Beyond the Surface: Unveiling Gaps in Medical Education Through the Eyes of Diverse

Abstract The ability to be able to visually identify and diagnose is fundamental to a health professional’s physical examination, impacting patient diagnosis and treatment. Inadequate education regarding disease manifestations in diverse skin colors hinders diagnostic skills and exacerbates health disparities. A critical deficiency exists in medical education regarding skin of color (SOC), namely, individuals at all levels of medical training, including students, residents, and attending physicians, have low confidence in identifying and diagnosing diseases in skin of color. To help further identify these concerns and gaps, this research project aims to identify medical students' confidence in recognizing cutaneous diseases in SOC and their viewpoints regarding SOC education at their institution. An eight-question, open-ended survey was provided to medical students before and after a presentation focused on skin of color. The survey assessed participants’ confidence in their diagnostic ability and perspectives on educational material provided by their institution. Among the 70 attendees, 58 (82.8%) and 64 (91.4%) completed the pre- and post-seminar surveys, respectively. There was a significant discrepancy in confidence levels when assessing cutaneous manifestations of internal pathology in light (Monk Skin Colors 1-5) versus dark (Monk Skin Colors 6-10) skin tones (p < 0.009). Notably, 78.7% (37/47) perceived the institutional learning materials as insufficient for SOC. Post-seminar reflections indicated that 87.2% (40/46) of students lacked confidence in diagnosing SOC, with 78.7% (32/46) citing inadequate curriculum coverage as the cause. An additional 8.5% (6/46) identified the predominance of white-centric medical descriptions as a hindrance. Students uniformly called for enhanced educational approaches, including better visual representation of diseases in darker skin. Medical education must continue to strive for increased SOC representation to train competent physicians in treating a diverse patient population and reduce health disparities in SOC patients.