National survey of undergraduate dermatologic medical education

Ramsay, D. L.

doi:10.1001/archderm.121.12.1529

Cited by 12 publications

(8 citation statements)

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“…U.S. medical students receive an average of is between 16 and 22 hours of dermatologic training—less than 1% of their undergraduate medical education. 39-41 Consequently, fewer than 40% of primary care residents feel that their medical school curriculum adequately prepared them to manage common skin conditions. 42 Similarly, a recent survey of United Kingdom students found that the majority (55.7%) believed that their undergraduate medical education did not provide adequate education in dermatology.…”

Section: Dermatology Education and Health Disparitiesmentioning

confidence: 99%

Dermatologic Health Disparities

Buster

Stevens

Elmets

2012

Dermatologic Clinics

193

172

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Though significant data exist highlighting the extent of health disparities there is limited data specifically on dermatologic health disparities. Melanoma and nonmelanoma skin cancer outcomes are poorer for ethnic minorities, people of low socioeconomic status, less educated, elderly, and uninsured. Recent reports indicate that atopic dermatitis is more prevalent among ethnic minorities; however it is unclear if morbidity is also increased in these populations. Given the current dermatology workforce shortage, the increased patient load may have an adverse effect on dermatologic care access. Additional concerns include the state of dermatologic training, insufficient research involving ethnic minorities, and a lack of investigations of dermatologic health disparities. As the U.S. demographics shift to become more racially diverse, the need to address and reduce dermatologic health disparities will increase.

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Section: Dermatology Education and Health Disparitiesmentioning

confidence: 99%

Dermatologic Health Disparities

Buster

Stevens

Elmets

2012

Dermatologic Clinics

193

172

View full text Add to dashboard Cite

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“…The high numbers of patients with skin morbidities reporting to PCPs having limited training in dermatology poses serious implications for appropriate cost-effective treatment and care. [ 10 11 12 ]…”

Section: Introductionmentioning

confidence: 99%

Diagnostic agreement between a primary care physician and a teledermatologist for common dermatological conditions in North India

Patro

Tripathy

et al. 2015

Indian Dermatol Online J

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Background:Primary care physicians (PCPs) encounter a large number of patients with dermatological diseases. However, delivering appropriate management is a challenge considering the inadequate dermatology training offered during the undergraduate medical curriculum. Teledermatology is the clinical evaluation of skin lesions by dermatologists and allows patients to be diagnosed and treated from a distant site. It is seen as a potential solution to the shortage of specialists and providing equitable service in remote areas.Aim:The study was aimed at estimating the diagnostic agreement of common dermatological conditions between a PCP and a teledermatologist.Materials and Methods:Consecutive patients with dermatological ailments who attended a primary health care clinic were recruited into the study, examined by the PCP and offered a diagnosis. The clinical images and patients’ history were collected and transferred to a dermatologist at a tertiary center who also made a diagnosis. Agreement between diagnosis made by the PCPs and the teledermatologist was measured using kappa (κ) statistics.Results:Overall agreement between the diagnoses made by a PCP and the dermatologist was found to be 56%. Poor κ agreement (<0.4) was seen in the diagnosis of psoriasis and eczema.Conclusion:Teledermatology can supplement specialist dermatology service in remote areas. There was poor agreement in the diagnosis of psoriasis, classifying various types of eczematous conditions and fungal infections. Scarce manpower in dermatology at the primary health care level compounded by the burden of skin ailments necessitates training of PCPs in common dermatological conditions.

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“…[6][7][8][9] One reason primary care physicians do not perform as well as dermatologists in diagnosing and providing evaluation plans for skin cancer is that they receive little education in this area. 7,10 Past efforts that used singlecomponent interventions to improve medical students' dermatologic abilities have had limited success.…”

mentioning

confidence: 99%

Improving primary care residents’ proficiency in the diagnosis of skin cancer

Gerbert¹,

Bronstone²,

Wolff³

et al. 1998

J Gen Intern Med

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OBJECTIVE:To determine whether a brief, multicomponent intervention could improve the skin cancer diagnosis and evaluation planning performance of primary care residents to a level equivalent to that of dermatologists. PARTICIPANTS:Fifty-two primary care residents (26 in the control group and 26 in the intervention group) and 13 dermatologists completed a pretest and posttest. DESIGN:A randomized, controlled trial with pretest and posttest measurements of residents' ability to diagnose and make evaluation plans for lesions indicative of skin cancer. INTERVENTION:The intervention included face-to-face feedback sessions focusing on residents' performance deficiencies; an interactive seminar including slide presentations, case examples, and live demonstrations; and the Melanoma Prevention Kit including a booklet, magnifying tool, measuring tool, and skin color guide. MEASUREMENTS AND MAIN RESULTS:We compared the abilities of a control and an intervention group of primary care residents, and a group of dermatologists to diagnose and make evaluation plans for six categories of skin lesions including three types of skin cancer-malignant melanoma, squamous cell carcinoma, and basal cell carcinoma. At posttest, both the intervention and control group demonstrated improved performance, with the intervention group revealing significantly larger gains. The intervention group showed greater improvement than the control group across all six diagnostic categories (a gain of 13 percentage points vs 5, p Ͻ .05), and in evaluation planning for malignant melanoma (a gain of 46 percentage points vs 36, p Ͻ .05) and squamous cell carcinoma (a gain of 42 percentage points vs 21, p Ͻ .01). The intervention group performed as well as the dermatologists on five of the six skin cancer diagnosis and evaluation planning scores with the exception of the diagnosis of basal cell carcinoma. I n the United States, managed care organizations currently rely on primary care physicians to triage for many specialized areas of medicine, including dermatology. Successful triaging involves screening, making correct initial diagnosis and evaluation planning decisions, and appropriately referring to specialists. Because many of these managed care organizations use financial incentives and administrative mechanisms to encourage generalists to limit referrals to specialists, 1 we must ensure that primary care physicians can screen, diagnose, and evaluate effectively with reduced access to specialists. In dermatology, primary care physicians may not need to be as skilled as dermatologists at diagnosing and planning treatment for the approximately 2,000 named skin diseases, 2 but, at a minimum, they need to proficiently screen, diagnose, and evaluate lesions indicative of skin cancer. 3 In this study, we focused on improving primary care residents' performance on diagnosing and making evaluation plans for lesions indicative of skin cancer. CONCLUSIONS:Primary care physicians have the opportunity to play a major role in the early detection of skin cancer. Up...

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National survey of undergraduate dermatologic medical education

Cited by 12 publications

References 0 publications

Dermatologic Health Disparities

Dermatologic Health Disparities

Diagnostic agreement between a primary care physician and a teledermatologist for common dermatological conditions in North India

Improving primary care residents’ proficiency in the diagnosis of skin cancer

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