Scoping Review Maps How U.S. Medical Schools Teach Dermatology Before Clinical Years

Medical students in the United States receive wildly uneven dermatology training before they ever see a patient on the wards, and a new scoping review has now mapped exactly how schools are trying to close that gap. The review, published in Archives of Dermatological Research, systematically searched PubMed, Web of Science, and Embase for studies published between January 1, 2010 and May 6, 2024. The search returned 7,118 records; after duplicate removal and screening of titles, abstracts, and full texts, 22 studies met the inclusion criteria. All focused on teaching methods, curriculum design, or educational outcomes for preclinical medical students in the United States, with sample sizes ranging from 19 to 817 participants.

The motivation behind the review is straightforward: skin conditions are among the most common problems physicians encounter, yet non-dermatologists are often the first point of contact for patients with skin disease. The authors argue that limited or inconsistent undergraduate dermatology training may contribute to diagnostic errors and treatment delays. Because dermatology exposure, curricular structure, and accreditation standards vary substantially across American medical schools, the review focused specifically on the U.S. context and aimed to characterize contemporary pedagogical methods, curricular frameworks, and reported outcomes related to students’ diagnostic and clinical competence.

Methodologically, the review followed a scoping review framework with a structured search, predefined inclusion and exclusion criteria, dual-reviewer screening and data extraction, and a descriptive narrative synthesis. Two reviewers screened titles and abstracts, performed full-text review, and independently screened reference lists of included articles, resolving discrepancies by consensus. Studies were excluded if they addressed postgraduate education, lacked a dermatology-specific component, were published before 2010, or were not in English. Because the included studies varied widely in design, intervention, and outcome measures, the authors synthesized findings thematically rather than quantitatively, and notably, no formal quality or risk-of-bias assessment was performed.

The 22 publications were grouped into three pedagogical domains: experiential and procedural learning, technology-enhanced and digital learning, and curricular and representation-focused interventions. In the first domain, hands-on interventions consistently showed favorable results. Baker and colleagues reported in 2014 that a cadaveric skin biopsy project improved dermatology knowledge among 156 first-year students and increased interest in dermatology careers by 23 percent. Cervantes and colleagues found in 2017 that 19 students using fresh-tissue cadaver models achieved significant technical skill gains and greater engagement. In 2023, Flagg and colleagues showed that a biopsy and suturing workshop using simulated skin pads significantly enhanced procedural confidence in shave biopsies, punch biopsies, and suturing, with all comparisons reaching p < .001 among 41 students.

Technology-based tools also produced measurable benefits, though the studies were small. Cervantes and colleagues reported in 2019 that 14 students receiving computer-based video instruction scored higher on knowledge retention for shave biopsies, with mean scores of 3.66 versus 2.67 for controls (p = .01), and for punch biopsies, with means of 4.00 versus 2.99 (p < .001). Rimoin and colleagues found in 2015 that perceptual adaptive learning modules significantly improved lesion pattern recognition in cohorts of 79 and 157 students. And in a different vein, Ashrafzadeh and colleagues described a virtual dermatology elective at Harvard Medical School in which students each conducted roughly 100 telehealth consultations, meeting 12 of 13 core clinical competencies despite limited procedural exposure.

The third domain, curricular design and representation, addressed a persistent blind spot in medical education: the underrepresentation of darker skin tones in teaching materials. Nayudu and colleagues reviewed 427 images in 2024 and identified underrepresentation of darker skin tones. Okorie and colleagues reported in 2023 that integrating enhanced skin of color content increased diagnostic accuracy in skin of color cases from 51 percent to 82 percent among 63 students (p < .001). Kassamali and colleagues and Le and colleagues similarly reported improved engagement and perceptions following increased skin of color representation in educational materials. These findings suggest that diversifying case imagery is not merely a matter of optics but can directly change diagnostic performance.

Broader curriculum redesigns that incorporated active learning and multimedia also yielded positive outcomes, though of a different character. Ivy and Larson observed in 2016 that exam scores remained stable, moving from 88 percent to 92 percent among 205 students, while course satisfaction rose from 94 percent to 99 percent after interactive modules were added. Garg and colleagues documented significant gains in melanoma knowledge among 817 second-year students across multiple institutions, including improved recognition of the ABCDE criteria (98.4 percent versus 91.2 percent, p < .001), increased confidence in skin cancer examinations (66.9 percent versus 16.4 percent, p < .001), and a 99 percent intention to perform such examinations. Tactile tools added further evidence: Dunnick and colleagues reported in 2023 that among 96 students using a three-dimensional Tactile Learning Tool, 94.8 percent expressed satisfaction and 85.4 percent reported improved confidence, while a randomized study by Garg and colleagues in 2010 found that students learning with 3D prosthetics outperformed those using 2D images in both immediate and three-month retention assessments (p ≤ .03).

The review’s authors are careful to frame these results as associations within a heterogeneous evidence base rather than definitive proof of efficacy. Variation in study design, educational intervention, outcome measures, and follow-up makes head-to-head comparison difficult, and the current literature is constrained by small sample sizes, single-institution settings, short follow-up intervals, and reliance on subjective or knowledge-based endpoints rather than objective performance metrics. Because inclusion was limited to U.S. studies, the findings may not generalize to international medical education systems with different curricular structures and training requirements. Many programs, the review notes, still lack comprehensive hands-on training and adequate inclusion of diverse skin types.

Implementation barriers also loom large. Cadaveric workshops, tactile models, and simulation-based procedural training can be financially prohibitive for institutions with limited educational funding or restricted access to dermatology faculty and laboratory infrastructure. Adaptive learning platforms, digital image repositories, and virtual teaching modules require sustained technological support and faculty training, while compressed preclinical curricula leave little room for longitudinal dermatology instruction. The authors warn that institutional disparities in technological infrastructure and specialist availability risk widening educational inequities between well-resourced academic centers and smaller or community-based medical schools.

As a practical path forward, the review proposes a blended, resource-conscious framework: brief, high-yield procedural workshops embedded within existing anatomy or clinical skills courses; asynchronous technology-based modules for reinforcement; and adoption of freely available or low-cost skin of color image repositories to diversify teaching cases. Inter-institutional collaboration, potentially supported by national dermatology organizations, could facilitate resource sharing, standardize core content, and reduce the financial and logistical burden on individual programs. The authors call for larger, multi-institutional studies using objective and longitudinal measures of clinical performance to define best practices, emphasizing that multimodal instruction, technology-enhanced learning, and improved representation of diverse skin tones likely hold relevance across undergraduate medical education even as the specifics await rigorous, scalable evaluation.

Subject of Research: Teaching methods and curriculum design in preclinical dermatology education in the United States

Article Title: Preclinical dermatology education in the United States: a scoping review of teaching methods and curriculum design

Article References: Tan, I. J., Wolfe, S. M., & Pappert, A. S. (2026). Preclinical dermatology education in the United States: a scoping review of teaching methods and curriculum design. Archives of Dermatological Research, 318(1), Article 545. https://doi.org/10.1007/s00403-026-05024-5

Image Credits: AI Generated

DOI: 10.1007/s00403-026-05024-5

Keywords: dermatology education, scoping review, medical students, preclinical curriculum, simulation training, skin of color, adaptive learning, procedural skills, telehealth, medical education, Preclinical, dermatology