Impact of the COVID-19 pandemic on dermatology residency education in the United States: A cross-sectional survey

To the Editor: The COVID-19 pandemic has resulted in unprecedented disruptions to dermatology residency education.1Jones V.A. Clark K.A. Puyana C. Tsoukas M.M. Rescuing medical education in times of COVID-19.Clin Dermatol. 2021; 39: 33-40https://doi.org/10.1016/j.clindermatol.2020.12.010Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar,2Stewart C.R. Lipner S.R. Experiences of resident dermatologists during the COVID-19 pandemic: a cross-sectional survey.Dermatol Ther. 2021; 34e14574https://doi.org/10.1111/dth.14574Crossref Scopus (6) Google Scholar Following the novel disruptions of COVID-19 on medical training, it is imperative to support residents. However, there has been limited research evaluating the impact of the COVID-19 pandemic on US dermatology training as perceived by dermatology residents.3Li Y.M. Galimberti F. Abrouk M. Kirsner R.S. US dermatology resident responses about the COVID-19 pandemic: results from a nationwide survey.South Med J. 2020; 113: 462-465https://doi.org/10.14423/SMJ.0000000000001141Crossref PubMed Scopus (15) Google Scholar This survey analyzes the impact of the COVID-19 pandemic on dermatology trainees. With new SARS-CoV-2 variants arising and the possibility of future public health crises, these reflections are of particular importance. An institutional review board-exempted web-based survey was distributed to dermatology residency programs nationwide. Likert scale and free-response questions focused on the impact of the COVID-19 pandemic on residency education from March to June 2020. Interviews with dermatology providers and residents allowed for the identification of relevant questions. A statistician reviewed the survey’s content and face validity. The survey was available from July 14, 2020, to August 3, 2020. Study data were collected and managed via Lifespan’s REDCap electronic data capture tools. A total of 85 residents completed all Likert scale survey questions. Respondents included residents from a variety of demographics (Table I).Table IDemographics of surveyed residents (time evaluated: March to June 2020)Variablen (%)Age, y 20-241 (1.2) 25-2926 (30.6) 30-3450 (58.8) 35-395 (5.9) 40-443 (3.5)Sex Male17 (20.0) Female68 (80.0)Race American Indian or Alaska Native1 (1.2) Asian23 (27.1) Black or African American12 (14.1) Native Hawaiian or Pacific Islander0 (0.0) White49 (57.6)Ethnicity Hispanic4 (4.7) Non-Hispanic81 (95.3)Marital status Single35 (41.2) Married or cohabiting49 (57.7) Divorced, widowed, or separated1 (1.2)Children Yes18 (21.2) No67 (78.8)Year of training First year40 (47.1) Second year29 (34.1) Third year16 (18.8)Practice setting Academic74 (87.1) Private practice11 (12.9) Open table in a new tab Of the core dermatology competencies, residents felt that their procedural dermatology education was most negatively impacted, with greater than 80% of respondents noting a negative impact on dermatological procedures (82%), surgical dermatology (81%), and cosmetic dermatology (82%). Residents also reported an adverse effect on general and pediatric dermatology training, with 65% and 55% of respondents noting a negative impact on these areas, respectively. Dermatopathology stood out as the discipline least negatively impacted, with 30% of residents even noting a positive impact (Fig 1). This is likely due to more recent technological advances, such as virtual pathology tools that support remote teaching.1Jones V.A. Clark K.A. Puyana C. Tsoukas M.M. Rescuing medical education in times of COVID-19.Clin Dermatol. 2021; 39: 33-40https://doi.org/10.1016/j.clindermatol.2020.12.010Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar Educational activities that involve live patient participation, including grand rounds and live patient interactions, were viewed as negatively impacted by 63% and 89% of dermatology residents, respectively. However, half of the residents (50%) reported a positive impact on didactics, underscoring changes to curricula that programs may wish to continue employing. In free-form responses, several residents noted increased educational availability and opportunity, such as virtual conferences, didactics, virtual pathology, collaborative teaching from other programs, and online lectures. These changes likely allowed for increased exposure to guest lecturers and may have contributed to a sense of community during a time of isolation. Importantly, almost half of the residents surveyed noted an interest in supplemental dermatological training. As such, residency programs may wish to consider additional surgical and procedural training sessions should future health crises cause training interruptions. Residents also noted lost opportunities for peer-to-peer teaching as a negative impact of COVID-19 in free-form responses, suggesting more small group sessions that could safely facilitate peer-to-peer learning may be of import. These data build upon findings of prior studies and mirror findings seen in other cohorts.3Li Y.M. Galimberti F. Abrouk M. Kirsner R.S. US dermatology resident responses about the COVID-19 pandemic: results from a nationwide survey.South Med J. 2020; 113: 462-465https://doi.org/10.14423/SMJ.0000000000001141Crossref PubMed Scopus (15) Google Scholar,4Bednar E.D. Doiron P.R. Abu-Hilal M. Impact of the COVID-19 pandemic on Canadian dermatology residents: a cross sectional survey study.J Cutan Med Surg. 2022; 26: 325-326https://doi.org/10.1177/12034754211058397Crossref PubMed Scopus (1) Google Scholar We hope that by furthering the knowledge of the pandemic's effects on resident education, we can effectively manage its outcomes and build upon its successes. None disclosed.

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