Although teledermatology (TD) is regarded as a tool to improve patient access to specialty healthcare, little has been done to evaluate its role in medical education. We describe the TD program at the Denver (CO) Department of Veterans Affairs Medical Center and evaluate its use as an educational tool for teaching dermatology to dermatology residents and medical students. Dermatology residents manage TD consultations and review all cases with a faculty preceptor; medical students participate as observers when possible. This study assessed dermatology resident (n = 14) and medical student (n = 16) perceptions of TD and its usefulness in teaching six core clinical competencies. Both residents (79%) and medical students (88%) ''strongly agree'' or ''agree'' that TD is an important educational tool. In general, medical students were slightly more satisfied than residents across all of the core competencies assessed except for patient care. Medical students and residents were most satisfied with the competencies of practice-based learning and improvement and medical knowledge, whereas they were least satisfied with those of interpersonal and communication skills and professionalism. Overall, TD is valued as a teaching tool for dermatology in the areas of patient care, medical knowledge, practicebased learning and improvement, and systems-based practice.

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Identifying hard-to-reach programs requires persistence and creativity, as well as a rigorous approach to generating a census of programs.

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