Diversity in Academic Dermatology

June 2022 | Volume 21 | Issue 6 | 6899 | Copyright © June 2022


Published online April 28, 2022

Jacob Beer MDa, Jade Heningburg b, Jeanine Downie MDc, Kenneth Beer MDd

aTulane Department of Dermatology, New Orleans, LA
bUniversity of Chicago, Chicago, IL
cImage Dermatology, Montclair, NJ
dBeer Dermatology, Palm Beach, FL

Abstract
The American Medical Association recently declared racism to be a public health threat. It declared that “Racism negatively impacts and exacerbates the health inequities among historically marginalized communities”.1 The New England Journal of Medicine echoed this declaration in a recent article that included goals for making medicine more diverse by transforming “the ranks of institutional research leadership, faculty, trainees, and staff to reflect the demographic diversity of the communities their organizations serve.”2 The article also calls for more transparent selection criteria for choosing leaders in medicine. Necessary changes are articulated and provide a pathway towards more equality in medicine. One subspecialty in the field of medicine (dermatology) lacks the type of diversity one would expect from physicians who study the skin. Although the problem has been discussed for years, it has yet to be rectified.

J Drugs Dermatol. 2022;21(5) doi:10.36849/JDD.6899

INTRODUCTION

Recent events highlight disparities for skin of color (SOC) patients in dermatology. These disparities affect the care received by SOC patients. One determinant of outcome and degree of comfort for SOC patients is the skin color of their dermatologist. At the present time, there is a dearth of diversity among dermatologists as well as a paucity of examples of leaders with SOC in dermatology. This lack of role models for SOC medical students is one reason that very few choose careers in dermatology. Of those who pursue a career in academic dermatology, a disproportionately low number will become chairs of a department, leaders of residency training programs, editors of academic journals, presidents of dermatology associations, or course directors of national meetings. Since other specialties have grappled with these issues with differing degrees of success, it is worthwhile to compare some of the metrics when considering priorities for making dermatology a more equitable specialty.

Very few medical students with SOC go on to choose careers in dermatology and of those who do, very few elect to stay in academic medicine. Currently, the most common ethnicity among dermatologists is white non-Hispanic. African Americans comprise only 3% of dermatologists in the US.3 This even though African Americans represent about 13% of the population. The statistics for SOC female dermatologists are even more skewed. Other specialties including ophthalmology and women’s health have grappled with these issues with varying degrees of success. As we consider how to make dermatology more equitable, it is worth examining how other specialties have approached this problem.

Although willing to see anyone who can help them, African American patients are often unable to see an African American dermatologist. This is even though greater than 70% of African American patients have expressed a preference for seeing an African American dermatologist.4 This discrepancy of care is greater in dermatology than in many other fields that have more SOC practitioners. Presently, dermatology is the second least diverse specialty, only behind orthopedic surgery.5 It is also well known that Black patients consistently experience poorer communication quality in doctor–patient interactions and members of minority groups are more at risk of having negative interactions with their doctors.”6 Obtaining better, more equitable outcomes will depend on improving the recruitment of medical students with SOC to pursue careers in dermatology.

One way to accomplish this goal is to increase the percentage of senior academic leaders who have SOC.7 By providing mentorship and guidance, medical students might consider a career in dermatology. There are scant advocates, examples, or information for dermatology applicants with SOC. When SOC applicants read dermatology journals or attend dermatology meetings, there are few editors or course directors who have SOC.