Skin of Color in Preclinical Medical Education: A Cross-Institutional Comparison and A Call to Action
Disease presentations can vary between different skin phototypes, at times requiring distinct management and therapies. Medical education curricula have yet to be updated to better reflect and address the dermatologic needs of an increasingly diverse population. The objective of this study was to determine if the preclinical dermatology curriculum at 3 US medical schools provided adequate representation of skin of color patients in their didactic presentation slides. Three US medical schools—all members of the American Medical Association (AMA) Accelerating Change in Medical Education consortium—were included in the study. The institutions were a blend of private and public schools located across different geographic boundaries. The main outcome measures included the proportion of total skin of color photographs for each institution, the number of priority conditions for skin of color patients, and the discussion of differences between skin types. The results strongly suggested that skin of color is underrepresented in the preclinical dermatology curriculum at all 3 institutions. Efforts should be made to increase images and discussion of skin of color in preclinical didactics.
Practice Points
- The United States rapidly is becoming a country in which the majority of citizens will have skin of color.
- Our study results strongly suggest that skin of color may be seriously underrepresented in medical education and can guide modifications to preclinical dermatology medical education to develop a more comprehensive and inclusive curriculum.
- Efforts should be made to increase images and discussion of skin of color in preclinical didactics.
Conclusion
Future studies would benefit from the inclusion of audio data from lectures, syllabi, and small group teaching materials from preclinical courses to more accurately assess representation of skin of color in dermatology training. Additionally, future studies also may expand to include images from lectures of overlapping clinical specialties, particularly infectious disease and rheumatology, to provide a broader assessment of skin of color exposure. Furthermore, repeat assessment may be beneficial to assess the longitudinal effectiveness of curricular changes at the institutions included in this study, comparing older lectures to more recent, updated lectures. This study also may be replicated at other medical schools to allow for wider comparison of curricula.
Acknowledgment—The authors wish to thank the institutions that offered and agreed to participate in this study with the hopes of improving medical education.
