Lack of Diversity in Academic Dermatology

Diversity and Representation in Dermatology 

Dermatology is the second least diverse specialty in medicine, right behind orthopedic surgery, with only about 3% of all dermatologists in the U.S being Black / African American.^{1 2} A study I conducted on the characteristics of Black dermatologists in academia found that only about 5%  of all academic dermatologists are Black. This percentage is incredibly low, especially given the diversifying landscape of the patient populations we serve. The demographic makeup of the U.S consists of 13% Black / African American individuals.³ Representation in dermatology should reflect this diversity, which is only expected to increase in the coming years.

Across 142 accredited dermatology programs in the U.S, there are only three Black dermatology department chairs:

• Dr. Amy McMichael at Wake Forest University School of Medicine,
• Dr. Pamela Allen at the University of Oklahoma College of Medicine, and
• Dr. Ginette Okoye at Howard University School of Medicine.

Our study also found a disheartening yet somewhat unsurprising trend: across all institutions, there exists a decreasing percentage of Black faculty as academic rank from assistant to full-time professor. This means that there are even fewer Black dermatologists occupying high-ranking professorial positions at their respective institutions. We also found that the majority of Black dermatologists on faculty did not hold leadership positions within or outside their institutions. Leadership positions examined included boards for professional dermatologic organizations and editorial boards. A paucity of editors and leaders for top dermatology journals with skin of color (SOC) expertise has also been highlighted,⁴ with most of the editors found to be White males.

The scarcity of role models and mentors within these academic positions for underrepresented in medicine (UIM) medical students considering dermatology as a career path is concerning for the future of the specialty. Without proper examples, mentorship, and support, more UIM students and residents may choose to deviate from academic medicine at the conclusion of their formal training. As it stands, few UIM students decide to purse dermatology, and of the few who do, a very small percentage remain in academia.⁴

Call to Action

Diversification of academic dermatology is critical for many reasons. Seeing dermatologists of color in academic leadership encourages more UIM students to pursue dermatology, ultimately diversifying the workforce. Additionally, SOC education in dermatology and advancements in this area are made possible largely by SOC leaders and researchers in academic medicine passionate about this work. A lot has been done to improve SOC representation in dermatologic educational resources, but there is still much work to be done. Ultimately, these factors significantly impact the health experiences of our patients, particularly those with SOC, who often go underdiagnosed or misdiagnosed and have more issues with poor communication and increased risk for negative interactions with their healthcare providers.⁶

There need to be more institutional mechanisms in place for not only the recruitment but the retention of Black dermatologists in academia. There should be more intentional support and recruitment for dermatologists from these underrepresented groups, especially early in their careers as they begin to decide whether to remaining in academia after completing residency. This a critical decision-making period that young dermatologists should be supported through at the start of their careers beyond formal training. There needs to be more senior, high-ranking leaders who identify as Black / African American in academia. These individuals serve as role models, mentors, and advocates for future leaders to follow. Additionally, dermatologic journals should also be intentional about recruiting a representative cohort of dermatologists to serve as editors and leaders in research and evidence-based medicine.

References

1. Akhiyat S, Cardwell L, Sokumbi O. Why dermatology is the second least diverse specialty in medicine: How did we get here? Clin Dermatol. 2020;38(3):310-315. doi:10.1016/j.clindermatol.2020.02.005
2. Lu JD, Sverdlichenko I, Siddiqi J, Khosa F. Barriers to Diversity and Academic Promotion in Dermatology: Recommendations Moving Forward. DRM. 2021;237(4):489-492. doi:10.1159/000514537
3. U.S. Census Bureau QuickFacts: United States. Accessed November 2, 2022. https://www.census.gov/quickfacts/fact/table/US/PST045221
4. Beer J, Heningburg J, Downie J, Beer K. Diversity in Academic Dermatology. J Drugs Dermatol. 2022;21(6):674-676. doi:10.36849/JDD.6899
5. 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. doi:10.1016/j.jaad.2015.10.044
6. Cooper LA, Beach MC, Johnson RL, Inui TS. Delving below the surface. Understanding how race and ethnicity influence relationships in health care. J Gen Intern Med. 2006;21 Suppl 1:S21-27. doi:10.1111/j.1525-1497.2006.00305.x