Medicine is simultaneously an art and a science requiring a rigorous scientific background and nuanced appreciation for the heterogeneity of disease. As a medical student, one of the greatest challenges I have faced in training is recognizing variable presentations of diseases of the same pathologic entity.
What I have come to learn through my time in the hospital and on clinical rotations is how infrequently the classic patient presentation seen on board examination questions walks into the clinic. Now that I am more experienced in direct patient care I understand how vital it is that we are exposure to variety. It is exposure to variety that creates physicians that are clinically competent and capable of treating a diverse patient population.
I find this to be especially true within the field of dermatology, where visual recognition is vital to accurate diagnosis, yet the appearance and etiology of different skin diseases can vary dramatically based on the patient’s skin type and social context. It is the appreciation for the subtle differences in appearance and patient history that makes clinicians much more than machines programmed to discern distinct pathologic patterns.
Take for example atopic dermatitis. The classic erythematous papules and plaques can be much subtler in patients with darker skin. As a medical student, VisualDx has been a helpful resource for accessing clinical images in multiple skin types and recognizing how differently the same pathology can look based on the location, texture, and color of the background.
When learning new diseases, I like how I can start with basic descriptor terms to walk through a visual diagnostic algorithm (including inputting the color, texture, size, location of a specific lesion), look at the generated potential diagnoses that fit this description, and then flip through the clinical images to compare how each individual disease presents in different skin types.
The VisualDx database serves as an easy-to-access resource while in the clinic that reminds me to think critically and methodically when examining patients and remain diligent about avoiding clinical and pathological anchoring and availability heuristics.
I strive to be a physician for a diverse patient population and am committed to providing the best recommendations and treatment I know to every patient I engage with. Integral to this level of competency is exposure to and education on how disease presentation can vary drastically between patients. I value the growing library of clinical resources and educational opportunities like VisualDx that are committed to increasing awareness about current representation gaps we have in our educational frameworks and texts.
There is still more work to do, but it is exciting to be a medical student in an era with expanding access to a rich source of clinical images and diagnostic approaches. It makes me feel more capable of becoming an effective medical provider to our growing population. I hope to continue gaining familiarity with the visual heterogeneity encountered in dermatology both through use of this tool and direct exposure in my future training.