INTRODUCTION

In recent decades, dermatology has undergone substantial changes, resulting in advancements in medical practice [1]. Modern biological therapies have notably improved dermatological treatments [2]. Additionally, aesthetic medicine has expanded, and more dermatologists are integrating it into clinical practice. As a result, dermatology has gained prominence among postgraduate medical specialties. However, it’s worth noting that dermatology’s perception within the wider medical community is sometimes limited [3].

THE AIM OF THE STUDY

The aim of this study was to evaluate the perspectives and attitudes of medical students towards dermatology as a distinct medical specialty.

MATERIAL AND METHODS

For this study, a customized questionnaire was created using Google Documents. The questionnaire design was influenced by a similar study involving German medical students [4]. To ensure broad participation, the survey was distributed through online platforms and forums frequented by medical students across various cities in Poland. The questionnaire comprised 19 items, including two questions with a 5-point Likert scale, three open-ended questions, and five single-choice questions. The Likert scale ranged from “strongly agree” to “strongly disagree” and was employed to assess participants’ perceptions in three key areas: (i) understanding of skin disorders, (ii) attitudes toward dermatologists, and (iii) views on the dermatological curriculum. Data collection occurred from May 4^th to May 10^th, 2020. Incomplete responses were automatically excluded, and comprehensive analysis was performed on all completed questionnaires.

The statistical analysis was performed using the IBM SPSS Statistics v. 26 (SPSS INC., Chicago, IL, USA) software. Firstly, the data was assessed for normality with the use of the Shapiro-Wilk normality test. Subsequently, the minimum, maximum, mean, median, standard deviations, and quartiles were calculated. The comparison between groups in qualitative data was performed using the chi2 test. For quantitative data, depending on normality, the T-student test or the Mann-Whitney U test was used. A two-sided p-value of less than 0.05 was considered statistically significant.

RESULTS

A total of 852 students (679 females, 173 males) participated in the survey, with a median age of 22.5 years (ranging from 18 to 32). Among the participants, 578 (67.8%) resided in cities with over 100,000 inhabitants, 109 (12.8%) lived in rural areas, 95 (11.2%) in cities with 50,000 to 100,000 inhabitants, and 70 (8.2%) in cities with less than 50,000 inhabitants. No statistically significant association was observed between the students’ place of residence and their inclination towards specialising in dermatology (p > 0.001).

Among the respondents, 526 (61.7%) had completed a dermatology course, while 326 (38.3%) had not. Completion of dermatology classes did not show a statistically significant impact on the choice of dermatology as a specialisation (p > 0.001). Within the study group, 329 students (38.6%; 295 females, 34 males) expressed an interest in pursuing dermatology as their future specialisation. Among them, 191 (58%) had already completed the dermatology course. The students considering dermatology as a potential specialisation cited attractive working conditions as their primary motivation. These included a perceived low-stress work environment with minimal emergencies (280; 32.9%), the prospect of high income (194; 22.8%), and a holistic approach to patient care (85; 10.0%). Notably, there was a statistically significant association (p < 0.001) between gender and the choice of dermatology. Females were more inclined to select dermatology due to its perceived calmness, with 252 women compared to 28 men considering this factor as a benefit.

Among the 523 respondents (61.4%; 384 females, 139 males) who were not interested in dermatology, 287 (54.9%) had completed the dermatology course, while 236 (45.1%) had not. The main reasons cited against pursuing dermatology were discomfort associated with the clinical presentation of skin lesions (134; 25.6%) and the requirement of high scores in final exams for specialty applications (105; 20.1%).

Regarding the perception of skin diseases, all participants either agreed or strongly agreed that dermatological disorders are prevalent. The majority of respondents found them to be aesthetically displeasing (739; 86.7%), detrimental to the patient (670; 78.6%), and psychologically burdensome (821; 96.4%). Only 259 individuals (30.4%) considered skin diseases to be contagious (Fig. 1).

Figure 1: Dermatological diseases: Overview according to students.

Concerning treatment modalities, 599 respondents (70.3%) acknowledged that skin disorders are treatable, with 465 (54.6%) indicating that dermatologists primarily employ topical medications in their treatment approaches. A significant portion of students (627; 73.6%) believed that dermatologists focus more on performing aesthetic procedures rather than providing medical treatment (Table 1).

Table 1: Dermatologists’ scope beyond skin diseases according to students.

In terms of the specialty’s perception, 518 students (60.8%) expressed the belief that dermatology receives limited respect within the general physician community. Additionally, 744 respondents (87.3%) believed that dermatologists do not bear significant professional responsibility. However, 283 individuals (33.2%) recognized the wide range of development opportunities available within dermatology. Furthermore, 425 participants (49.9%) believed that dermatologists allocate more time to each patient compared to doctors in other specialties, while 517 students (60.7%) perceived dermatologists to have more leisure time than their counterparts in other medical fields.

Regarding the societal perspective, 380 respondents (44.6%) agreed or strongly agreed that dermatology is considered a prestigious specialty among the general public. Moreover, 618 students (72.5%) believed that dermatology offers a higher income compared to other specialisations (Fig. 2). Notably, there was a statistically significant difference (p = 0.001) in the gender distribution of individuals who regarded high income as an advantage of dermatology. This aspect was more important to women (171; 20%) than to men (23; 1.5%).

Figure 2: Evaluation of dermatologists relative to physicians from diverse specialisations: A student perspective.

DISCUSSION

Dermatology has elicited mixed opinions among medical students, with contrasting perspectives observed [1,5]. A significant number of students described dermatological diseases as being common, causing disfigurement, and being chronic in nature. This perception may be attributed to the predominantly non-acute and non-lethal nature of most dermatological conditions. Similar findings were reported among medical students in Germany [4].

Dermatology is widely recognized as a highly competitive and prestigious medical specialisation, known for its potential for high scores, societal prestige, generous remuneration, and favourable work-life balance [6], findings which align with our own study results. This trend is observed not only in our study but also in studies carried out in Latin America [7].

Both students at a medical school in Germany [4], United Kingdom [8] and a medical school in the United States [9] identified common barriers when considering a dermatology residency. These barriers included the difficulty of securing a placement in dermatology, a high demand for research involvement during the application process and concerns about academic performance.

CONCLUSIONS

In conclusion, tackling the perception challenges within dermatology necessitates a holistic strategy that encompasses education, awareness campaigns, and interdisciplinary collaboration. By accentuating the medical and scientific aspects of the field, we can rectify misconceptions, elevate its reputation, and ensure a strong trajectory for dermatological care.

REFERENCES

1. Mohsin N, Hernandez LE, Martin MR, Does AV, Nouri K. Acne treatment review and future perspectives. Dermatol Ther. 2022;35:e15719.

2. Rosales Santillan M, Morss PC, Porter ML, Kimball AB. Biologic therapies for the treatment of hidradenitis suppurativa. Expert Opin Biol Ther. 2020;20:621-33.

3. Phillips JP, Wilbanks DM, Rodriguez-Salinas DF, Doberneck DM. Specialty income and career decision making:a qualitative study of medical student perceptions. Med Educ.2019;53:593-604.

4. Ludriksone L, Tittelbach J, Elsner P. Perception of Dermatology and Dermatologists Among Medical Students. Acta Derm Venereol. 2019;99:248-9.

5. Abdelwahab R, Shahin A, Kim YH, Coias J, Qureshi MB, Vidal N. Scoping review of medical students’perceptions of the field of dermatology. Skin Health Dis. 2022;3:e171.

6. Olsson C, Järnbert-Pettersson H, Ponzer S, Dahlin M, Bexelius T. Swedish doctors choice of medical speciality and associations with cultural capital and perceived status:a cross-sectional study. BMC Med Educ. 2019;19:244.

7. Ng-Sueng LF, Vargas-Matos I, Mayta-Tristán P, Pereyra-Elías R, Montenegro-Idrogo JJ, Inga-Berrospi F, et al. Gender Associated with the Intention to Choose a Medical Specialty in Medical Students:A Cross-Sectional Study in 11 Countries in Latin America. PLoS One. 2016;11:e0161000.

8. Guckian J, Sridhar A, Meggitt SJ. Exploring the perspectives of dermatology undergraduates with an escape room game. Clin Exp Dermatol. 2020;45:153-8.

9. Soliman YS, Rzepecki AK, Guzman AK, Williams RF, Cohen SR, Ciocon D, et al. Understanding Perceived Barriers of Minority Medical Students Pursuing a Career in Dermatology. JAMA Dermatol. 2019;155:252-4.