer and Sun-Protective Behaviors. J Am Osteopath Assoc. 2018;118(7):444-454. doi:10.7556/jaoa.2018.098 Citation Format: Elian A. Martin Lopez, Hannah Riva, Shravya Kichena Kichena, Daniel Lovasz, Brian Kan, Tannis Hogg, Jessica Chacon. Evaluation of skin cancer screening education provided by dermatologists with The Sun Bus for medical students [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C012

Computer Vision Meets Large Language Models: Performance of ChatGPT 4.0 on Dermatology Boards-Style Practice Questions

Background: ChatGPT is a generative artificial intelligence that has numerous professional applications. Applications in medical education are currently being explored. ChatGPT 4.0 performance on image-based dermatology boards-style practice questions has not been assessed. Objective: The objective of this study was to determine the accuracy with which ChatGPT can answer dermatology boards examination practice questions. Methods: 150 multiple-choice questions from the popular question bank DermQbank were inputted into ChatGPT. Of these, 83 were text-only questions and 67 had associated images. These same questions were inputted into ChatGPT again in July 2024. An additional 150 questions were inputted for a total of 300 different questions where 169 were text-only and 133 had associated images. Results: Of the aggregate 300 question data, ChatGPT answered 232 questions correctly (77.3%). ChatGPT performed significantly better with text-only questions than with questions that included images (85.2% (144/169) vs 67.7% (90/133), P&lt;.001). Of image-based questions, ChatGPT performed better with clinical image questions than with dermatopathology questions (69.0% (78/133) vs. 58.8% (10/17), P=.40), but this difference was not statistically significant partially due to the sample size of the dermatopathology questions. Compared to post-graduate year 4 (PGY-4) residents, ChatGPT performed above the 46th percentile. ChatGPT agreed with the answer choice picked by the majority of question bank users 75.3% of the time. Multivariable regression demonstrated that significant predictive variables for ChatGPT answering a question correctly included the percent of dermatology trainees who answered a question correctly and whether the question was text-based (P&lt;.001and P=.004, respectively). Conclusions: ChatGPT answered 77.3% of dermatology board examination practice questions correctly, performing above the 46th percentile of PGY-4 question bank users. If using ChatGPT as a study resource for dermatology board examination preparation, residents should be judicious with exactly how they employ ChatGPT to avoid learning incorrect information.

52030 Strategies for Improvement of the Virginia Dermatology Trainee Advocacy Day Conference

52030 Strategies for Improvement of the Virginia Dermatology Trainee Advocacy Day Conference

53796 Awareness, attitude and quality of life among primary caregivers of children with atopic dermatitis attending the Regional Dermatology Training Center in 2023

53796 Awareness, attitude and quality of life among primary caregivers of children with atopic dermatitis attending the Regional Dermatology Training Center in 2023

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.

Identifying Care Gaps and Referral Patterns in Acute Dermatology at Urgent Care Centers.

Limited urgent access to board-certified dermatologists drives patients to seek dermatologic care at urgent care centers (UCC). UCC are staffed by clinicians with comparatively limited dermatology training, often resulting in lower quality care for acute dermatology conditions. This study investigates health care referral outcomes of patients seeking dermatologic care at UCC, examine the appropriateness of UCC dermatologic care, and assess the feasibility of referral management by eConsult. We utilize a retrospective cohort of 807 patients and a provider survey to examine referral outcomes of patients referred to University of Rochester Dermatology (UR-Derm), a tertiary care university-based teaching hospital, from UR UCC between January 1, 2021, and August 31, 2022. Outcomes for healthcare referrals included patient demographics, referral completion rates, UR-Derm appointment wait times, and diagnostic concordance rates between UCC and UR-Derm. Outcomes from the provider survey included appropriateness of UCC treatment plans, appropriateness of UCC referral to UR-Derm, and feasibility of referral management by eConsult. Patients who utilized UCC were predominately white (77.0%) females (53.9%) with a mean age of 37.9 years. Most patients referred by UCC did not complete an in-person UR-Derm evaluation (58.6%). Of those who did complete a UR-Derm visit, the average wait time was 38.3 days. Only 56% of UCC and UR-Derm diagnoses were concordant. Our surveyed dermatologists deemed 30% of the UCC treatment plans appropriate. The majority of referrals (83.5%) were viewed as manageable with an eConsult with only 10% of referrals requiring in-person visit. Several practice gaps exist in specialty care delivery in UCC and additional inefficiencies exist in the urgent referral process. These gaps could be addressed by targeted educational interventions and availability of dermatology consultation to support urgent care.

Effects of a skin type diversity seminar on undergraduate medical students’ self-assessed competence in managing skin diseases in patients with skin of color

BackgroundSkin diseases in patients with skin of colour (Fitzpatrick skin types IV to VI) are underrepresented in dermatology training, which may lead to lower quality of care for these patients. To address this underrepresentation in medical education, a newly developed seminar on skin type diversity using an interactive teaching method was implemented in an undergraduate medical curriculum. This study examined the effects of a seminar on the self-assessed competence of medical students in managing skin conditions in patients with skin of colour.MethodsA questionnaire survey was conducted among fourth-year undergraduate medical students at the University of Hamburg (Germany) between October 2023 and February 2024. Students’ self-assessed competence was compared before and after the obligatory seminar (pre- and post-design).ResultsIn total, 158 students participated in the survey. After the seminar, knowledge of the presentation of skin diseases in patients with skin of colour and the associated psychological burden, differences in the incidence of skin diseases in different skin types, and the ability to diagnose skin diseases in darker skin types increased. Most participants stated that they wanted to attend more courses on this topic.DiscussionAppropriate courses for medical students can improve their competence in managing different skin diseases in patients with skin of colour. In the future, more attention should be paid to teaching the diversity of skin types in dermatology education.

Dermatology Education for Medical Students: Assessing Participation Rates in Clinical Dermatology Electives

Introduction: Skin conditions affect 1.9 billion people worldwide and are a common reason for patients to seek health care1. With the high prevalence of skin disease, it is vital that medical students should receive clinic-based education in recognizing and treating skin disorders. University of Pittsburgh School of Medicine (UPSoM) currently offers a 4-week clinical dermatology elective to third or fourth year medical students. However, in an increasingly crowded clinical curricula, the dermatology elective is not taken by many students. Methods: We assessed the percentage of UPSoM students who completed the dermatology elective and analyzed the residency selection of these students between academic years 2012 to 2022. We also explored dermatology elective offerings of medical schools across the United Sates that have a dermatology residency program and investigated the number of schools offering a shortened elective through the American Medical Association’s FREIDA database. Results: During academic years (AY) 2012 to 2022, 1579 students were enrolled at UPSOM. In this time period, 205(13.0%) students participated in the elective course. Of these 205 students, 31(15.1%) pursued dermatology residency, 105(51.2%) pursued primary care and 22(10.7%) students pursued surgical subspecialties. Of the 142 dermatology residency programs, only nineteen programs (17.0%) offer a shortened elective. Discussion: Many medical students graduate medical school with little to no dermatology training, despite a high likelihood of encountering skin disease in their future careers. Offering a shortened clinical dermatology elective may allow for more students to participate in hands-on dermatology training.

Representation of Skin Color, Disease Severity, and Anatomic Location in Hidradenitis Suppurativa Images

Introduction: Hidradenitis suppurativa (HS) is an inflammatory dermatosis disproportionately affecting patients of color. We evaluated characteristics of HS images in dermatology online image resources and textbooks. Methods: Images of HS were collected in December 2021 from online and textbook sources. Data regarding anatomic region, Hurley stage, and Fitzpatrick skin tone (FST) were collected and analyzed. Results: 318 images remained after exclusion criteria. VisualDx contained the highest number of dark skin (FST V-VI) images (59%, 47/79), followed by Google (4%, 2/52) and DermNetNZ (4%, 4/100). In textbook sources, dark skin represented 25% (4/16) of images. Across sources, 47% (151/318) of images represented Hurley stage 2, followed by 32% (101/318) stage 3, and 21% (66/318) stage 1. The axilla (49%, 156/318) was the most common anatomic location featured, followed by the groin (18%, 58/318) and breast/chest (9%, 28/318). Involvement of non-classic locations was represented in 3% (8/318) of images. There was a positive correlation between higher Hurley stage and darker skin (r=0.26, p&lt;0.05). Discussion/Conclusion: Overall there is underrepresentation of dark skin tones, “non-classic” anatomic locations, and mild HS which may lead to missed opportunities for patient education and dermatology training. Dermatologists should take the lead to improve image diversity across educational resources.

Educational Gaps in Dermatologic Diagnoses Among Otolaryngology Residents.

Otolaryngologists frequently serve as the first touchpoint for patients presenting with dermatologic conditions of the head and neck. This study aims to identify and quantify gaps in dermatologic training among otolaryngology residents, and to assess their diagnostic accuracy in comparison to dermatology residents. It comprised 14 multiple-choice questions focused on common dermatologic diagnoses related to the head and neck. Sixty-one dermatology and 36 otolaryngology residents participated in the study. Dermatology residents significantly outperformed otolaryngology residents, with average scores of 90% (SD = 8) compared to 71% (SD = 10) (P < .001). The observed effect size (Cohen's d = 2.010) significantly exceeded the expected effect size (0.603). Otolaryngology residents performed significantly lower on 7 out of the 14 questions. Analysis based on postgraduate year level showed no significant differences in scores within dermatology (P = .119) or otolaryngology (P = .402) residency programs.

Availability of lasers and hands-on training in cosmetic dermatology in residency

Availability of lasers and hands-on training in cosmetic dermatology in residency

DS03 Survey of dermatological surgical training in the UK

DS03 Survey of dermatological surgical training in the UK

P050 Certificate of Eligibility for Specialist Registration (CESR) (portfolio pathway) satisfaction survey for dermatology trainees: a comparison of current CESR vs. national trainees, within a large UK teaching hospital

P050 Certificate of Eligibility for Specialist Registration (CESR) (portfolio pathway) satisfaction survey for dermatology trainees: a comparison of current CESR vs. national trainees, within a large UK teaching hospital

PA05 Paediatric dermatology training experience and career intentions: a survey of UK dermatology trainees

PA05 Paediatric dermatology training experience and career intentions: a survey of UK dermatology trainees

Closing the gap in dermatology training: Introducing Skin of Colour Training UK

Closing the gap in dermatology training: Introducing Skin of Colour Training UK

Multidisciplinary Training in Dermatology: Exploring the Spectrum of Board Certifications Among Physicians Practicing Dermatology in Texas.

Dermatology, a medical specialty focused on skin, hair, and nail conditions, often overlaps with various medical specialties. Although most physicians practicing dermatology are board-certified in dermatology, there are physicians practicing dermatology who are board-certified in a variety of different medical specialties. This cross-sectional study examines the board certifications of physicians who reported practicing dermatology in Texas. Data were sourced from the Texas Medical Board database updated in August 2023. The data showed that out of 1,614 practicing physicians declaring dermatology as a specialty in Texas, 1,080 (66.91%) physicians had one board certification, 200 (12.39%) had two, and 15 (0.93%) had three. Of the physicians with one board certification, 1,053 (97.5%) were board-certified in dermatology, with the remainder primarily being a mix of a variety of primary care specialties but also including other specialties. This study confirmed that while the vast majority of physicians practicing dermatology are board-certified in dermatology, there are opportunities for physicians board-certified in other specialties to practice dermatology as well.