Contact dermatitis education in dermatology residency programs: can (will) the American Contact Dermatitis Society be a force for improvement?

Abstract

Background: Contact dermatitis accounts for a considerable portion of outpatient clinic visits to dermatologists. The state of education in contact dermatitis at the level of dermatology residency training in the United States has not been examined.

Objective: To assess the state of education in contact dermatitis in dermatology residency programs in the United States.

Method: Cross-sectional survey of directors and chief residents of 105 dermatology training programs accredited by the American College of Graduate Medical Education.

Results: Seventy-seven percent of directors and 74% of chief residents responded to the survey. In general, both sets of respondents gave concordant responses although responses from directors were more positive. With respect to didactic education, the vast majority of programs (> 73%) held lecture conferences on contact dermatitis. Less than one-third included contact dermatitis-focused journals in journal club conferences. A bare majority of programs (57% of directors, 53% of chief residents) identified a faculty expert in contact dermatitis, with almost all experts conducting patch-test clinics and providing lectures on contact dermatitis. Seventy-five percent of experts were members of the American Contact Dermatitis Society (ACDS). Although residents in most programs (> 78%) performed patch tests to diagnose contact dermatitis, there were 14 programs in which none of their graduates performed such tests. Moreover, only 27% of programs had rotations dedicated to contact dermatitis and/or patch testing. Finally, directors and chief residents predicted that most graduates will incorporate the TRUE Test and not the more extensive or customized patch tests in their practices.

Conclusions: Several opportunities for improving contact dermatitis education in residency programs were identified, including recruitment or development of more faculty experts in contact dermatitis, creation of rotations dedicated to contact dermatitis, and greater inclusion of contact dermatitis-focused journals in journal club conferences. As the principal interest group for contact dermatitis in the United States, the ACDS is the logical organization to spearhead improvement of contact dermatitis education in residency programs.