The highly competitive nature of the dermatology match requires applicants to undertake a variety of measures in the hopes of securing a residency position. Among the opportunities available to applicants is the chance to participate in away or “audition” rotations during their final year of undergraduate medical education. Away rotations are now performed by a majority of medical students applying into dermatology, but littleresearch has been done to describe the nature of this opportunity for interested applicants. An analysis of all dermatology electives offered in the Visiting Student Application Service (VSAS) database wasperformed. Results indicate that students have the option to pursue electives in a variety of subjects offered by 100 sponsoring institutions spread across a wide geographic distribution. Although manyopportunities exist, this analysis sheds light on several areas for improving the quality of this experience for interested applicants, including providing more electives in advanced subject matter, permitting more flexibility in scheduling, and promoting wider participation in VSAS.

There are significant disparities in access to dermatologists in rural areas relative to urban areas. We examined the associations between demographic and medical school characteristics and entry into dermatology practice in urban versus rural counties. All dermatologists who graduated from U.S. allopathic or osteopathic medical schools in the 2020 Centers for Medicare & Medicaid Services Physician Compare Database were assessed. Dermatology practice locations were coded as metropolitan or non-metropolitan according to the Rural-Urban Continuum Codes. Of 10,076 dermatologists, 543 (5.4%) practiced in non-metropolitan counties. Male gender (odds ratio [OR] 1.48, 95% CI 1.23-1.77), public medical school attendance (OR 1.94, 95% CI 1.61-2.34), DO degree (OR 1.84, 95% CI 1.32-2.51), medical school location in a non-metropolitan county (OR 5.41, 95% CI 3.66-7.84), and medical school rural track program (OR 1.57, 95% CI 1.07-2.26) were associated with higher odds of non-metropolitan dermatology practice. Our findings highlight that male gender, graduation from a non-metropolitan or public medical school, DO degree, and rural tracks are associated with higher likelihood of non-metropolitan dermatology practice. These results can inform efforts within the field of dermatology to strengthen the rural dermatologist workforce and suggest that rural educational experiences during medical school may increase recruitment of rural dermatologists.

Background: Medical scribe integration into academic dermatology practices results in decreased attending documentation time, improved physician efficiency, and positive patient satisfaction. However, scribes' impact on dermatology education has not been explored. Methods: We conducted a cross-sectional survey at the Brigham and Women's Hospital Dermatology Department and its associated residency program assessing trainee and attending perceptions of scribe impact on documentation time, teaching time, and quality of teaching. Results: Thirty-nine surveys (67% of eligible population) were analyzed. The majority of faculty and trainees perceived that scribes decreased documentation time (92% attendings, 88% trainees), increased attendings' direct teaching time (57% attendings, 76% trainees), increased attending availability to answer questions (57% attendings, 68% trainees), and improved overall education (57% attendings, 80% trainees). Trainees generally perceived educational benefits of scribes more strongly than attendings. Trainees and attendings had discordant views regarding number of patients that the trainee sees (29% attendings, 72% trainees, P<0.05) and the amount of supervision provided for procedures (43% attendings, 56% trainees). Conclusions: The positive impact of scribes on dermatology education is consistent with results in other disciplines. Although hospitals typically invest in scribes to increase physician efficiency, this study suggests that scribes can also improve the educational experience.

Background: Health policy knowledge is critical in today's healthcare environment; efforts to understand dermatology residents' health policy literacy and education on policy reforms pertaining to dermatology practice are limited. Methods: A 25-question electronic survey was administered to current U.S. dermatology residents in ACGME-accredited residencies to assess health policy education/experiences, career goals, and familiarity with current issues in health policy and dermatology. Results: There were 46 respondents of equal gender and training stage distribution. Of these, 67% and 30% reported health policy instruction in medical school and residency, respectively; 17% reported no prior instruction. Additionally, 50% and 31% intended to pursue academic medicine and private practice, respectively. Although most believed dermatology careers to be compatible with non-clinical endeavors (organized medicine leadership, policy reform, political/legislative advocacy, elected office), few intended to pursue such endeavors. Fewer than 50% of respondents reported familiarity with health legislation, reimbursement models, and the American Academy of Dermatology Association's 2018 advocacy priorities. Conclusions: Although some dermatology residents have prior health policy education and/or receive training in residency, there remain gaps in their knowledge and preparation to face current healthcare issues. Medical schools and residencies should address such gaps and provide health policy opportunities to ensure trainees' future success.

Background and study aims  Data regarding endoscopic findings and symptom correlation in patients with gastroesophageal reflux disease (GERD) symptoms are largely limited to single-center experiences. We performed a nationwide study to examine the association between patient-reported GERD symptoms and clinically relevant endoscopic findings. Patients and methods  Using the National Endoscopic Database, we retrospectively identified all esophagogastroduodenoscopies (EGDs) performed for GERD symptoms from 2000 to 2014. Patients were categorized into three symptom groups: 1) typical reflux only (R); 2) airway only (A); and 3) both R and A (R + A). Outcomes were the point prevalence of endoscopic findings in relation to patient-reported GERD symptom groups. Statistical analyses were performed using R. Results  A total of 167,459 EGDs were included: 96.8 % for R symptoms, 1.4 % for A symptoms, and 1.8 % for R + A symptoms. Of the patients, 13.4 % had reflux esophagitis (RE), 9.0 % Barrett's esophagus (BE), and 45.4 % hiatal hernia (HH). The R + A group had a significantly higher point prevalence of RE (21.6 % vs. 13.3 % and 12 %; P  < 0.005) and HH (56.9 % vs. 45.3 % and 38.3 %; P  < 0.005) compared to the R or A groups, respectively. The R group had a significantly higher point prevalence of BE compared to the A or R + A groups, respectively (9.1 % vs. 6.1 % and 6.1 %, P  < 0.005). Conclusions  On a national level, patients experiencing R + A GERD symptoms appear more likely to have RE and HH, while those with only R symptoms appear more likely to have BE. These real-world data may help guide how providers and institutions approach acid-suppression therapy, set thresholds for recommending EGD, and develop management algorithms.