General practice trainees' clinical experience of dermatology indicates a need for improved education: A cross-sectional analysis from the Registrar Clinical Encounters in Training Study.
OBJECTIVE
Skin conditions are commonly encountered in general practice but dermatology is underrepresented in undergraduate medical courses. Australian and international studies have shown that the dermatological diagnostic ability of general practitioners (GPs) is suboptimal, contributing to increased dermatology outpatient referrals. Dermatological experience in GP vocational training is thus of particular importance. We aimed to document the prevalence of skin disease presentations and the range of skin diseases encountered by GP trainees. We also sought to establish associations of GP trainee's skin disease experience, including their personal characteristics, consultation factors, and the actions arising from the consultation.


METHODS
This study took place in the Registrars Clinical Encounters in Training (ReCEnT) study. ReCEnT is an ongoing, prospective, multi-site cohort study of Australian GP trainees' consultations. A descriptive cross-sectional analysis was performed on trainees' consultation data.


RESULTS
In total, 645 individual trainees contributed data from 84 615 consultations. Altogether, 11% of all problems managed were skin problems. Infections, dermatitis, injury and wounds were the most common presentations. Associations of consultations for skin problems (compared with all other problems) included seeking in-consultation advice, planning patient follow up and generating learning goals.


CONCLUSIONS
These findings suggest GP trainees find skin problems challenging and may indicate a need for more and better targeted undergraduate and GP trainee education.
School of Population Health and Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.|Adelaide to Outback General Practice Training, North Adelaide, South Australia, Australia.
Georgina
G
Whiting
GP Synergy, Liverpool, New South Wales, Australia.|School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
Parker
P
Magin
General Practice Training Valley to Coast, Mayfield, New South Wales, Australia.
Simon
S
Morgan
GP Synergy, Liverpool, New South Wales, Australia.
Amanda
A
Tapley
GP Synergy, Liverpool, New South Wales, Australia.
Kim
K
Henderson
Hunter Medical Research Institute, Newcastle, NSW Australia.
Chris
C
Oldmeadow
Hunter Medical Research Institute, Newcastle, NSW Australia.
Jean
J
Ball
School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Mieke
M
van Driel
Eastern Victoria GP Training, Hawthorn, Victoria, Australia.
Neil
N
Spike
School of Population Health and Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.
Lawrie
L
McArthur
General Practice Training Valley to Coast, Mayfield, New South Wales, Australia.
John
J
Scott
School of Population Health and Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia.
Nigel
N
Stocks
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice / Q000193:education*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation; D012871:Skin Diseases / Q000175:diagnosis* / Q000628:therapy; D055815:Young Adult
education; epidemiology; general practice; graduate medical; skin diseases