Primary-care clinicians are ideally suited to screen and triage people who are at high risk for skin cancer and those with suspicious lesions, but a survey of medical residents revealed infrequent clinical training for skin cancer examination (SCE) (Arch Dermatol. 2009;145:1131-1136).

A research team found that melanoma is the only detectable cancer for which death rates are not decreasing, despite the fact that screening rates remain the same. Prompt recognition and appropriate management of a person with suspicious lesions are essential, and nearly two-thirds of patients with melanoma report that they had visited an internist’s or family practitioner’s office in the year before melanoma diagnosis.

According to the survey results, however, only 15.9% of the 342 medical residents (94% of whom came from family medicine, internal medicine, pediatrics, and obstetrics and gynecology) were skilled in SCE. The majority of respondents (75.8%) said they had never been trained in SCE, 55.3% reported never having observed such an examination, and 57.4% never practiced the examination.

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“We see reasons for strong concern mixed with cautious optimism,” the authors of the study write. “Few residents report adequate practice or skill in the SCE, but small increases in training and practice opportunities were associated with higher self-reported skill levels.”