Foundation Doctors’ Confidence in Dermatology Referrals: A Multi-Site Survey
A RECENT survey across two UK hospital sites reveals that foundation doctors lack confidence in key dermatological skills, leading to misaligned expectations between them and dermatologists when it comes to inpatient referrals.
Study Overview
The study aimed to assess the confidence of foundation doctors in core dermatological competencies and to compare this with the expectations of dermatologists regarding the quality of inpatient referrals. Conducted at Basildon University Hospital and Northampton General Hospital, the survey included 87 foundation year doctors and 8 dermatologists.
Confidence Gaps in Dermatology Skills
The findings show that a significant proportion of foundation doctors reported low confidence in essential dermatology skills. For instance, only 8-29% of doctors felt confident in describing skin lesions or identifying serious dermatological conditions. In addition, over 65% expressed uncertainty about using different emollients, with only 2-10% confident in applying them effectively. Furthermore, approximately 30% of doctors were unfamiliar with the British Association of Dermatologists (BAD) handbook, a key resource for clinical guidance.
Mismatched Expectations Between Doctors and Dermatologists
Dermatologists surveyed noted that many referrals lacked the necessary clinical details, which are crucial for effective diagnosis and management. Common conditions like eczema, psoriasis, and scabies were often referred inappropriately, highlighting a disconnect between the expectations of dermatologists and the abilities of foundation doctors. Dermatologists emphasized the need for better information to guide treatment, which foundation doctors were either unaware of or inadequately trained to provide.
Call for Improved Dermatology Education
The study’s findings suggest that inadequate dermatology training during medical school contributes to these confidence gaps. Both foundation doctors and dermatologists observed deficiencies in referral quality, which could lead to suboptimal patient care and unnecessary specialist consultations. The authors advocate for improved dermatology education for medical students, clearer referral guidelines, and ongoing feedback from dermatologists to enhance the quality of inpatient referrals.
Reference: Khorshid KS et al. Comparing Foundation Doctors’ Confidence and Dermatologists’ Expectations in Inpatient Referrals: A Multi-site Survey. Cureus. 2025 Oct 4;17(10):e93830.
