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Table.  
Outline of Lectures, Activities, and Discussions in 4 Lessons
Outline of Lectures, Activities, and Discussions in 4 Lessons
1.
Pandya  AG, Alexis  AF, Berger  TG, Wintroub  BU.  Increasing racial and ethnic diversity in dermatology: a call to action.  J Am Acad Dermatol. 2016;74(3):584-587.PubMedGoogle ScholarCrossref
2.
Imadojemu  S, James  WD.  Increasing African American representation in dermatology.  JAMA Dermatol. 2016;152(1):15-16.PubMedGoogle ScholarCrossref
3.
Jacob  JA.  AAMC report examines how to increase the pipeline of black men entering medical school.  JAMA. 2015;314(21):2222-2224.PubMedGoogle ScholarCrossref
4.
Bae  G, Qiu  M, Reese  E, Nambudiri  V, Huang  S.  Changes in sex and ethnic diversity in dermatology residents over multiple decades.  JAMA Dermatol. 2016;152(1):92-94.PubMedGoogle ScholarCrossref
5.
Chapman  CH, Hwang  WT, Both  S, Thomas  CR  Jr, Deville  C.  Current status of diversity by race, Hispanic ethnicity, and sex in diagnostic radiology.  Radiology. 2014;270(1):232-240.PubMedGoogle ScholarCrossref
6.
Bernstein  J, Dicaprio  MR, Mehta  S.  The relationship between required medical school instruction in musculoskeletal medicine and application rates to orthopaedic surgery residency programs.  J Bone Joint Surg Am. 2004;86-A(10):2335-2338.PubMedGoogle ScholarCrossref
Research Letter
December 2017

Addressing Minority Representation in Dermatology: Answering a Call to Action Through Structured Mentorship and Instruction

Author Affiliations
  • 1Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Dermatol. 2017;153(12):1329-1330. doi:10.1001/jamadermatol.2017.3224

Recent attention has been called to the insufficient representation in dermatology of African American and Hispanic individuals, which comprise the major populations underrepresented in medicine (UIM).1,2 There have been 2 recent calls to action to increase UIM populations in dermatology, a task that necessitates action.1,2

Among the numerous approaches previously suggested, mentoring and tutoring have been cited as some of the best to increase diversity.1,2 We present the instructional and mentoring program we used to encourage UIM students in our community to consider dermatology careers in an attempt to show that even brief outreach programs can make a difference.

Methods

We partnered with the Medical Education Resources Initiative for Teens organization, a longitudinal program offering academic enrichment classes for UIM high school students in Baltimore, to encourage them to become health care leaders.3 Only those 10th grade students who live in Baltimore, attend a Baltimore city high school, and are either a potential future first-generation college student or eligible for the Maryland School Breakfast and Lunch Program (which is dependent on household income) are eligible to apply to this program. Institutional Review Board approval and informed consent from the participants were waived by the Johns Hopkins Institutional Review Board.

We implemented a 4-session, 6-hour dermatology curriculum for the students. Dermatology faculty and residents from the Johns Hopkins Dermatology Department taught lectures on fundamental dermatology concepts, held discussions about skin conditions more common in ethnic skin, and led skill sessions to teach skin biopsy techniques (Table).

Students were also given the opportunity to shadow dermatologists at the Johns Hopkins dermatology clinics to augment their classroom learning experience. Finally, students were asked to voluntarily complete anonymous survey evaluations before and after curriculum participation to assess the effectiveness of the program.

Results

Of the 30 students participating in the curriculum, 26 were female, 27 self-identified as African American, and 3 self-identified as Hispanic. Prior to these sessions, most students responded to the survey questions that they had not been formally taught dermatology (29 of 30 [97%]), had never visited a dermatologist (23 of 30 [77%]), and did not know a dermatologist (27 of 30 [90%]). On a scale of 1 (not likely) to 10 (very likely), 90% of the students scored their likelihood to pursue a career in medicine as 9 or 10, both before (mean score, 9.5) and after (9.4) curriculum participation (P = .87, 2-tailed t test). Although their initial likelihood of pursuing a career specifically in dermatology was much lower (4.7), this score significantly increased by the end of the curriculum (6.2) (P = .04, 2-tailed t test). The students most enjoyed the suturing sessions.

Discussion

We introduced inner-city UIM high school students to dermatology concepts and encouraged them to consider dermatology careers. All students showed a high interest in pursuing careers in medicine but initially had less interest in dermatology. Through lectures, hands-on workshops, and direct mentorship, our curriculum significantly increased their interest in dermatology.

Imadojemu et al2 emphasized the importance of mentorship to encourage students to enter dermatology. Accordingly, we helped our students find dermatology mentors to provide this experience.

Although our curriculum represented a limited intervention, course evaluation responses and anecdotal feedback showed that we successfully familiarized a group of high-achieving UIM students with dermatology. Prior research has shown that greater and earlier exposure to various medical fields increases ethnic diversity in those specialties.4-6 Our pilot study results suggested that programs invested in mentorship and dermatology instruction for young UIM students can encourage future careers in this field. It would be optimal, however, to follow students participating in this and similar programs to determine how many ultimately complete dermatology residencies.

We echo our colleagues’ plea for making diversity a priority in dermatology.1,2 We encourage others to use our curriculum as a template to develop similar programs in their own institutions. More broadly, our study indicates the importance of medical school faculty and resident interaction with underserved members of the community.3

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Article Information

Corresponding Author: Shawn G. Kwatra, MD, Department of Dermatology, Johns Hopkins University School of Medicine, 1550 Orleans St, Cancer Research Bldg II, Baltimore, MD 21231 (skwatra1@jhmi.edu).

Accepted for Publication: July 4, 2017.

Published Online: September 13, 2017. doi:10.1001/jamadermatol.2017.3224

Author Contributions: Dr Kwatra and Ms He had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: All authors.

Acquisition, analysis, or interpretation of data: Kwatra, He, Okoye.

Drafting of the manuscript: Kwatra, He.

Critical revision of the manuscript for important intellectual content: Kwatra, Loss, Okoye.

Statistical analysis: He.

Administrative, technical, or material support: Kwatra, He, Okoye.

Study supervision: Loss, Okoye.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was supported in part by the Johns Hopkins Department of Dermatology.

Role of the Funder/Sponsor: The Johns Hopkins Department of Dermatology had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We are indebted to Stephanie Landicho, MEd, MPH, who acted as liaison between the Johns Hopkins Department of Dermatology and the Medical Education Resources Initiative for Teens organization to set up this partnership. She received no compensation for her role.

References
1.
Pandya  AG, Alexis  AF, Berger  TG, Wintroub  BU.  Increasing racial and ethnic diversity in dermatology: a call to action.  J Am Acad Dermatol. 2016;74(3):584-587.PubMedGoogle ScholarCrossref
2.
Imadojemu  S, James  WD.  Increasing African American representation in dermatology.  JAMA Dermatol. 2016;152(1):15-16.PubMedGoogle ScholarCrossref
3.
Jacob  JA.  AAMC report examines how to increase the pipeline of black men entering medical school.  JAMA. 2015;314(21):2222-2224.PubMedGoogle ScholarCrossref
4.
Bae  G, Qiu  M, Reese  E, Nambudiri  V, Huang  S.  Changes in sex and ethnic diversity in dermatology residents over multiple decades.  JAMA Dermatol. 2016;152(1):92-94.PubMedGoogle ScholarCrossref
5.
Chapman  CH, Hwang  WT, Both  S, Thomas  CR  Jr, Deville  C.  Current status of diversity by race, Hispanic ethnicity, and sex in diagnostic radiology.  Radiology. 2014;270(1):232-240.PubMedGoogle ScholarCrossref
6.
Bernstein  J, Dicaprio  MR, Mehta  S.  The relationship between required medical school instruction in musculoskeletal medicine and application rates to orthopaedic surgery residency programs.  J Bone Joint Surg Am. 2004;86-A(10):2335-2338.PubMedGoogle ScholarCrossref
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