Skin Cancer in the Rural South: Strengthening Dermatologic Training for Frontline Primary Care

Skin cancer remains a major public health challenge in the rural Southeastern United States (US), where elevated disease burden coincides with limited access to dermatologic care. Rural populations face increased risk due to occupational exposure to ultraviolet light, poverty, lower rates of routine skin screening, and transportation barriers, yet many nonmetropolitan counties have no practicing dermatologists. Consequently, primary care physicians (PCPs) often serve as the first, and sometimes only, clinicians evaluating suspicious skin lesions. Despite this responsibility, dermatology remains underrepresented in undergraduate medical education and primary care training. Because dermatologic diagnosis relies heavily on pattern recognition, morphologic assessment, and familiarity with presentations across diverse skin tones, insufficient training may contribute to delayed recognition of premalignant and malignant lesions, particularly among medically underserved populations. This editorial argues that strengthening dermatologic education within general medical training is a pragmatic and immediately actionable strategy to address workforce maldistribution and reduce rural skin cancer disparities. This is not a proposal for PCPs to replace dermatologists, but rather a call to equip frontline clinicians with the foundational skills needed to recognize, triage, and appropriately manage high-risk dermatologic presentations.