Supporting students underrepresented in medicine
Mentorship, sponsorship needed to address lack of diversity in dermatology education and practice (1,500 words, 7 minutes)
There is a lack of diversity among dermatologists, and active mentorship and sponsorship are vital to correct the imbalance, Dr. Susan Taylor told the 2024 Colloquium on the Black Patient in Dermatology on August 17.
Dr. Taylor [pictured below] is the Bernett L. Johnson Endowed Professor and the vice-chair for diversity, equity and inclusion in the Department of Dermatology at the Perelman School of Medicine at the University of Pennsylvania. She is also the president-elect of the American Academy of Dermatology.
Dr. Taylor said only 5% of active physicians in the U.S. are Black, and only 6.2% of medical school graduates are Black. Dermatology is the second-least diverse medical specialty, ahead of only orthopedic surgery. Black Americans represent 12.8% of the U.S. population, but in 2020, Black residents made up only 4.6% of dermatology residents nationally.
She cited two studies identifying perceived barriers to dermatology residency for Underrepresented in Medicine (UIM) students (J Am Acad Dermatol Dec. 2020; 83(6):1770-1773 and J Drugs Dermatol July 1, 2021; 20(7):795-797).
Identified barriers include a lack of equitable resources, such as:
limited exposure to the field,
lack of institutional support,
financial constraints,
lack of group identity and
a lack of holistic review for residency applications.
Dr. Taylor said the same studies also identified some contributors to matching into dermatology. These include mentorship and participation in pipeline or enrichment programs.
Dr. Taylor said another study (Acad Med July 2016; 91(7):987-993) surveyed UIM undergraduate students about what they perceived as barriers to careers in medicine. Students answered that a significant barrier was the lack of access to mentors or role models.
Dr. Taylor said some solutions to inequities in the dermatology workforce include developing a pipeline of students at all stages, such as middle school, high school, college, and medical school. Established physicians can provide mentorship and sponsorship opportunities and help ensure there are holistic residency application reviews.
Dr. Taylor described a sponsor as someone who provides opportunities to mentees for promotion, advancement or increased professional visibility. The sponsor must leverage their status, access, and reputation to further the mentee’s goals.
In contrast, mentors help alleviate the high attrition rate of students of colour from science, technology, engineering and math (STEM) and give students confidence they can learn those subjects, said Dr. Taylor. They provide psychosocial and career support, act as role models and offer advice. Mentors also help mentees develop a network of other mentors and peers.
Bottom Line: There is a demonstrated lack of diversity among board-certified dermatologists. Mentorships and sponsorships are some of the best ways to increase diversity among medical students and dermatologists.
From the literature on dermatology in skin of colour
Assessing familiarity and interest in dermatology among underrepresented minority pre-medical students following an introductory lecture
This study evaluated an intervention where 62 pre-medical students attended a virtual dermatology seminar on May 6, 2022. The participants were part of a mentorship organization known as the University of California San Francisco (UCSF)-University of California (UC) Berkeley White Coats for Black Lives.
The seminar introduced dermatology, highlighted key leaders of colour, and provided an opportunity for questions and responses. Investigators administered surveys assessing familiarity with and interest in dermatology before and after the seminar.
In the pre-survey, 20 students (32%) reported being familiar or very familiar with dermatology, compared to 47 students (85%) in the post-survey (p<0.001). Additionally, 26% (n=16) of students reported being likely to consider dermatology as a profession in the pre-survey, while 22 (40.0%) reported this in the post-survey (p=0.04).
The authors conclude that targeted early-career interventions, such as this seminar, can increase familiarity and interest in dermatology among underrepresented medicine (UIM) students, potentially contributing to greater diversity in the field.
Cutaneous T cell lymphoma in skin of colour: A review
In this paper, the authors review and compile the differences in epidemiology, clinical presentation, treatments, and outcomes of cutaneous T-cell lymphoma (CTCL) subtypes in Black, Asian or Pacific-Islander (API), and Hispanic patients.
They note that the current literature supports the idea that there are nuances in the course of CTCL that differ with race. Across multiple studies, racial differences in incidence patterns have been reported, with the highest rates among Black patients. Cutaneous manifestations of CTCL are highly variable in patients with skin of colour, and the predilection for clinical CTCL variants often differs with race and the severity of cutaneous involvement (Body Surface Area).
They write that responses to any treatment also differ among patients with skin of colour. This may be partially attributable to the varying CTCL subtypes experienced by certain races.
Prognostic factors tend to vary with race, the authors note, although Black patients consistently experience poor outcomes, while API patients may have a more favourable prognosis. There is no definitive conclusion to account for differences observed in CTCL skin of colour patients. However, biological and socioeconomic factors have been proposed as potential drivers. As individuals with skin of colour comprise an increasing portion of the population, the authors conclude adequate physician awareness and knowledge of racial nuances in CTCL are necessary to begin addressing these disparities.
Clinico-epidemiological characteristics and long-term surgical outcome of basal cell carcinoma treated with standard excision in patients of skin of colour: A retrospective study from Northern India
Researchers conducted this retrospective study to explore the epidemiology, risk factors, clinical and pathological aspects, and long-term treatment outcomes of basal cell carcinoma (BCC) in a cohort of North Indian patients.
The investigators analyzed data about patients with a confirmed diagnosis of BCC registered in the dermatosurgery clinic of the Post Graduate Institute of Medical Education and Research in Chandigarh, India, between Jan. 1, 2017, and Dec. 31, 2022.
They found that among 83 patients, 56.6% were females, and the median age was 62 years (six to 85 years). Most patients (81.9%) had a single BCC lesion, resulting in 126 assessed lesions. The median size of BCC at presentation was 1.90 cm, with nodular BCC being the most common histopathological subtype (39.7%). Head and neck region involvement was observed in 82.5% of patients, with the malar region, nose, and periorbital region being the most commonly affected sites. Pigmentation was clinically evident in 45.2% of cases.
Surgical excision was the primary treatment modality (71.1% of patients), with a median follow-up duration of 40 months (six to 57 months). Recurrence occurred in five patients, with a more extended disease-free survival period observed in the surgically treated group (55.58±0.98 months) compared to patients treated with medical or destructive therapies (43.6±3.482 months) (p=0.003).
At the intersection of skin and society
The city of Halifax is launching a new grant program to support community projects to tackle anti-Black racism, reports CBC News.
The program was developed after consultations with African Nova Scotian communities.
“I think it can make a tremendous difference,” said Russel Brooks, the anti-Black racism lead with Halifax's African Nova Scotian Affairs Integration Office, in the news article. “I see a lot of awareness and education coming from this initiative.”
According to the city’s website, applicants are encouraged to explain or demonstrate how their project will combat or address at least one of these forms of anti-Black racism:
Racial segregation
Historic omission
Lack of recognition
Systemic expropriation
Negative portrayal in the media and literature
Project funding will range from $500 to $10,000, with the hope that the program will empower communities most impacted by anti-Black racism.
“[Applicants] can tell some of the historically omitted stories from the communities. And this is a way for them to lead it truly," Brooks said.
The city's website has a guidebook for applicants. Applications are being accepted until Oct. 31, 2024.
Registration now open for the 2024 Skin Spectrum Summit
Early-bird registration is open for the 2024 Skin Spectrum Summit. This 10th-anniversary event will be held on October 5, 2024, at the Art Gallery of Ontario (317 Dundas St. W, Toronto, Ontario).
The Skin Spectrum Summit is a landmark educational congress of healthcare professionals dedicated to providing better dermatologic care for Canada's diverse population.
This full-day event provides education on treating patients across all six Fitzpatrick skin types, emphasizing care for Types IV to VI.
To celebrate its 10th anniversary, this year's Summit will be a two-day hybrid event held in conjunction with the Indigenous Skin Spectrum Summit—a special half-day session on October 4, 2024, starting at 1:30 p.m., dedicated to improving the cultural competence of Canadian healthcare providers and giving practical advice on providing dermatologic care to Indigenous patients.
Readers of Skin Spectrum Weekly can take advantage of a 50% early-bird discount by registering using the button below.
This week
September is Childhood Cancer Awareness Month
September is Pain Awareness Month
Sept. 16 is International Day for the Preservation of the Ozone Layer
Something to think about in the week ahead . . .
—Ron Carlson, U.S. author (1947 to present)
Next week
In a presentation at the 2024 Colloquium on the Black Patient in Dermatology, Atlanta-based dermatologist Dr. Patricia Oyetakin discussed how social media has become a tool for addressing the lack of representation of darker skin in medical education and demanding accountability from the beauty industry.
If you value Skin Spectrum Weekly, why not check out Chronicle’s other publications, podcasts, and portal?
Established in 1995, The Chronicle of Skin & Allergy is a scientific newspaper providing news and information on practical therapeutics and clinical progress in dermatologic medicine. The latest issue features:
Dr. Jerry Tan (Windsor, Ont.) shares his thoughts on recent findings showing that benzoyl peroxide in acne products can break down into benzene when stored in high-temperature conditions.
Drs. Andrei Metelitsa (Calgary), Geeta Yadav (Toronto), and Rahul Shukla (Hamilton, Ont.) review several current innovations in cosmetic dermatology.
Drs. Jason Rivers (Vancouver), Cheryl Rosen (Toronto), Peter Hull (Halifax), and Jennifer Beecker (Ottawa) provide an overview of essential news in melanoma, including the use of artificial intelligence to support screening.
Plus regular features, including the popular column “Vender on Psoriasis” by dermatologist Dr. Ron Vender.
You can read a recent digital edition of The Chronicle of Skin & Allergy here. To apply for a complimentary subscription or to request a sample copy, please email health@chronicle.org with your contact information.
The Women in Dermatology e-newsletter updates readers with new findings concerning dermatologic issues affecting women and the female dermatologists who care for them. Read the current issue here.
Season three of the Vender on Psoriasis podcast with Dr. Ron Vender has begun. Listen to the new season here. In episode five, Dr. Vender discusses whether vitamin D influences psoriasis severity, sex differences in psoriatic inflammation itch, and the risk of psychiatric disorders associated with acitretin.
And if you’re looking for a web destination for all things derm, visit derm.city, “Where Dermatology Lives.” Please like, rate, review, and share it with your colleagues.