Identifying Gaps and Training Needs in Postgraduate Training in Dermatology Sub-specialties: An Online Survey Among Residents

Background: Dermatology has evolved into a diverse specialty with several sub-specialties such as dermatopathology, dermatosurgery, aesthetics, onychology, and trichology.While the National Medical Commission (NMC) provides guidelines for essential dermatological competencies, significant variability exists in the adequacy and uniformity of training across institutions and hence, the confidence of trainee residents, in these areas.Methodology: An anonymised, online, nation-wide survey was conducted using a pre-validated 21-item questionnaire.It was divided into nine sections covering dermatology sub-specialties such as pediatric dermatology, dermatoscopy, onychology, dermatopathology, pigmentary disorders, trichology, procedural dermatology, aesthetics, and LASERS.Responses were collected from dermatology residents across India, on a 5-point Likert scale, ranging from "Strongly Agree" to "Strongly Disagree."The survey was disseminated through email, and social media platforms, via snowball sampling.Data was analysed to assess training adequacy and confidence levels. Results:The study surveyed 216 dermatology residents.These included 21.3% first year residents, 29.6% second year residents, 34.3% third year residents or recent graduates, and 14.8% senior residents.Most respondents belonged to Delhi (18.1%),Karnataka (12.5%), and Andhra Pradesh (11.6%).Overall, 72% were from government medical colleges and 28% from private ones.The adequacy of training was reported as good, with over 50% of students agreeing that their training was adequate in pigmentary disorders, trichology and dermatosurgery.Less than half of the respondents agreed that their training was adequate in dermatopathology, dermatoscopy, and onychology.Similarly, more than 50% of students expressed confidence regarding clinical practice in pigmentary disorders and paediatric dermatology.However, less than 50% expressed confidence in practising dermatosurgery, dermatopathology, dermatoscopy, onychology, and trichology.Fewer than 30% respondents felt confident regarding aesthetic practice.Conclusions: While residents expressed a higher confidence in the training and treatment of pigmentary disorders, there remained significant gaps in their training with respect to other sub-specialties, particularly aesthetic dermatology.Areas such as trichology, onychology, dermatoscopy, paediatric dermatology dermatosuregry, LASERs and dermatopathology could benefit from enhanced and focussed training during the residency.