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March 11, 2020
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Insufficient dermatology education reported at US medical schools

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Jules Lipoff
Jules Lipoff

Dermatology-specific education may be insufficient at U.S. medical schools, according to a research letter.

Jules Lipoff, MD, assistant professor in the department of dermatology at the Perelman School of Medicine at the University of Pennsylvania, discussed the shortage of dedicated dermatology departments in an interview with Healio. “While I can’t speak to the specifics here, I imagine that some of it comes down to hospital priorities and where they want to spend money and that they do not necessarily see it as in their best interest,” he said.

Lipoff and colleagues aimed to gain further understanding of the current status of dermatologic education in U.S. medical schools. Despite the prevalence, burden and morbidity of dermatologic conditions, they conducted the study due to the assumption that dermatology departments may be underrepresented in the U.S. medical education system.

Between October 2018 and August 2019, the researchers contacted, by telephone, 137 allopathic medical schools accredited by the Liaison Committee on Medical Education.

Representatives from the office of student affairs, the office of medical education or equivalent were asked questions about dermatology curricula and rotations. In situations in which the respondent was unable to provide complete answers, the researchers viewed official websites for pertinent information.

Results showed a 100% response rate. While just 12% of those schools had a course dedicated to dermatology in preclinical curricula, 36% had dermatology lectures throughout broader education blocks. However, those education blocks included other bodily and organ systems.

Cahn Infographic
Dermatology-specific education may be insufficient at U.S. medical schools, according to a research letter.

Only 1% had a mandatory third-year clinical rotation in dermatology ranging from 1 to 4 weeks, according to the findings. However, dermatology was offered as an elective in the third-year rotation at 62% of responding institutions.

The researchers suggested that this situation is problematic because approximately 27% of the U.S. population seeks treatment for a dermatologic complaint each year. These complaints comprise 3.8% of health care expenditures in the country.

Lipoff further put these circumstances into context. “Lack of departments translates to lack of access to academic dermatologists and lack of educational interaction between dermatology and other specialties at all levels,” he said. “This means medical students will not learn from the most trained physicians in that area, and residents cannot consult dermatologists for inpatient cases, nor do they learn about those diseases from the most trained physicians.”

While Lipoff and colleagues understand that educational institutions must make their own priorities and acknowledge that taking resources from internal medicine or surgery could have its own pitfalls, he stressed that many students in U.S. medical schools are simply not getting enough education in dermatology.

“This compounds the existing problem of access to dermatologists’ offices because primary doctors are thus more dependent on specialists if they are not given even a basic education in how to handle dermatologic conditions,” he said. “With basic education, likely primary doctors could handle more bread and butter dermatologic cases and allow more of the cases that truly need specialist time to get the access and time they need.” – by Rob Volansky

Disclosures: The authors report no relevant financial disclosures.