Supporting Underrepresented in Medicine (UIM) and non-UIM Trainees Applying into Dermatology: A Qualitative Analysis
July 2021 | Volume 20 | Issue 7 | Editorials | 795 | Copyright © July 2021
Published online June 18, 2021
Zizi Yu BA*,a Justin L. Jia BS*,b Surya A. Veerabagu BA,c Nicole M. Burkemper MD,d Adam J. Friedman MD,e David Rosmarin MD,f Jennifer T. Huang, MD,a,g Andrea T. Murina MD,h Kristin M. Nord MDb,i
aHarvard Medical School, Boston, MA
bDepartment of Dermatology, Stanford University School of Medicine, Stanford, CA
cTulane University School of Medicine, New Orleans, LA
dDepartment of Dermatology, Saint Louis University School of Medicine, St. Louis, MO
eDepartment of Dermatology, George Washington School of Medicine and Health Sciences, Washington, DC
fDepartment of Dermatology, Tufts University School of Medicine, Boston, MA
gDermatology Program, Boston Children's Hospital, Boston, MA
hDepartment of Dermatology, Tulane University School of Medicine, New Orleans, LA
iDermatology Service, VA Palo Alto Healthcare System, Palo Alto, CA
*These authors contributed equally
Abstract
Background: Recently, there have been calls to improve diversity among the dermatology workforce, with emphasis placed on the resident selection process and trainee pipeline. However, there is limited data on the perspectives of dermatology applicants, especially among UIM trainees, and the support that they need and want to successfully apply in dermatology.
Methods: To assess trainee perspectives, we disseminated a survey to medical students, interns (matched into dermatology), and dermatology residents asking how dermatology residency programs can best support trainees through the dermatology application process. We developed a codebook drawing upon grounded theory methodology, and consensus coded all qualitative responses.
Results: We received 224 qualitative responses from underrepresented in medicine (UIM) (65, 29.0%) and non-UIM trainees (159, 70.9%). UIM trainees were more likely to mention diversity and inclusion initiatives (46.2% vs 3.8%,
P<0.001), transparency in program information (40.0% vs 24.5%,
P=0.021), holistic review (30.8% vs 6.3%,
P<0.001), UIM student outreach/pipeline programs (23.1% vs 0.6%,
P<0.001), and mentorship (21.5% vs 8.2%,
P=0.009).
Conclusion: Improving programmatic efforts to address unique challenges UIM trainees face when applying into dermatology is instrumental to mitigating barriers. We highlight opportunities for dermatology residency programs to create a more fair and equitable dermatology application process and support a more diverse pipeline of future dermatologists.
J Drugs Dermatol. 2021;20(7):795-797. doi:10.36849/JDD.6043
INTRODUCTION
To promote health for all members of society, medical institutions must play an active role in breaking down structural racism in medical education, scientific research, and workforce representation. Dermatology is one of the least diverse specialties, and some suggest lack of exposure to the specialty begins early in medical school.1 Underrepresented minority trainees face additional barriers in pursuing a career in dermatology, including lack of existing diversity, socioeconomic factors, perceived negative perceptions by residency programs, and lack of mentors with similar backgrounds.2 To address the lack of diversity in our workforce, calls to action have endorsed evidence-based methods to improve the residency selection process and recruitment of UIM trainees to the field of dermatology.1 However, there is limited data assessing trainee perspectives and needs throughout this process, representing an untapped area for improvement.3
In July 2020, a survey was administered to medical students, interns (matched in dermatology), and dermatology residents through the Dermatology Interest Group Association and Dermatology-in-Review listservs in the United States. Participants were asked to respond to the open-ended question: “How can residency programs better support trainees through
