How Can We Improve Diversity in Dermatology?

Dermatology has a diversity problem, and according to dermatologists at the University of California San Francisco, the root of this racial imbalance begins with residency admissions.

Only 3 percent of dermatologists are African-American, 4.2 percent are Latino, and Native Americans and Alaskan Natives represent a mere .2 percent of the specialty. The overwhelming majority of dermatologists are white, with nearly 68 percent identifying themselves as Caucasian in a 2017 Medscape survey.

In a paper published in JAMA Dermatology, Amy Chen, MD, and Kanade Shinkai, MD, explain that the racial disparities in dermatology are due to several factors, including “unconscious bias, late medical school exposure to dermatology, lack of mentors, dramatically lower underrepresented minority university (URM) graduation rates, and increased URM attrition rates and delayed graduation for academic reasons in medical school.”

According to the authors, the practical solutions to promoting balanced representation lie in reworking the basic structures of our public education system and prioritizing diversity in residency admissions. Instead of putting so much weight on test scores, Dr. Chen and Dr. Shinkai recommend placing value on the applicants’ community involvement and intellectual pursuits. They suggest that admissions departments implement diversity-focused sub committees and including diversity-centered questions during interview day.

“Though important considerations, shifting away from extrinsic motivators reduces systematic bias, especially of standardized testing, and may better identify intrinsically motivated candidates,” write the authors. “Who may in turn be happier, more fulfilled residents. In addition, deemphasizing numbers mitigates the intense pressure on applicants to publish for the sake of improving their application, which likely contributes to the significant academic misrepresentation among dermatology applicants found in a recent study.”