Supporting Underrepresented in Medicine (UIM) and non-UIM Trainees Applying into Dermatology: A Qualitative Analysis

responses mentioned coordination of interview dates, which was implemented by some dermatology programs during the 2020-2021 application cycle. Further, UIM trainees’ appeals for greater emphasis on diversity and inclusion, UIM student outreach/pipeline programs, holistic review, and mentorship are in line with calls for shifting priorities in resident selection, including prioritization of non-academic competencies and cultivation of mentoring relationships.¹ Students from medical schools without home dermatology programs may also benefit from additional mentorship opportunities, pipeline programing, and readily accessible program specific information. Our results provide firsthand insight into the unique challenges UIM students face in applying to dermatology residency.

Programmatic efforts such as improving transparency throughout the application process,⁴ increasing the completeness and diversity of curricular content, incentivizing diversity and inclusion scholarship, and providing implicit bias and anti-racism training may help mitigate some of these challenges.⁵ Beginning in medical school, dermatology coursework should be inclusive of skin of color curricular and photographic content, including full-spectrum representation of dermatoses across skin tones. Additionally, departments should advertise existing resources for UIM students and openly publish information on diversity initiatives and faculty member designees who can serve as points of contact. Underrepresented minority and low-income students are more likely to cite socioeconomic barriers, such as lack of loan forgiveness, as deterrents to applying for dermatology residency.² Increasing resources and support for UIM students is particularly important in light of dermatology being one of the least diverse specialties in medicine.¹ Study limitations include potential response bias, incomplete representation of all UIM trainees, and difficulty capturing wide-ranging responses with standardized themes. Nevertheless, our results highlight opportunities for dermatology residency programs to create a more fair and equitable application process and support a more diverse pipeline of future dermatologists.

Drs. Burkemper, Friedman, Huang, Murina, Nord, and Rosmarin are members of the Association of Professors of Dermatology Program Directors Task Force and Residency Program Transparency Work Group. Additionally, Dr. Burkemper serves as the dermatology residency program director at Saint Louis University; Dr. Friedman serves as the dermatology residency program director at George Washington University, Dr. Huang serves as the dermatology residency program director at Harvard University; Dr. Murina serves as the dermatology residency program director at Tulane University; Dr. Nord serves as the dermatology residency program director at Stanford University; Dr. Rosmarin serves as the dermatology residency program director at Tufts University.

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4. Rosmarin D, Friedman AJ, Burkemper NM, Nord KM, Murina AT, Huang JT. The Association of Professors of Dermatology Program Directors Task Force and Residency Program Transparency Work Group Guidelines on Residency Program Transparency. J Drugs Dermatol. 2020;19(11):1117-1118. doi:10.36849/JDD.2020.5600
5. Burgin S, Dlova NC, Goldsmith LA. Dermatological education for the 21st century: prioritizing diversity. Br J Dermatol. Published online November 1, 2020. doi:10.1111/bjd.19663

Kristin M. Nord MD knord@stanford.edu