10.5826/dpc.1302a93
Introduction: Dermoscopy is a useful technique that aids in early detection of skin cancer by increasing diagnostic accuracy with adequate training. However, dermoscopy is not uniformly taught to residents worldwide. Dermoscopy training in Latin American dermatology residency programs has not been explored.
Objectives: To assess current dermoscopy training among dermatology residency programs in Latin America (e.g. training modalities, preferred/most effective modalities per residents, diseases/pathologies taught).
Methods: Cross-sectional survey distributed via email between March and May 2021. Chief residents from Argentina, Brazil, Colombia, Costa Rica, Chile, Ecuador, Guatemala, Mexico, Panama, and Uruguay were invited to participate.
Results: 81 chief residents completed the questionnaire (81/126, 64.2%). 72% of programs had an established dermoscopy curriculum, with dedicated hours of training varying greatly by program. Institutions commonly utilized sessions with “unknown” dermoscopy images and direct teaching by experts in the clinical setting as supplements to lectures, also described by residents as most effective. The most commonly taught methods included pattern analysis (74.1%), the two-step algorithm (61.7%), and the ABCD rule (59.3%). Almost all respondents reported desiring additional training during residency and believe that dermoscopy training should be a requirement to graduate from residency.
Conclusion: This study highlights the current landscape in dermoscopy training among dermatology residency programs in Latin America, demonstrating room for improvement and standardization in dermoscopic education and training. Our results serve as a baseline reference and provide valuable information to guide future educational initiatives incorporating successful teaching strategies (e.g. spaced education/repetition, flipped classroom model) used in dermatology and other fields.
text/xml
2160-9381
2689
en
Natalia Jaimes
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Medical Education
Dermoscopy in Selected Latin American Countries: A Preliminary Look into Current Trends and Future Opportunities Among Dermatology Residency Programs
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Original Article
2023-04-29
2022-07-06
2023-04-29
2023-05-31
e2023093
Dermatol Pract Concept
Introduction: Dermoscopy is a useful technique that aids in early detection of skin cancer by increasing diagnostic accuracy with adequate training. However, dermoscopy is not uniformly taught to residents worldwide. Dermoscopy training in Latin American dermatology residency programs has not been explored.
Objectives: To assess current dermoscopy training among dermatology residency programs in Latin America (e.g. training modalities, preferred/most effective modalities per residents, diseases/pathologies taught).
Methods: Cross-sectional survey distributed via email between March and May 2021. Chief residents from Argentina, Brazil, Colombia, Costa Rica, Chile, Ecuador, Guatemala, Mexico, Panama, and Uruguay were invited to participate.
Results: 81 chief residents completed the questionnaire (81/126, 64.2%). 72% of programs had an established dermoscopy curriculum, with dedicated hours of training varying greatly by program. Institutions commonly utilized sessions with “unknown” dermoscopy images and direct teaching by experts in the clinical setting as supplements to lectures, also described by residents as most effective. The most commonly taught methods included pattern analysis (74.1%), the two-step algorithm (61.7%), and the ABCD rule (59.3%). Almost all respondents reported desiring additional training during residency and believe that dermoscopy training should be a requirement to graduate from residency.
Conclusion: This study highlights the current landscape in dermoscopy training among dermatology residency programs in Latin America, demonstrating room for improvement and standardization in dermoscopic education and training. Our results serve as a baseline reference and provide valuable information to guide future educational initiatives incorporating successful teaching strategies (e.g. spaced education/repetition, flipped classroom model) used in dermatology and other fields.
Natalia Jaimes
2023/04/29
10.5826/dpc.1302a93
e2023093
Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
2160-9381
Medical Education
en
e2023093
Kuperstock JE, Horný M, Platt MP. Mobile app technology is associated with improved otolaryngology resident in-service performance. The Laryngoscope. 2019;129(1):E15-E20.
Dermoscopy in Selected Latin American Countries: A Preliminary Look into Current Trends and Future Opportunities Among Dermatology Residency Programs
https://dpcj.org/index.php/dpc/article/download/2689/2113
  Dermoscopy in Selected Latin American Countries:
  A Preliminary Look into Current Trends and Future
         Opportunities Among Dermatology
                 Residency Programs
           Mariana Perez1, Natalie M. Williams1, Alejandra M. Avila2, Renato Bakos3,
     Flavia Bittencourt4, Blanca Carlos-Ortega5, Laura Garzona6, Alejandra Larre-Borges7,
     Cristian Naverrete-Dechent8, Victor Pinos9,10, Gabriel Salerni11, Jackie Shum-Tien12,13,
                                       Natalia Jaimes1,14


1 Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
2 Department of Dermatology, Universidad Pontificia Bolivariana, Medellin, Colombia
3 Department of Dermatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
4 Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
5 Consultorio privado, Hospital Durango, Roma Norte, Ciudad de México, México
6 Hospital Clínica Bíblica, San José, Costa Rica
7 Hospital Británico, Montevideo Uruguay. Former Hospital de Clínicas UDELAR, Montevideo, Uruguay
8 Melanoma and Skin Cancer Unit, Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile,
  Santiago, Chile
9 Department of Dermatology, Hospital Metropolitano, Quito, Ecuador
10 Universidad Central del Ecuador, Quito, Ecuador
11 Department of Dermatology, Hospital Provincial del Centenario de Rosario, Universidad Nacional de Rosario, Argentina
12 Clínica Dermatológica Arosemena, Ciudad de Panamá, Panamá
13 Clínica Mediskin, Ciudad de Panamá, Panamá
14 Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida



Key words: dermoscopy, dermatology residency, Latin America, medical education
Citation: Perez M, Williams NM, Avila AM, et al. Dermoscopy in Selected Latin American Countries: A Preliminary Look into Current
Trends and Future Opportunities among Dermatology Residency Programs. Dermatol Pract Concept. 2023;13(2):e2023093.
DOI: https://doi.org/10.5826/dpc.1302a93
Accepted: October 19, 2022; Published: April 2023
Copyright: ©2023 Perez et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Natalia Jaimes, MD, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Sylvester
Comprehensive Cancer Center, Miami, Florida. University of Miami Miller School of Medicine, Dermatology Research Clinic 1600 NW
10th Ave. RSMB 2023A, Miami, FL 33136 Phone: 305-243-6735 E-mail: njaimes@med.miami.edu




Original Article | Dermatol Pract Concept. 2023;13(2):e2023093                                                                       1
    ABSTRACT          Introduction: Skin cancer remains a global public health burden. Dermoscopy is a useful technique
                      that aids in early detection and increases diagnostic accuracy with adequate training. However, der-
                      moscopy is not uniformly taught to residents worldwide. Dermoscopy training in Latin American
                      dermatology residency programs has not been explored.
                      Objectives: To assess current dermoscopy training among dermatology residency programs in Latin
                      America (eg training modalities, preferred/most effective modalities per residents, diseases/pathologies
                      taught).
                      Methods: Cross-sectional survey distributed via e-mail between March and May 2021. Chief resi-
                      dents from Argentina, Brazil, Colombia, Costa Rica, Chile, Ecuador, Guatemala, Mexico, Panama, and
                      Uruguay were invited to participate.
                      Results: 81 chief residents completed the questionnaire (81/126, 64.2%). Seventy-two percent of pro-
                      grams had an established dermoscopy curriculum, with dedicated hours of training varying greatly
                      by program. Institutions commonly utilized sessions with “unknown” dermoscopy images and direct
                      teaching by experts in the clinical setting as supplements to lectures, also described by residents as
                      most effective. The most commonly taught methods included pattern analysis (74.1%), the two-step
                      algorithm (61.7%), and the ABCD rule (59.3%). Almost all respondents reported desiring additional
                      training during residency and believe that dermoscopy training should be a requirement to graduate
                      from residency.
                      Conclusions: This study highlights a preliminary look into current landscape in dermoscopy training
                      among selected Latin American dermatology residency programs, demonstrating room for improve-
                      ment and standardization in dermoscopic education and training. Our results serve as a baseline refer-
                      ence and provide valuable information to guide future educational initiatives incorporating successful
                      teaching strategies (eg. spaced education/repetition, flipped classroom model) used in dermatology and
                      other fields.




Introduction                                                       Objectives
Skin cancer continues to be a public health burden glob-           The use of dermoscopy among dermatology residents in
ally. Early detection remains the most cost-effective means        Latin America has not been explored. The objective of this
of improving prognosis and reducing morbidity, mortality,          study was to better understand current dermoscopy training
and health-related costs [1-3]. Dermoscopy is a non-invasive,      among dermatology residency programs in Latin America
in-vivo imaging technique that allows for the visualization        (eg types of training modalities, training modalities con-
of subsurface structures of the skin that are otherwise not        sidered to be most effective by residents, preferred training
visible to the naked eye [4,5]. Dermoscopy increases the di-       modalities by residents, and the diseases/pathologies taught)
agnostic accuracy for skin cancer, including melanoma, by          as a first step toward the creation and implementation of
up to 50% compared to the naked eye examination alone;             educational and training initiatives.
however, this is contingent on adequate training [6,7].
    Although dermoscopy has demonstrated its value in
                                                                   Methods
early detection of skin cancer, it is not uniformly taught
to residents worldwide. Studies show that dermoscopy use           We performed a cross-sectional study using an electronic
among dermatology residents in Europe and Australia is on          anonymous survey. Only the chief residents of selected Latin
the rise [8-10]. Similarly, studies assessing the use of dermos-   American dermatology residency programs from Argentina,
copy among dermatology residents in the United States (US)         Brazil, Colombia, Costa Rica, Chile, Ecuador, Guatemala,
demonstrate that the majority of trainees are receiving di-        Mexico, Panama, and Uruguay were invited to participate
dactic lectures and clinical training on the use of this tool      in the study. Only chief residents were invited to answer
in differentiating benign (eg nevi, seborrheic keratosis) from     the survey, since they would be familiar with their curric-
malignant lesions (eg melanoma, basal cell carcinoma, squa-        ulum and the educational practices of their institution. The
mous cell carcinoma) [11]. Nevertheless, dermoscopy train-         survey was distributed via e-mail between March and May
ing continues to have one of the lowest satisfaction rates         of 2021, and participation was voluntary. The survey was
among residency programs [12,13].                                  available in English, Spanish, and Portuguese on the online



2                                                                      Original Article | Dermatol Pract Concept. 2023;13(2):e2023093
Qualtrics® platform (Qualtrics, LLC, SAP America Inc.             handheld dermatoscope (ie polarized and non-polarized
company). Multiple submissions were prevented by use of           light) was the most commonly used type of dermatoscope.
            ®
Qualtrics       software. Participating countries were selected   All participants reported using a dermatoscope to aid in the
by convenience sampling, based on availability of represen-       detection of malignant tumoral pathologies such as mela-
tative contacts. Based on the number of dermatology resi-         noma, basal cell carcinoma, and squamous cell carcinoma.
dency programs in each country, the estimated sample size
was 126. Summary statistics and descriptive frequencies were                  Table 2. Participant-reported current
collected using Microsoft Excel™. The study was approved                                dermoscopy use.
by the Institutional Review Board at University of Miami.              Current dermoscopy use                         N (%)
                                                                      All                                              81

Results                                                               Daily dermatoscope use
                                                                        Yes                                         80 (98.8)
The response rate was 64.2% (81/126). Overall, 81 chief                 No                                           1 (1.2)
residents from dermatology residency programs in Brazil,              Dermatoscope type   a

Argentina, Colombia, Mexico, Chile, Ecuador, Guatemala,
                                                                       Handheld dermatoscope,                      69 (85.1)
Panama, Uruguay, and Costa Rica completed the question-                 hybrid (polarized and non-
naire (Table 1). Almost all respondents hailed from urban               polarized light)
training programs.                                                     Handheld dermatoscope                       30 (37.0)
    Half of the participants (54%) reported receiving a                 adaptable to photo camera
dermatoscope from their institution (Table 2). The hybrid               or smartphone
                                                                       Specific device for digital                 10 (12.3)
                                                                        dermoscopy
   Table 1. Participant demographics including
                                                                       Handheld dermatoscope,                       4 (4.9)
        location and country of residency.                              only polarized light
                  Demographics                        N (%)           Dermatoscope provided by
 All                                                    81            institution
 Sex                                                                    Yes                                         44 (54.3)
   Female                                           64 (79.0)           No                                          37 (45.7)
   Male                                             16 (19.8)         Situations for dermatoscope
   Other                                              1 (1.2)         usea

 Year of dermatology residency                                         To aid in melanoma                          81 (100.0)
                                                                        detection
   1st                                                5 (6.2)
       nd
                                                                       To aid in basal cell                        81 (100.0
   2                                                  7 (8.6)
                                                                        carcinoma detection
   3rd                                              56 (69.1)
                                                                       To aid in squamous cell                     81 (100.0)
   Other                                            13 (16.0)           carcinoma detection
 Location                                                              To aid in actinic keratosis                 73 (90.1)
   Urban                                            78 (96.3)           detection
   Suburban                                           2 (2.5)          To aid in seborrheic                        71 (87.7)
   Rural                                              1 (1.2)           keratosis detection

 Country                                                               To aid in vascular                          74 (91.4)
                                                                        neoplasm detection
   Argentina                                        17 (21.0)
                                                                       To aid in diagnosing                        56 (69.1)
   Brazil                                           29 (35.8)
                                                                        infectious skin conditions
   Chile                                              4 (4.9)
                                                                       To aid in differentiating                   70 (86.4)
   Colombia                                         13 (16.0)           cutaneous tumors from
   Costa Rica                                         1 (1.2)           inflammatory dermatoses
   Ecuador                                            2 (2.5)           To aid in hair diseases                     79 (97.5)
   Guatemala                                          2 (2.5)           To aid in nail diseases                     68 (84.0)
   Mexico                                           10 (12.4)          Other: mucosal lesions,                      5 (6.2)
   Panama                                             2 (2.5)           guided biopsy
   Uruguay                                            1 (1.2)     a
                                                                  Multiple response (ie “select all that apply”).




Original Article | Dermatol Pract Concept. 2023;13(2):e2023093                                                                   3
A large majority of participants also reported using derma-     not all of them had a formal training program. Specifically,
toscopes to assist in the diagnosis of hair diseases (97.5%),   72% reported an established dermoscopy training curricu-
actinic keratoses (90.1%), vascular neoplasms (91.4%),          lum as part of the residency program, and hours of training
seborrheic keratoses (87.7%), inflammatory dermatoses           varied greatly by institution (Table 3). Dermoscopy lectures
(86.4%), nail diseases (84.0%), and infectious skin condi-      frequently covered topics such as differentiation of nevi from
tions (69.1%). Other cited uses included guided biopsies and    melanoma, non-melanoma malignancies, benign lesions in-
mucosal lesions.                                                cluding seborrheic keratoses; facial lesions, acral lesions,
      Although almost all participants (99%) reported using     and hair dermoscopy. Less commonly covered topics in-
a dermatoscope in their everyday clinical practice (Table 2),   cluded mucosal lesions, nail dermoscopy, and inflammatory


                               Table 3. Participant-reported current dermoscopy training.
          Current dermoscopy training               N (%)             Current dermoscopy training                    N (%)
    Dermoscopy training is part of residency                      Pattern analysis or revised pattern              60 (74.1)
    curriculum                                                     analysis
      Yes                                          58 (71.6)       7-point checklist                                29 (35.8)
      No                                           23 (28.4)      CASH algorithm (Colors, Architecture,            10 (12.3)
    Hours of training per academic year                            Symmetry, Homogeneity)
      0                                            9 (11.1)        Two-step algorithm                               50 (61.7)
      1-5                                          9 (11.1)       TADA (Triage Amalgamated                          8 (9.9.)
                                                                   Dermoscopy Algorithm)
      5-10                                         10 (12.4)
                                                                   None                                              5 (6.2)
      10-20                                        15 (18.5)
                                                                   Other                                             3 (3.7)
      20-30                                        9 (11.1)
                                                                   No answer available                               1 (1.2)
      >30                                          29 (35.8)
                                                                 Use of other dermoscopy training
    Topics covered in dermoscopy lecturesa
                                                                 resources
      Differentiation of nevi from melanoma        73 (90.1)
                                                                   No                                               20 (24.7)
     Non-melanoma malignancies                    71 (87.7)
                                                                   No answer available                               1 (1.2)
      (ie basal cell carcinoma, squamous cell
      carcinoma)                                                   Yes                                              60 (74.1)
     Benign lesions (ie seborrheic keratoses,     64 (79.0)       If answer to “use of other
      angiomas)                                                     dermoscopy training resources” is yes,
                                                                    What are other resources used?a
      Skin infections                              30 (37.0)
                                                                   Online quizzes                                 32/60 (53.3)
      Inflammatory condition                       32 (39.5)
                                                                   Online lectures                                41/60 (68.3)
      Hair dermoscopy                              53 (65.4)
                                                                   Textbooks                                      53/60 (88.3)
      Nail dermoscopy                              39 (48.1)
                                                                   Online text                                    43/60 (71.7)
      Mucosae                                      27 (33.3)
                                                                    Online forums/discussion groups               27/60 (45.0)
      Facial lesions                               54 (66.7)
                                                                   Other                                           4/60 (6.7)
      Acral Lesions                                60 (74.0)
                                                                 Training by dermoscopy expert
      Other                                         4 (4.9)
                                                                   No                                               35 (43.2)
     N/A (do not receive dermoscopy                8 (9.9)
      lectures)                                                    No answer available                               2 (2.5)
    Dermoscopy sessions using images                               Yes                                              44 (54.3)
    (aka “Kodachromes” or “unknowns”)                              Hours per month spent with
    provided by institution                                         dermoscopy expert in clinical setting
      Yes                                          51 (63.0)       1-5                                            15/44 (34.1)
      No                                           29 (35.8)       5-10                                           7/44 (15.9)
      No answer                                     1 (1.2)        10-20                                          10/44 (22.7)
                                    a
    Methods taught by institution                                  20-30                                           2/44 (4.5)
      ABCD rule of dermoscopy                      48 (59.3)       >30                                            8/44 (18.2)
      Menzies method                               28 (34.6)        No answer available                            2/44 (4.5)
a
 Multiple response (ie “select all that apply”).



4                                                                   Original Article | Dermatol Pract Concept. 2023;13(2):e2023093
conditions. More than half of programs employed case-based                 dermoscopy images, hands-on training with experts, and di-
sessions with dermoscopy images (63%) and direct teach-                    dactic lectures were regarded as effective teaching methods,
ing by a dermoscopy expert in the clinical setting (54.3%).                followed by independent learning.
Pattern analysis was the most commonly reported method
(74.1%), followed by the two-step algorithm (61.7%) and
                                                                           Conclusions
the ABCD rule (59.3%). In addition to institutional lectures,
sessions using dermoscopy images and expert training, 74%                  Dermoscopy has proved to be a valuable instrument in the
of respondents reported utilizing other dermoscopy training                early detection of skin cancer, thus reducing morbidity, mor-
resources, such as textbooks and online material.                          tality, and health-related costs, while improving patient care
    Almost all chief residents reported desiring additional                and quality of life. The efficacy and thereby utility of this
training during residency (91.3%) and believe that dermos-                 device, however, depends on adequate training [6,7]. Data
copy training should be a requirement to graduate from                     shows that at least 62%-84% of dermatology residents in
residency (93.8%) (Table 4). Although the ideal training                   the US receive training during residency [13,14]. Residents
duration varied greatly among respondents, sessions using                  in Europe have not been specifically studied, but surveys of
                                                                           practicing dermatologists show that at least 32%-42% re-
                                                                           ceived training during residency [15]. In Australia, dermos-
Table 4. Participant preferences for dermoscopy                            copy education is a core part of residency training, with all
                    training.                                              residents receiving formal didactic training and most pro-
         Dermoscopy Training                                               grams providing dermatoscopes for resident use [16]. In our
             Preferences                              N (%)                study, almost all surveyed residents from Latin American der-
 Additional dermoscopy training                                            matology programs reported using a dermatoscope in their
 desired in residency                                                      everyday practice in a variety of clinical contexts, but only
   Yes                                              74 (91.3)              half reported receiving a dermatoscope from their training
    No                                                3 (3.7)              program. Dermoscopy was formally included in the didac-
    No answer available                               4 (4.9)              tic curriculum of more than two thirds of programs (72%),
 Dermoscopy training should be                                             with lectures spanning a broad range of topics, including
 required to graduate residency                                            differentiation of nevi from melanoma and non-melanoma
   Yes                                              76 (93.8)              malignancies.
    No                                                1 (1.2)                 Given the different modalities for teaching dermoscopy
    No answer available                               4 (4.9)              and associated learning preferences, in addition to under-
                                         a                                 standing the current landscape of dermoscopy use among
 Most effective method of training
                                                                           trainees in a given region, it is also important to understand
  Sessions with dermoscopy                         66 (81.5)
   images/cases (aka unknowns                                              the modalities taught, the effectiveness of these strategies,
   /Kodachromes)                                                           and the trainee learning preferences before embarking on
    Didactic lectures                               57 (70.3)              larger dermoscopy education initiatives. Among the surveyed
    Hands-on training with expert                   66 (81.5)              residents, pattern-analysis was taught in 74% of programs,

  Independent learning (online,                    32 (39.5)              followed by the two-step algorithm (61.7%) and the ABCD
   textbook)                                                               rule (59.3%). Institutions employed the use of lectures, ses-
    Other                                             3 (3.7)              sions with dermoscopy images, and expert training, though
 Ideal duration of hands-on                                                74% of residents reported utilizing supplemental training
 training                                                                  resources such as textbooks and online content. Importantly,
    Hours (mean ± sd)                             (18.5 ± 40.2)            almost all residents believed dermoscopy training should be
    Days (mean ± sd)                              (12.7 ± 21.7)            a requirement for graduation and desired additional training

 Ideal duration of in-person course                                        than they were currently receiving.
                                                                              There is limited evidence in the literature regarding
    Hours (mean ± sd)                             (12.3 ± 11.6)
                                                                           specific approaches to dermoscopic education and their
    Days (mean ± sd)                              (10.5 ± 13.3)
                                                                           long-term efficacy. At one US institution, a flipped classroom
 Ideal duration of online
                                                                           approach for dermoscopic education (students review pre-
 dermoscopy video
                                                                           paratory instructional content outside the classroom and
    Hours (mean ± sd)                             (5.7 ± 11.2)
                                                                           participate in faculty-guided active learning within the class-
    Sessions (mean ± sd)                          (11.8 ± 13.3)
                                                                           room) was suggested to improve satisfaction and learning by
Sd = standard deviation.aMultiple response (ie “select all that apply”).   promoting accountability, though data was mostly anecdotal



Original Article | Dermatol Pract Concept. 2023;13(2):e2023093                                                                          5
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the convenience sampling (ie surveying chief residents from         9. Forsea AM, Tschandl P, Del Marmol V, et al. Factors driving
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impedes generalization of survey results and may result in
                                                                       EPMID: 27469990.
biased data due to underrepresentation of the population. Of
                                                                   10. Piliouras P, Buettner P, Soyer HP. Dermoscopy use in the next
note, the total number of residents of all years represented by        generation: a survey of Australian dermatology trainees. Aus-
the survey amounts to more than 1,300; though specific in-             tralas J Dermatol. 2014;55(1):49-52. DOI: 10.1111/ajd.12061.
formation regarding the precise number of residents in each            PMID: 23713814.
program and each country was not available for all coun-           11. Chen YA, Rill J, Seiverling EV. Analysis of dermoscopy teach-
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tries. Therefore, these results can be considered preliminary
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and may be improved upon with a larger and more represen-
                                                                       /dpc.070308. PMID: 29085718. PMCID: PMC5661161.
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the current landscape and preferences in dermoscopy training           inars. Arch Dermatol. 2008;144(7):896-900. DOI: 10.1001
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demonstrating room for improvement and standardization
                                                                       for improved dermoscopy training in residency: a survey of US
in dermoscopic education and training. Our results serve as a          dermatology residents and program directors. Dermatol Pract
baseline reference and provide valuable information to guide           Concept. 2017;7(2):17-22. DOI: 10.5826/dpc.0702a03. PMID:
future educational initiatives, which can include successful           28515987. PMCID: PMC5424656.
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