How Increasing Research Demands Threaten Equity in Dermatology Residency Selection and Strategies for Reform

The shift in United States Medical Licensing Examination (USMLE) Step 1 scoring to pass/fail has intensified the emphasis on research productivity in dermatology residency applications. Through a cross-sectional survey, we examined barriers to research engagement among dermatology applicants. Time constraints, limited access to opportunities, uncertainty in beginning research, and a lack of mentorship emerged as considerable barriers. Regression analysis revealed that lower socioeconomic status, underrepresented in medicine status, and higher debt levels predicted greater financial barriers and institutional limitations. Barriers including limited research access and insufficient mentorship correlated with decreased publication output. Notably, respondents rating time constraints and uncertainty in how to begin research as notable barriers were more likely to consider changing their specialty choice. These findings suggest that structural barriers, rather than lack of interest or ability, may create cumulative disadvantages that deter capable candidates and potentially exacerbate existing diversity gaps in the dermatology workforce.