Diversity in Dermatology: Dermatology Resident Exposure to Skin of Color

September 2021 | Volume 20 | Issue 9 | Editorials | 1005 | Copyright © September 2021


Published online August 23, 2021

Alysha Colon MDa, Xiomara Brioso Rubio MDb, Ryan Gillihan MDc, Marjorie Montañez-Wiscovich MD PhDd, Kiran Motaparthi MDd

aDepartment of Dermatology, Howard University College of Medicine, Washington, DC
bDepartment of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT
cDepartment of Dermatology, University of Kansas School of Medicine, Kansas City, KS
dDepartment of Dermatology, University of Florida College of Medicine, Gainesville, FL

Abstract

INTRODUCTION

Due to increasing diversity of the United States, with an estimated 50 percent of the population identifying as non-white by the year 2050,1 it is imperative to improve medical knowledge regarding specific conditions affecting this population as well as medical trainees’ confidence when caring for these patients. Disparities in dermatologic training regarding skin of color (SOC) pathology have been observed.2,3 Dermatologic health inequalities in ethnic minorities have also been reported.1 This study evaluates current trends in SOC residency curricula and assesses confidence in caring for this population, from the standpoints of both the program director (PD) and resident.

An anonymous survey approved by the Institutional Review Board at the University of Florida was distributed to dermatology postgraduate year (PGY) 2–4 residents and program directors (PDs) through the Association of Professors of Dermatology e-mail listserv. The number of questions varied based on respondent answers. The survey evaluated SOC pathology exposure via lectures, on-site clinics, electives, or instruction by SOC experts. Additional questions were asked regarding resident confidence level in treating affected patients of color. PDs also received questions regarding their assessment of resident confidence levels.

Demographics and geographic distribution of respondents are displayed in Supplementary Table and Figure 1, respectively. The anonymous survey received 137 responses (summarized in Supplementary Table) from over 50 residency programs, with 54 PD, 33 PGY-2, 26 PGY-3, and 24 PGY-4 respondents. A Pearson’s χ2 test was used to analyze the relationship between SOC specific experiences and residents’ confidence level in diagnosis and treatment in SOC compared to Caucasian patients (Table 1). Our study found that residents with an expert in SOC in their program are 3.08 (95% CI, [1.12, 8.5]) times more likely to feel equally/more confident in diagnosing skin disorders in SOC versus Caucasian patients compared to residents without an expert attending. However, a statistically significant relationship was not shown when analyzing resident confidence level and SOC clinics, lectures, or electives. The