A Hispanic man with a six-month history of red, itchy, scaly spots on his torso and arms presents his symptoms to an outpatient clinic. He works as an architect, is a nonsmoker but drinks socially. A photo is shown of his condition: gray patches are seen on the dark skin of his abdomen.
Viewers of an online educational module are invited to participate in a quiz. What is the diagnosis? Pityriasis rosea, psoriasis, secondary syphilis, or lichen simplex chronicus?
The correct diagnosis is psoriasis, which is classically described in patients without skin of color as erythematous plaques with gray-silvery scale, in contrast to gray or brown plaques commonly seen in skin of color patients.
Educational material from the American Academy of Dermatology (AAD) offers more case studies like this one. The AAD curriculum illustrates what psoriasis, atopic dermatitis, inflammatory blistering disorders and countless other diseases look like on skin of color.
The AAD “Skin of Color Curriculum” is featured on the AMA Ed Hub™️, an online learning platform that brings together high-quality CME, maintenance of certification, and educational content from trusted sources, all in one place—with activities relevant to you, automated credit tracking and reporting for some states and specialty boards.
Gaps in dermatology training
Published studies have demonstrated gaps in knowledge regarding skin-of-color dermatology for medical students, residents and attending physicians, said Susan C. Taylor, MD, who co-created this new curriculum with Daniela Kroshinsky, MD, MPH, a dermatologist with Massachusetts General Hospital.
The gaps include diagnosis and treatment, said Dr. Taylor, vice chair for diversity, equity, and inclusion in the dermatology department at the Perelman School of Medicine at the University of Pennsylvania and also directs the skin-of-color research fellowship there.
The AAD “Skin of Color Curriculum” is worth 15.25 CME credits. As of this article’s deadline, about 3,000 learners have engaged with the curriculum.
While the course is principally designed to meet the educational needs of dermatology residents and practicing dermatologists, medical students rotating through a dermatology service are encouraged to participate as well.
The curriculum encompasses 64 modules, with courses focusing on dermatologic conditions in the pediatric, inpatient, outpatient and surgical categories. Each course presents various dermatological conditions, walks through case studies, quizzes the knowledge of users, and offers clinical pearls.
Dermatologists and others who complete the curriculum will learn to:
- Diagnose dermatologic conditions of the skin, hair and nails in in adult and pediatric patients with skin of color, and identify and prevent dermatologic surgical and cosmetic complications in these patients.
- Discuss systemic challenges facing people of color who want careers in medicine and find ways to mentor these students.
- Recognize and identify health care inequities in medicine and implicit bias and microaggressions.
Addressing implicit bias
Most of the modules include information on inequities in dermatology. One section takes an especially deep dive, addressing implicit bias and microaggressions, health inequities within dermatology and in general medicine, and mentoring dermatologists, residents and medical students from historically marginalized racial and ethnic groups.
One of the courses drives home the fact that patients from these groups are significantly less likely to report being treated with respect by health professionals than are white patients.
Dermatologists should exercise humility, empathy, respect and awareness, said Amit Pandya, MD, who discussed this portion of the AAD curriculum. Doing so is “central to professionalism, or doing what’s in the best interest of the patient,” Dr. Pandya said.
There is significant interest and excitement about this curriculum, said Dr. Taylor, who noted that dermatologists are pleased to find out that the curriculum exists and is so easily accessible. Some have reported that it is the best online CME they’ve ever done, she added.
For established practicing dermatologists, those still in residency or fellowship training, and medical students alike, the hope is that the curriculum will help them better understand workplace diversity while pursuing more opportunities for mentoring, said Dr. Taylor.
More resources on confronting health injustice are available at the AMA Ed Hub Health Equity Education Center, including tools centered on the betterment of public health that use a social justice lens to support comprehensive strategies to promote excellence in health for all patients and communities.