Perceived Barriers to Career Advancement: Medical Students and Resident Physicians.

BACKGROUND: The path to becoming a physician is challenging, with various barriers influencing medical student and resident physician residency and fellowship training career decisions. Studies comparing perceived obstacles at disparate training levels are limited and given these obstacles are dynamic, studies are frequently needed to evaluate perceived barriers to pursuing residency specialty or fellowship of interest for physician trainees. OBJECTIVE: To evaluate and compare perceived barriers to obtaining residency specialty or fellowship of choice for medical students and resident physicians, respectively. METHODS: A Likert scale survey assessing perceived barriers was administered via the listservs of medical schools and organizations in 2021. Differences in the Likert scale score mean between medical students and resident physicians were measured with student t-tests (2-sided). RESULTS: A total of 404 medical trainees participated (301 medical students and 103 resident physicians). Medical students indicated lack of opportunity to obtain alpha omega alpha membership as the most crucial perceived barrier (mean Likert scale score ± standard deviation, 4.01±1.97), followed by USMLE Step 1 score (3.92±1.89) and lack of home program in specialty/fellowship of interest (3.62±1.85). Similarly, resident physicians implicated the lack of a home program in a specialty/fellowship of interest as the most prominent barrier (3.48±1.78), followed by lack of connections/networking (3.17±1.50) and probability of matching (3.14±1.44). CONCLUSIONS: The lack of a home program was an important barrier to pursuing a specialty or fellowship of choice for both medical students and resident physicians, respectively, and may have been heightened during the COVID-19 pandemic. J Drugs Dermatol. 2023;22(11):e17-e20    doi:10.36849/JDD.7005e.

Underrepresented Groups and Perceived Educational Barriers for Residency and Fellowship Success.

BACKGROUND: The study aimed to compare barriers perceived by medical students and resident physicians identifying as of underrepresented groups in medicine (UIM) and/or as sexual and gender minorities (SGM) to individuals not identifying with these groups, especially for trainees with an interest in dermatology. METHODS: Cross-sectional survey of medical students and resident physicians based in the United States from February 2021 to July 2021, with subgroup analysis of trainees with interest in dermatology. FINDINGS: Among trainees interested in dermatology, the most notable barriers for the UIM group were 1) lack of home program in specialty/fellowship of interest (4.71±1.73); 2) lack of connections/networking opportunities (4.14±1.29); 3) lack of opportunity to obtain AOA membership (4.00±1.96); 4) obtaining mentorship (4.00±1.47); and lack of diversity in specialty/fellowship of interest (3.93±1.14). CONCLUSIONS AND RELEVANCE: Increasing focused mentorship programs and fostering environments that embrace diversity are key to reducing perceived barriers for minority candidates. J Drugs Dermatol. 2023;22(12):1210-1215. doi:10.36849/JDD.7528R1.

Emerging Intralesional Treatments for Plantar Warts: A Systematic Review.

BACKGROUND: Therapies for plantar warts remain subjective and unclear, which has led to continual pursuit of an optimal treatment. As a consequence, many intralesional therapies have emerged over the last decade. This warrants a systematic review from a clinical lens which provides updates on intralesional treatment options for plantar warts from the last decade. METHODS: A PubMed/MEDLINE literature search was performed, in accordance with PRISMA reporting guidelines for systematic reviews. Original peer-reviewed articles on safety/efficacy of intralesional plantar wart treatments, published from January 2012 to January 2021, were considered for inclusion. RESULTS: Twenty-6 studies were included and the following intralesional modalities were identified (median cure rates): vitamin D3 (80%), bleomycin (74%), 5-fluorouracil (59%), Candida antigen (66%), zinc sulfate (70%), and purified protein derivative (67%). CONCLUSION: Intralesional vitamin D3, in particular, demonstrated promising results as a potential second- or even first-line agent although not accessible in the United States. Candida antigen and bleomycin are less effective than intralesional vitamin D3, but given their greater accessibility and superiority to cryotherapy, should continue to be considered for treating recalcitrant plantar warts. Moreover, the quadrivalent human papillomavirus (HPV) vaccine, showing success in case reports, warrants further attention for both the treatment and prevention of plantar warts. J Drugs Dermatol. 2022;21(12):1322-1329. doi:10.36849/JDD.6735.

Total body skin exams: the role of gynecology and dermatology-a cross-sectional study.

The literature demonstrates practice gaps in performance of the genital skin examination. To further elucidate and understand these practice gaps, we surveyed dermatologist and obstetrician-gynecologist (OB/GYN) attending and resident physicians. Analysis of 73 dermatology survey responses revealed a lack of satisfaction with training received in examination of the female genitalia. Moreover, examination of 69 OB/GYN survey responses showed a lack of satisfaction with residency training received to identify high risk skin lesions. Interestingly, only 52.2% of OB/GYN respondents inspect perianal skin during pelvic region examinations. Our results highlight the need to improve residency training through standardization of breast/genitalia skin examinations during both dermatology and OB/GYN residency and for increased collaboration between specialties.

Free open access data sources for dermatology researchers.

Free open access data sources are a valuable tool for dermatology researchers and may uncover crucial information about dermatological diseases and delivery of dermatological care. This short review discusses six open access data sources including: National Health and Nutrition Examination Survey (NHANES), National Health Interview Survey (NHIS), National Survey of Children's Health (NSCH), National Ambulatory Medical Care Survey (NAMCS)/National Hospital Ambulatory Medical Care Survey (NHAMCS), Centers for Medicare and Medicaid Services (CMS), and Gene Expression Omnibus (GEO). We explain the role of each data source in dermatology and provide examples of past studies, which have used these data repositories.