Diversity of Skin Images in Medical Texts: Recommendations for Student Advocacy in Medical Education.

Foundational academic medical texts facilitate foundational understanding of disease recognition in medical students. Significant underrepresentation of darker skin tones and overrepresentation of lighter skin tones in dermatologic texts, general medical texts, and scientific literature is observed. This compromises the clinical tools of trainees when it comes to darker skin tones. Text publishers and editors are steadily beginning to address these disparities, but bottom-up change from trainees is necessary to comprehensively address this issue. In this article the authors propose institutional review panels as a framework for building awareness of underrepresentation of darker skin tones and ensuring that faculty intentionally share diverse presentations in didactics. They also propose trainee engagement in building diverse medical image libraries and including texts on skin of color in institutional libraries. Empowering trainees to be advocates and call out any implicit or explicit biases in image selection can engender change in this area of medical education.