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Skin Biopsies and Diagnostic Outcomes at a Multisite Family Medicine Residency Network
Alice J Lin1, Laura K Ferris2, John Maier3
1From the University of Pittsburgh School of Medicine.
Southern Medical Journal
|October 4, 2024
Summary
Family Medicine residents perform more skin biopsies than attendings, with differences in biopsy types and lesion diagnoses. This highlights variability in dermatologic procedural training during residency.
Area of Science:
- Family Medicine
- Dermatology
- Medical Education
Background:
- Non-dermatologists manage most skin conditions, with family physicians being a significant group.
- Dermatologic procedural training in Family Medicine residencies lacks standardization, leading to variable physician skills.
Purpose of the Study:
- To compare the scope and diagnostic outcomes of skin biopsies performed by Family Medicine residents versus attendings.
- To assess the impact of residency training on dermatologic procedural competence.
Main Methods:
- Retrospective chart review of skin biopsies performed at eight Family Medicine residency sites and one faculty practice.
- Inclusion criteria: patients with a skin finding undergoing at least one skin biopsy between January 2020 and October 2022.
Main Results:
- Residents performed skin biopsies more frequently (3.6%) than attendings (1.8%).
- Residents favored punch biopsies, while attendings performed more shave biopsies.
- Residents biopsied more benign and malignant lesions, whereas attendings biopsied more dysplastic and atypical lesions.
Conclusions:
- Family Medicine residents in this network receive diverse skin biopsy training.
- Differences in biopsy practices and outcomes between residents and attendings may stem from patient populations, expertise, and referral patterns.
