Analyzing diversity, equity, and inclusion content on dermatology fellowship program websites.

Diversity, Equity, and Inclusion (DEI) initiatives have garnered increasing attention within medical education as there have been increased efforts to diversify the physician workforce among medical students, residents, fellows, and attendings. One way in which programs can improve their DEI initiatives and attract a more diverse pool of applicants is through DEI content on their graduate medical education websites. Prior studies characterizing the content and prevalence of DEI material on residency webpages have shown that dermatology residencies have relatively low levels of DEI content on their websites in which almost ¾ of all programs having no DEI content. Little is known, however, if similar findings are to be expected for the three main dermatology subspecialty fellowship program webpages: Dermatopathology, Pediatric Dermatology, and Micrographic Surgery and Dermatology Oncology. Fellowship programs were identified using the Accreditation Council for Graduate Medical Education's online database of fellowship programs. Programs were evaluated on a standardized scoring system for five equally weighted criteria: fellowship-specific DEI webpage, DEI commitment statement, DEI initiatives (summer research opportunities for under-represented minorities, DEI council, etc.), link to the institution's DEI homepage, and information about bias training. The mean score among all programs was 12.5. Pediatric dermatology ranked the highest among all specialties, while Mohs ranked the lowest. A link to the institution's DEI homepage was the most prevalent factor accounting for 42.1% of all programs collected, whereas information about bias training and fellowship-associated DEI webpage were the least prevalent. The results of this study reveal an overall lack of DEI content across all dermatology subspecialties' webpages and represent an actionable area of improvement for fellowship directors to increase their DEI efforts to attract a diverse pool of applicants to their program.

Geomapping of pediatric dermatologists: A tool to promote diversity and equity in dermatology.

There is a lack of racial and ethnic diversity across the field of dermatology, including the subspecialty of pediatric dermatology. Residency programs are improving recruitment and mentorship of medical students who identify with racial or ethnic minority communities (underrepresented in medicine [URiM]) to dermatology overall, a goal similarly held by our subspecialty. The objectives of this study were to create an online mapping tool to visually centralize the list of 142 dermatology residency programs, 105 with practicing pediatric dermatologists on faculty and 51 that offer financial scholarships for URiM visiting medical students completing away rotations. With this tool, we hope that prospective students may not only identify potential pediatric dermatology mentors for virtual and in-person activities, but that they may also build connections with and increase their chance of matching at prospective residency programs with demonstrable commitment to diversity, equity, and inclusion.

Perceived Benefits of a Research Fellowship for Dermatology Residency Applicants: Outcomes of a Faculty-Reported Survey.

Dermatology continues to represent one of the most competitive specialties for medical students to match into for residency. The number of publications reported by applicants contributes to this competitiveness. Many students hoping to obtain a dermatology residency position are completing research fellowships (RFs) prior to applying. We conducted a survey to determine if those involved in the residency selection process recommend completion of an RF and how they view the perceived benefits of RF completion.

Delegation and oversight of non-physician practitioners in dermatology.

A rising demand for dermatologic procedures has led to a recent increase in the number of non-physician operators (NPOs) in the dermatology workforce. Nurse practitioners, physician assistants, and aestheticians commonly perform procedures in both physician-based practices and medical spas with varying degrees of dermatology-specific training and physician oversight. Although the lack of regulations can negatively impact patient outcomes and adverse events, the role of NPOs in dermatology continues to grow. Among Medicare beneficiaries, nurse practitioners and physician assistants are independently billing for a growing number of dermatologic procedures, whereas the number performed by dermatologists remains relatively stable. Medical spas are an increasingly popular destination for aesthetic consumers, and the majority employ only NPOs as primary providers. Recent data suggest that compared to dermatologists, NPOs have a higher rate of adverse events. As attempts are made to standardize and improve the training requirements for dermatologic procedures, a concerted effort should be made to prioritize patient outcomes and safety.

Diversifying the Mohs Workforce: Understanding Barriers of Applicants to Mohs Micrographic Surgery Fellowship.

BACKGROUND: The population of the United States is becoming increasingly diverse, yet dermatology, especially Mohs micrographic surgery (MMS), lags behind. OBJECTIVE: This survey study investigates perceived barriers of underrepresented groups in medicine (URM) who are pursuing fellowship in Mohs micrographic surgery and dermatologic oncology (MSDO). METHODS AND MATERIALS: An IRB-approved survey was distributed electronically to accredited dermatology residencies between December 2020 and April 2021. RESULTS: One hundred and thirty-three dermatology residents responded to the survey and of the participants, 21% identified as a URM. There was no significant difference in those interested in applying for MSDO fellowship between URMs and non-URMs. URMs rated the following factors significantly higher when deciding to pursue MSDO fellowship: lack of perceived diversity in target patient population (mean 3.61, SD 1.66), race/ethnicity/gender of past MSDO fellows (mean 3.25, SD 1.71), perceived attitudes of MSDO fellowships towards an applicant’s race or ethnicity (mean 3.25, 1.65 SD), and lack of diversity of trainees and faculty in MMS (mean 3.61, SD 1.47). CONCLUSION: This study is one of the first to evaluate perceived barriers to diversifying the MMS workforce. The perceived barriers we have identified are complex and require concerted efforts for improvement. J Drugs Dermatol. 2023;22(5): doi:10.36849/JDD.7083.

Diversity, Equity, and Inclusion in Dermatology Residency.

Improving diversity, equity, and inclusion (DEI) in dermatology is a critical aim for the specialty to improve the workforce, clinical care, education, and research. This article outlines a framework for DEI initiatives at the residency training level: improving mentorship and residency selection process to improve representation of dermatology trainees; curricular development to train residents to provide expert care to all patients and to better understand principles of health equity and social determinants of health as they pertain to dermatology; establishing inclusive learning environments and mentoring structures that support residents to become successful future clinicians and leaders of the specialty.

Dermatology workforce in the United States - Part I: Overview, transformations, and implications.

The dermatology workforce continues to evolve to meet the growing and diversified demands of the US population. Part 1 of this continuing medical education series is designed to provide an overview of the dermatology workforce as well as delineate the motivators and socioeconomic implications of significant workforce transformations which are impacting dermatologic health care. Part 2 of the series will consider the impact of workforce challenges on patient outcomes and discuss potential actions that may help to optimize workforce organization and care delivery.

Fellowships in Complex Medical Dermatology.

Complex medical dermatology fellowships currently are offered at 5 institutions in the United States. The decision to pursue this fellowship is individualized; however, additional training can prove to be beneficial when practicing in an environment with medically challenging patient populations.

Perceptions of Community Service in Dermatology Residency Training Programs: A Survey-Based Study of Program Directors, Residents, and Recent Dermatology Residency Graduates.

Integrating community service (CS) into the dermatology residency program curriculum creates a rewarding training environment that promotes an interest in health disparities, increases skin health equity, and augments the cultural sensitivity of its trainees. To better understand the importance of CS activities in dermatology residency programs, program directors, residents, and recent dermatology residency graduates were surveyed about their perceptions and participation in CS-defined as participation in activities to increase dermatologic access, education, and resources in under-served communities.

Post-Residency Training Instead of Medical Student Research Fellowships Will Improve Dermatology Patient Care and Excellence.

Research fellowships among prospective dermatology residency applicants are becoming increasingly popular. These fellowships provide opportunities for mentorship, publications, and clinical experience, but unpaid positions impose a significant financial burden. We advocate for a more holistic analysis of dermatology applicants, with less emphasis on publication quantity, and propose allocating funds for post-residency fellowships in underserved areas of dermatology.

Diversity within US dermatology residency programs and opportunities to care for underserved populations: A 2020 survey study.

Dermatology is the second-least diverse medical specialty. In this survey study, we identified the current proportion of underrepresented in medicine (UIM) residents and faculty in dermatology residency programs, perceptions on the importance of program diversity, and various opportunities for dermatology residents to care for underserved populations. We found that programs that provided greater resident exposure to the care of underserved populations and those that strongly considered residency applicants' desire to work with underserved populations had greater percentages of UIM residents. These findings illustrate the importance of expanding diversity among residency programs as this may be key to improving health disparities among underserved populations. Additionally, we identified various barriers that programs have to incorporating service-oriented curricula, including faculty time and cost.