Mona Shahriari, MD, FAAD

Skin of Color Savvy: The Art and Science of Treating Patients of Color

Trial design, not patient reluctance, often limits diverse enrollment.

Outcome measures should capture erythema and post-inflammatory hyperpigmentation across skin tones.

Clinicians should check race, ethnicity, and skin tone reporting before applying trial results.

 podcast, Mona Shahriari, MD, associate professor of dermatology at Yale University, spoke with Valerie D. Callender, MD, about whether 

 clinical trials now reflect the patients seen in everyday practice, and about what it takes to earn the trust of patients with skin of color.

 leaders. Callender, a SOCS leader, is a professor of dermatology at Howard University College of Medicine, leads Callender Dermatology & Cosmetic Center, and founded the Callender Center for Clinical Research.

Skin of Color Savvy: Trials & Trust—What Meaningful Representation Means

Are Dermatology Clinical Trials Becoming More Representative?

Callender said representation has improved since she began conducting trials in 2001, when skin of color research was largely limited to phase 4 and investigator-initiated studies. Her site now takes part in phase 2 and 3 programs, and she credited the FDA push for diversity action plans with encouraging sponsors to build diverse populations into protocols.¹ Shahriari noted that meeting an enrollment target is only the first layer, since a study can hit a demographic goal and still miss the patient in the exam room.

Both dermatologists described how protocol design can quietly exclude patients. Callender pointed to exclusions for keloid or hypertrophic scar history, visit schedules limited to business hours, and shampoo studies requiring daily hair washing, which would screen out many Black women. She recommended evening or Saturday visits, while Shahriari said sponsors should budget for the staffing and overtime those accommodations require, along with transportation and virtual visit options.

Callender also said outcome measures often miss what matters to patients. Erythema is harder to see in darker skin, and she suggested dermatoscopy or other objective tools to confirm active inflammation. Shahriari added that post-inflammatory pigment change can matter more to patients than clearance scores. Callender said the 2025 SOCS summit, which she helped lead with Valerie Harvey, MD, identified disease areas with poor outcome measures, and a paper is forthcoming. Patients at that meeting also raised concern about losing access to a drug that worked once a study ends, a point Shahriari said sponsors could address.

How Can Investigators Earn Trust From Patients of Color in Clinical Research?

Callender said investigators, not patients, should take responsibility for trust. She recommended transparency, visible community involvement, diverse staff, and humility during informed consent. Shahriari said many diverse investigators remain underrepresented as trial sites and that patients often feel more comfortable when the investigator resembles them. For retention, Callender stressed communication, being present for visits, returning patient calls personally, and compensating participants for time, transportation, and meals. She also described Skin of Color Society training with the National Medical Association dermatology section that mentors early-career investigators on contracts, budgets, recruitment, and retention.

What Should Clinicians Ask Before Applying Pivotal Trial Data to Patients of Color?

Callender said she first checks demographics, wanting race, ethnicity, and skin tone all reported, then sample size, inclusion and exclusion criteria, and whether the design is controlled or open label. A systematic review of 626 dermatology trials found that reporting of race or ethnicity was limited, even among US studies.² Both clinicians review adverse event tables, particularly for topicals, to see whether post-inflammatory hyperpigmentation occurred and resolved. Shahriari said clinicians should be open with patients about what the data do and do not show.

Callender expects the field to keep working toward representation and said progress may take 15 to 20 years. She encouraged new investigators to look for gaps in their own clinics, search the literature, and build relationships with sponsors and medical science liaisons.

To learn more about SOCS’s programs and initiatives, visit the 

Editor’s note: This summary was edited with the help of AI tools. Shahriari and Callender had no relevant financial disclosures of note.

Diversity action plans to improve enrollment of participants from underrepresented populations in clinical studies: draft guidance for industry. US Food and Drug Administration. June 2024.

Charrow A, Xia FD, Joyce C, Mostaghimi A. Diversity in dermatology clinical trials: a systematic review. 

. 2017;153(2):193-198. doi:10.1001/jamadermatol.2016.4129.

Podcasts

Mona Shahriari, MD, and Valerie D. Callender, MD, discuss trial diversity, better outcome measures, and how investigators can earn patient trust.

Physicians often find it easier to discuss clinical failures than personal exhaustion.

People-pleasing and fear of lost opportunities can push women physicians toward burnout.

Women in medicine can be excellent clinicians while still exhausted or imperfect.

, host Mona Shahriari, MD, associate clinical professor of 

 at Yale University and a practicing dermatologist in Connecticut, is joined by Shannon C. Trotter, DO. Trotter is a dermatologist from Springfield, Ohio, a speaker and educator, and host of the ‘

This podcast episode is a sequel to Shahriari’s appearance on Trotter’s own show. It explores the gap between the polished podium version of physicians and the real-life version that emerges over coffee, in hotel lobbies, and in group chats with trusted colleagues.

The Medical Sisterhood: How to Approach Burnout, Boundaries, and Authenticity in Medicine

Shahriari opens with a series of candid statements for Trotter to react to. The first is that expertise alone does not earn someone a microphone. Trotter agrees that research or clinical expertise and the ability to communicate it are separate skill sets, and that only some clinicians have both. The two discuss the challenge of co-presenting with colleagues whose energy and style differ from their own. Trotter describes how a spontaneous live demonstration with a more reserved co-presenter became one of the session’s strongest moments.

Why Do Physicians Hide Exhaustion More Than Clinical Failures?

Trotter suggests physicians find clinical failures easier to discuss because they can be explained by outside factors, such as incomplete patient histories, adherence issues, or a trial that missed its end point. Personal exhaustion, by contrast, tends to be seen as a flaw in oneself. Both clinicians note that women in medicine often hold themselves to especially high standards, a pattern reinforced by curated social media feeds.

Shahriari describes canceling a lunch meeting after a cross-country lecture schedule left her running on minimal sleep, and notes how long she hesitated before admitting she was tired. Trotter links this hesitation to people-pleasing and to fear that declining a commitment could cost future opportunities. That cycle, she says, can push clinicians toward burnout. Survey data continue to show higher rates of burnout among women physicians than among men.

How Can Physicians Handle Missteps When Speaking in Public?

Trotter emphasizes the power of pausing before speaking and asking whether a comment adds value. Criticism of a colleague’s presentation, she notes, belongs in a private conversation rather than a public chat. She acknowledges that jokes sometimes fall flat on stage and that constant recording makes such moments feel more permanent, but encourages speakers to keep going and accept imperfection. Both agree that speakers are usually their own harshest critics, and Shahriari has stopped listening to recordings of herself for that reason. Trotter adds that learning not to take rejection personally is especially hard for younger clinicians.

What Should More Women in Medicine Say Out Loud?

Trotter describes herself as a serious physician who is not always a serious person. She uses humor to build rapport with patients while reading each room to decide how far to take it. The two share lighthearted confessions about conference life, including pretending to recognize colleagues, slipping out of events unnoticed, and the effort behind polished social media photos. Trotter also recounts responding to emergencies outside the clinic, including a stroke on an airplane, as an example of physicians’ innate drive to help others. She closes by urging women physicians to acknowledge that they can be excellent clinicians while still feeling exhausted or disorganized. She also encourages them to promote themselves without making themselves smaller for others’ comfort.

Editor’s note: This summary was edited for the purposes of grammar and clarity using AI tools. Shahriari and Trotter highlighted no relevant financial disclosures of note. 

Want to join The Medical Sisterhood community? Click here to join our LinkedIn Group!

Berg S. What’s behind the persistent gender gap in physician burnout. American Medical Association. Published April 30, 2026. Accessed October 28, 2026. 

https://www.ama-assn.org/practice-management/physician-health/what-s-behind-persistent-gender-gap-physician-burnout

Ortega MV, Hidrue MK, Lehrhoff SR, et al. Patterns in physician burnout in a stable-linked cohort. 

. 2023;6(10):e2336745. doi:10.1001/jamanetworkopen.2023.36745.

Shannon C. Trotter, DO, and Mona Shahriari, MD, discuss burnout, people-pleasing, public speaking, and the real life behind physicians’ polished personas.

Murina believes adequate clinical hours remain essential for building competence, even as duty-hour and wellness policies evolve.

AI could ease documentation and administrative burdens so physicians can focus on patient care and teaching.

Prospective physicians should expect setbacks, trust mentors, and stay open to alternate pathways.

podcast, host Mona Shahriari, MD, associate clinical professor of 

 at Yale University and a practicing dermatologist in Connecticut, is joined by Andrea Murina, MD, an associate professor of dermatology and the program director at Tulane University School of Medicine in New Orleans, Louisiana.

Together they explore a question many physicians quietly ask: knowing what they know now, would they still recommend medicine to someone they love? For Murina, a general dermatologist and mother of 3, the question is far from theoretical. Her oldest son has expressed interest in pursuing medicine, and more recently so have his 2 younger brothers.

The Medical Sisterhood: Is Becoming a Doctor Still Worth It? With Andrea Murina, MD

The Medical Sisterhood: Is Becoming a Doctor Still Worth It?

Murina also oversees more than 400 residents and fellows across the university's graduate medical education programs. She describes an initial sinking feeling at her son's news, rooted in memories of the effort, uncertainty, and stress required to reach medical school and residency. She came from a nonmedical background and entered training with little guidance. Viewing the system through a parent's eyes, she notes, has made her more critical of how medical education is structured and more reflective about how she approaches learners.

Ultimately, she concludes that the struggle is often where the meaning of the profession is found. She would choose medicine again despite years of imposter syndrome and the challenge of overcoming a tendency to faint during procedures. She also highlights the unexpected variety of her career, from teaching and hospital committees to journal reviewing and creative presentations.

How Should Residency Programs Balance Duty Hours With Clinical Competence?

Murina argues there is a limit to how far duty hours can be restricted without leaving trainees underprepared. She compares residency to training for a marathon or an Olympic event and emphasizes that competence and confidence come only through practice.

In her view, the goal of training is to produce physicians who may not know every answer but know how to find one without fear or panic. Shahriari echoes this point, recalling a residency interview in which she was asked to estimate a figure she could not possibly know, a test of problem-solving rather than recall.

At the same time, Murina rejects the long-standing expectation that physicians work while ill. She supports Accreditation Council for Graduate Medical Education requirements allowing residents and fellows to attend health care appointments, including mental health visits, as needed. She notes that physicians who fail to build these habits during training rarely adopt them later, which contributes to poor health outcomes across the profession. She encourages full use of vacation time but cautions against using sick days simply because they are available.

Can AI Reduce Administrative Burden for Dermatologists?

Murina describes herself as cautiously optimistic about artificial intelligence (AI). She sees particular potential in offloading documentation, billing, and prior authorizations, which she views as tasks below physicians' level of expertise and key contributors to burnout. Even with AI scribes, she notes that managing callbacks and messages across 3 clinic locations remains a significant burden. She hopes future tools will free more time for patient care, shared decision-making, and teaching. She also anticipates that dermatology subspecialties may evolve over the next decade, potentially creating new technology-driven roles.

What Should Prospective Physicians Know Before Choosing Medicine?

Addressing generational differences, Murina rejects the notion that younger physicians lack work ethic and frames the issue as one of expectation management. Both clinicians acknowledge a tendency toward people-pleasing and difficulty disconnecting on vacation. They agree that setting boundaries with patients supports long-term practice. For prospective physicians, Murina stresses normalizing failure, remaining open to alternate pathways, and trusting guidance from mentors.

She also acknowledges that admissions and dermatology residency applications have grown dramatically more competitive. Shahriari closes by suggesting the key question for the next generation is not whether to become a physician, but what kind of physician to become and what kind of life medicine should fit into.

Editor’s note: Neither speaker had any relevant disclosures of note. This episode was summarized with the help of AI tools.

Andrea Murina, MD, weighs whether she would recommend medicine to her own children amid AI, physician burnout, and evolving residency training standards.

Building trust with patients who have diverse skin tones, and addressing 

 as a condition that reaches beyond the skin, were the focus of this segment of the most recent 

featuring Jennifer Soung, MD, and Mona Shahriari, MD.

Soung is known for her work as a board-certified dermatologist and as the director of clinical research at Southern California Dermatology in Santa Ana, California. Shahriari is an associate clinical professor of dermatology at Yale University and the host of HCPLive’s 

 podcast. Both spoke in this new episode of Skin of Colorsavvy, a podcast hosted by 

Why Trust and Timing Shape Psoriasis Outcomes in Skin of Color

Why Does Early Psoriasis Diagnosis Matter?

Shahriari opened by asking how clinicians can get patients into the office sooner for an accurate diagnosis, noting that delayed diagnosis in patients with diverse skin tones can leave disease harder to treat and less likely to reach remission. Soung said the current health care system is largely built around catastrophic care, responding once a patient has extensive body surface area involvement or can no longer work, rather than intervening early. She noted that early treatment improves outcomes across skin tones, but patients with diverse skin tones often face additional barriers to access and may distrust the health care system.

Soung said addressing that gap starts with meeting patients in their communities and building trust through cultural curiosity, including simple open-ended questions about a patient's skincare routines or cultural background. She described using telehealth in her own practice to reduce travel time and time away from work for patients, calling personalized, culturally sensitive care the future of the specialty.

How Can Clinicians Build Trust With Diverse Patient Populations?

Shahriari said patients increasingly assume a shared background signals expertise in treating their skin, recalling a patient who told her she must understand his skin because she looked like him. She said that assumption can be leveraged productively, but clinicians without shared backgrounds can build similar trust through curiosity and cultural sensitivity rather than assumed cultural knowledge. Both agreed that as demographics shift, patients with diverse skin tones will represent a growing share of dermatology practices, making early, trust-based diagnosis increasingly important to patient outcomes.

What Psychosocial Burdens Should Clinicians Watch For?

Shahriari asked how Soung addresses the psychosocial impact of psoriasis and connects patients with mental health support when needed. Soung said she now opens visits by asking patients how psoriasis has affected them, a question that can prompt strong emotional responses, including embarrassment and social stigma tied to visible plaques. She described a patient in his mid-30s who avoided removing his shirt at the beach for years until a stranger, noticing his discomfort, urged him to see a dermatologist.

Soung said moments like that reflect why many clinicians entered medicine, the ability to help patients feel normal again through connection and collaboration. Shahriari said she sometimes splits diagnosis and broader psoriasis-related counseling across separate visits so patients are not overwhelmed by comorbidity discussions on day one, an approach her schedule as a practice owner allows her the flexibility to offer.

How Should Treatment Plans Account for Patient Routines?

Soung noted that patients are often reluctant to admit dissatisfaction with an otherwise effective treatment unless directly asked, and that she has learned the most by asking patients at follow-up visits whether they are happy with their treatment. Shahriari raised the example of scalp psoriasis treatments that require daily shampoo use, noting that regimen is often unrealistic for patients with afro-textured or tightly coiled hair, and asked how treatment routes can better match a patient's daily routine and long-term adherence. Both agreed that efficacy alone does not determine whether a patient continues a treatment, and that the confidence and trust built during a visit often shape treatment success as much as the medication itself.

Editor's note: This summary was edited with the help of AI tools.

Soung J, Shahriari M. Skin of Color Savvy: Advice on Diagnosing Psoriasis in Diverse Skin Tones. HCPLive. August 26, 2026. Accessed September 22, 2026. 

https://www.hcplive.com/view/skin-color-savvy-advice-diagnosing-psoriasis-diverse-skin-tones

Videos

Jennifer Soung, MD, and Mona Shahriari, MD, discuss trust-building, psychosocial burden, and treatment fit in psoriasis care for diverse skin tones.

Mona Shahriari, MD, FAAD

Articles