Table 4. Quotations describing the experience of dermatology training in residency.

Theme	Quotation Number	Quotation
Clinical Competency	1	“I really can’t stress enough the importance of seeing a volume of skin lesions and presentations because it really is something that, you know, takes a trained eye and, and you just cannot get that out of a textbook or out of images.... So, I do feel way more confident identifying some of the more obscure and more sinister presentation that you can see in dermatology.” (LY)
Clinical Competency	2	“I think I was always good with my hands, but now.... I have more of a comfort of what I can and cannot handle.” (HY)
Clinical Competency	3	“I’m happy to take five minutes and address something because it’s easy for me and it be a benefit for the patient.” (LY)
Clinical Competency	4	“It, it feels nice to, to, to be able to look at something and know what, what it is or think you know what it is; and at least have a couple of different ideas, if you don’t know of what it could be and the way you can attack the problem, and things you can try before you have to refer.” (KR)
Transferable Skills	5	“I’m much more comfortable with that, having had, had the experience in [place]. And then the initial management, like you know your first top three questions for certain things. I’m willing to, you know, pursue those before I would probably just say ‘I don’t know what this is’, or ‘I don’t really know what to do about it.’” (KR)
Transferable Skills	6	“I found that I was actually in my electives when I was kind of the most expert person on the internal medicine team about how to deal with a vasculitis type rash; and how to appropriately biopsy it; what mediums to send it in,; and what particularly you were sending it for but that’s where I really felt like all my training has equipped me to deal with real-life problems in a special way.” (DZ)
Transferable Skills	7	“...I’m back on electives and I’m back in the hospital. And so, you know, suturing a central line or even just, you know, doing that skin punch biopsy to rule out vasculitis on internal medicine, whereas some of the internal medicine residents haven’t had all of that same hands-on skin training has left me feeling, you know, like I’m competent and confident in doing those with, you know, no supervision.” (DZ)
Transferable Skills	8	“I can provide a couple of stories where even in my early clinical practice; I’ve been able to pick up sinister lesions pretty quickly. And even, even in the emergency room, you know, identifying sinister rashes that are, are not just limited to a dermatological disease is, is an important skill set.” (LY)
Transferable Skills	9	“...as a junior resident, I remember we had a young girl who was probably 13, just about to go for Grade 8 grad the following month. And she had pretty bad acne and not, not Accutane worthy quite yet but definitely pretty severe acne. And we had probably another two or three months to go before her grad so we had some time to make a, make a, make a difference with her acne. And it was just, it was so lovely being able to tell her that we could make it quite a bit better before her grad. And just the way her face lit up, it was just, it was just lovely. It makes you feel good about what you’re doing.” (HY)
Transferable Skills	10	“ I think most of the patients are very happy when their family doctor does additional procedures or additional work-up rather than feeling anxious and waiting for referrals. You know, there’s a small subset of, of patients who prefer to see specialists, but I think the vast majority of people want their problem dealt with as quickly and efficiently as possible.” (DZ)
Health Systems Challenges	11	“I know some of these common things and can save my patients... like I can appropriately treat them instead of having them worry and wait for, you know, six months to a year to see a dermatologist.” (JS)
Health Systems Challenges	12	“I do some things different than my colleagues at the clinic I’m at now. So, for example, like immunofluorescence. Like they would never send, they never had the bottles. They never really checked that off...So that way, that’s an extra step for patients, like that’s a step for patients that’s at least is getting done and not, you don’t have to wait for dermatology then to do that.” (AO)
Health Systems Challenges	13	“I definitely feel that I still refer to Dermatology especially for things that are beyond my level of training and my comfort level. So a lot of times if I’m concerned about patients that have very extensive disease for whatever, whether it be psoriasis or acne and things like that, sometimes I do get a second opinion just to make sure that before starting very aggressive therapy such as oral retinoids or even a biologic, that I do confirm that the diagnosis is correct, and that there aren’t any other treatment options that I haven’t exhausted.” (YH)
Health Systems Challenges	14	“As family docs . . . skin is a huge part of {sic} the patients coming through the door. And if you’re not equipped, then we just burden, like there is lots of stuff we should be able to treat confidently that we’re referring to tertiary dermatologists, which they’re way over-qualified to treat.” (JS).
Health Systems Challenges	15	“I think it is a good use of resources. I think from a system point of view there’s no need for simple, basic, you know, common conditions to need to be managed with an expensive consulting code . . . You can see here in [place], much difference with GP dermatology like because there’s this little pocket here and Dr. [name] and some other clinics” (JS)
Health Systems Challenges	16	“I think for the patient population, rurally, it’s more important because you don’t have access. So, knowing what to do or knowing how to do it is important” (YH)
Health Systems Challenges	17	“...Certainly, in rural/regional areas, patient access just to coming to a town is much more difficult. It’s usually a further drive and they just don’t have the means to get into a larger centre. So, if their GP can provide that service, I think it is fantastic. So, I would say probably more needed in a rural community and better to have those additional skills if you are more of a rural/regional physician.” (KR)