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The dermatology elective often constitutes the future physician's only exposure to dermatologic practice. Cost–benefit considerations dictate that the elective enables the students to acquire useful diagnostic expertise in the short time period available, and that this expertise is not rapidly forgotten after completion of the elective.In order to determine the efficacy of a 2-week dermatology elective in promoting diagnostic skills and to ascertain the preservation of the acquired expertise, kodachrome slide-based multiple-choice examinations were administered to 84 sixth year medical students at the beginning (pre-test) and completion (post-test) of the elective. The long-term retention of diagnostic skills was evaluated by re-testing 4–9 months after completion of the elective (follow-up test).The mean scores of correct answers at the pre- and post-test were 39.73% and 72.46%, respectively. The mean score at the follow-up test for students with a previous dermatology elective was 80.22%, compared with a score of 46.00% for students who did not participate in the elective.The 2-week dermatology elective significantly improved the diagnostic skills of the participants, and the knowledge obtained during the elective was retained for at least 4–9 months.