Background: California, home to over 15.8 million Hispanic individuals, faces disparities in dermatologic care driven by language discordance and underrepresentation. Language barriers contribute to delayed diagnoses and poorer outcomes, especially in melanoma and hidradenitis suppurativa [1]. Despite the proven benefits of language-concordant care, only 4% of dermatologists identify as Hispanic/Latinx [2], and few programs offer formal Spanish training [3]. This study evaluates dermatology residents' Spanish proficiency, communication challenges, and interest in training, with the aim of informing future curriculum development.

Methods: We conducted an IRB-approved, cross-sectional needs assessment using a voluntary, anonymous Qualtrics survey distributed to dermatology residents (PGY2–PGY4) across 11 ACGME-accredited programs in California. Program directors and coordinators assisted with dissemination. The self-assessment survey included both multiple-choice and open-ended items evaluating residents’ self-rated Spanish proficiency, frequency of Spanish-speaking patient encounters, prior medical Spanish training, and interest in a dermatology-specific Spanish curriculum. It also explored perspectives on culturally responsive care and informed early curriculum planning.

Results: Dermatology residents from multiple California programs reported a wide range of Spanish proficiency: 33% identified as advanced or native speakers, while 44% rated themselves as intermediate or below. Only 17% had received formal Spanish-language instruction in medical school, and none had received such training during residency. Confidence using medical Spanish was low, with just 29% feeling very confident in clinical settings. Still, 59% reported that more than a quarter of their patient visits involved Spanish-preferring individuals. Frequently reported communication challenges included autoimmune diseases, psoriasis, and bullous disorders. Interest in structured Spanish-language training was high, with 82% expressing a desire for a dermatology-specific curriculum. These preliminary findings reflect current trends; data collection is ongoing through May 2025.

Conclusions: Preliminary findings suggest that dermatology residents in California frequently care for Spanish-preferring patients yet often lack formal training, confidence, and proficiency. Communication challenges were commonly reported in managing chronic and complex conditions. These early insights highlight a disconnect between clinical demands and current education. With strong interest in structured training, this study supports the next step: developing a Spanish-language curriculum tailored to dermatology.

References

1. Ngo-Metzger Q, Telfair J, Sorkin DH, Weidmer BA, Weech-Maldonado R. Cultural competency and quality of care: obtaining the patient's perspective. Health Aff (Millwood). 2006;25(3):783–91. doi:10.1377/hlthaff.25.3.783

2. Pritchett EN, Pandya AG, Ferguson NN, Hu S. Diversity in dermatology: roadmap for equity. JAMA Dermatol. 2018;154(11):1229–1230. doi:10.1001/jamadermatol.2018.3491

3. Ortega AN, Rodríguez HP, Vargas Bustamante A. Policy dilemmas in Latino health care and implementation of the Affordable Care Act. Annu Rev Public Health. 2015;36:525–544. doi:10.1146/annurev-publhealth-031914-122421