Closing the gap in dermatology training: Introducing Skin of Colour Training UK

The 2021 UK census revealed that the skin of colour (SOC) population increased from a little over 7.8 to 10.9 million in the last 10 years.¹ Despite this, SOC images are underrepresented in medical education,² and research has shown that 54% of Dermatology trainees in the UK lacked confidence in managing SOC-related conditions, echoing similar findings amongst Dermatology trainees in the US and Australia with similar population shifts.^3-5 Additionally, 86% of UK dermatologists felt inadequately trained in managing hyperpigmentation, a prevalent concern in SOC.⁶

It is imperative that dermatological conditions are adequately diagnosed and managed to reduce potential health inequalities in SOC patients. SOC education can be evaluated via SOC-related didactics, dedicated SOC rotation or rotations in which residents primarily see SOC patients.⁷ In Australia, a survey done 5 years after the introduction of SOC learning objectives to the national training curriculum, specifically showed the largest increase in confidence in the management of vitiligo (43%–61%) between 2017 and 2022.⁸ Overall, however, there was a reduction in the confidence in the overall management of SOC conditions from 36% to 32% between 2017 and 2022. This highlighted a need to vary the training delivery methods to include face-to-face interactions, as up till that point; the newly introduced SOC-related content was provided via didactic lectures and case presentations at the annual Australasian Dermatology Meeting.

To bridge this knowledge gap highlighted in the UK surveys above, SOC competencies were added to the UK Dermatology Syllabus Guidance in 2021 and Skin of Colour Training UK (SOCTUK) was set up to train the UK workforce comprising of dermatologists, general practitioners, and other healthcare professionals.

Between 2021 and 2023, three virtual annual training events, supported by the British Association of Dermatologists, were organised. These focussed on common SOC dermatological presentations as highlighted by previous publications, delegate feedback and the updated dermatology syllabus recommendations. In 2022, the event occurred over 2 days, and in 2023, workshops, oral presentations and a poster walk by medical students were incorporated into the programme.

The data were analysed from post-conference surveys over the years (Figures 1 and 2). Responses were obtained from 71.1% (2021), 69.2% (2022) and 53% (2023) of delegates of whom 73.6% (2021), 65.1% (2022), 78.8% (2023) were dermatology doctors (i.e., Consultants, Specialist, Associate Specialist and Specialty (SAS) and Registrars) and 8.6% (2021), 11.2% (2022) 5.3% (2023) were General Practitioner doctors (i.e., GP's and GP Registrars).

Following our inaugural meeting, 85.1% reported that their goal of learning about and managing SOC conditions was fully achieved, 14.2% partially achieved and 0.7% not achieved. 98.6% (2021), 98.3% (2022) and 97.7% (2023) found the programme good or excellent; 96.4% (2021), 95.8% (2022) and 95.2% (2023) rated the range of topics as good or excellent and 93.3% (2021), 95.3% (2022) and 96.9% (2023) found the topics useful to clinical practice.

With over 90% rating the programme highly for quality, relevance, and breadth of topics, this highlights the interest in such educational initiatives. The incorporation of abstracts and presentations provides diverse perspectives, whilst workshops allow for small-group teaching. The virtual nature of the meetings, however, poses problems with technical glitches, which impacted our 2023 meeting the most and was reflected in the feedback. This may be overcome by in-person meetings, which would allow for better concentration and interaction, especially with the workshops. In future, feedback analysing delegate confidence in managing SOC-related conditions will likely provide useful insight into the clinical effectiveness of such meetings.

In conclusion, the introduction of SOCTUK facilitates the translation of relevant and much-needed knowledge into clinical practice, equipping physicians with the necessary tools to confidently manage patients with SOC.

The manuscript was written by the first two authors, while the remaining authors aided with feedback collection and editing of the manuscript.

The authors have no funding to report.

The authors declare no conflict of interest.

Not applicable.