# Skin of colour dermatology education in US primary care residency programmes: a nationwide cross-sectional survey of programme directors

## TL;DR

This study finds that only a small percentage of US primary care residency programs offer training in dermatology for skin of color, highlighting a need for improved education.

## Contribution

The study provides the first nationwide assessment of skin of color dermatology education in primary care residency programs in the US.

## Key findings

- Only 4.0% of contacted primary care residency programs responded to the survey.
- Most SOC education occurs through integration into general dermatology lectures or board review sessions.
- Program directors who plan to include SOC education are more likely to already offer related training.

## Abstract

Physicians-in-training report inadequate education in skin of colour (SOC) dermatology during residency. Although dermatology programmes have made progress in teaching SOC dermatology, the status of SOC dermatology education in primary care residency programmes remains unclear.

To characterize SOC didactic and clinical training opportunities available to primary care residents, laying the groundwork for future curriculum development of SOC dermatology.

This cross-sectional study consisted of a nationwide 16-question survey disseminated by email between October 2022 and February 2023 to US primary care residency programmes identified using the Accreditation Council for Graduate Medical Education (ACGME) database.

Of responding programmes (n = 49/1224, 4.0%), 29/49 offered SOC didactic training, most often through integration of content within general dermatology lectures (n = 29/49, 59.2%) and board review sessions (n = 13/49, 26.5%). Over half of programmes (n = 35/49, 71.4%) offered SOC clinical training through rotation in a general dermatology clinic (n = 33/49, 67.3%) and skin-related chief concerns in primary care clinics (n = 29/49, 59.2%). Programmes with directors indicating that they planned to incorporate SOC education into future curricula (n = 20/49, 40.8%) were more likely to already have SOC didactic and clinical training opportunities (P = 0.01 and P = 0.02, respectively). Regarding future directions, programme directors were most interested in integrating SOC topics within dermatology lectures (n = 31/49, 63.3%); identifying an expert (n = 31/49, 63.3%) and allocating lecture time (n = 10/49, 20.4%) were the most frequently cited barriers.

Some primary care programmes provide SOC dermatology didactic and clinical training opportunities, which are influenced by programme directors’ willingness to incorporate such training into curricula, and present opportunities for dermatologists to educate primary care residents.

Physicians-in-training report inadequate education in skin of colour (SOC) dermatology during residency. Although dermatology programmes have made progress in teaching SOC dermatology, the status of SOC dermatology education in primary care residency programmes remains unclear. This study aims to characterize the SOC didactic and clinical training opportunities available to primary care residents, laying the groundwork for future curriculum development.