A Podiatric Residency Program Perspective on Social Media
One may attribute the increased utilization of online social networking (OSN) by those in the medical field to many factors, among them being advancements in technology and the COVID-19 pandemic.1,2 During this pandemic, information, updates, and health literature were disseminated primarily virtually. Even as the COVID-19 pandemic restrictions lifted, medicine continues to have a robust online presence. Residency programs and prospective residents have shown an increased use of social media to help extend their impact and information to potential employers, colleagues, and patients.1,2
Social media provides an avenue for residencies to create a program “brand.”3 These OSN pages may showcase program accomplishments, highlight a program’s social events, feature alumni, and present cases. In medical training, virtual interviews and the use of social media have allowed students who may not have the opportunity to physically visit a prospective program to meaningfully engage with them.1-3 There are clear benefits for having a strong social media presence. Most OSN pages are free marketing platforms for prospective residents to access at any time and in any location. However, negative implications of social media have also been discussed in the literature, such as publishing unprofessional content and the spreading of misinformation.4,5
Previous published studies investigated allopathic and osteopathic residency programs’ perspectives on online social networks.6,7 However, no published studies to our knowledge have yet investigated these same concepts in the podiatric space. Our team set out to analyze the perspective of podiatric residency programs on OSN.
Methods
We obtained approval from our Institutional Review Board to conduct an online survey for residency program directors and coordinators. The Central Application Service for Podiatric Residencies (CASPR) website was used to access contact information for residency programs. If a program did not have an email listed, we performed a Google search to see if a program’s website would contain access to such email information. Each program received an email with an online survey. We did not offer any specific incentive to fill out the survey. The survey included questions about the following: age range of the program and residency director, if the program currently uses social media and for how long, why they may not use social media, if they look at prospective residents’ OSN prior to the match, if OSN impact residency program rankings, and if programs believe social media has a positive or negative impact on programs (see PDF).
Statistical Analysis
Descriptive statistics were analyzed for responses from residency programs. All data were collected and analyzed in Excel (Microsoft Corporation, Redmond, WA). A chi-square test was used to compare Categorical variables. P-values < 0.05 were assumed to be statistically significant.
Results
As of the time of our investigation, 226 residency programs appeared on CASPR website. However, we only found about 170 with active emails listed. Of these, 22 programs responded, capturing 9.7% of residency programs.
What Did the Responses Reveal?
Age. The most common age range of residency directors was 51-60 (Figure 1).
The average age of the residency program was 26.3 +/- 13.0 years (Figure 2). The average age of program directors among the programs with social media was 49.5 +/- 11.3 and 56.0 +/- 8.5 for those without social media. This was not found to be statistically significant. The average length of a program having social media was 2.8 +/- 1.4 years.
Social Media Use. The survey asked each program if they have a social media page and what social media platform(s) they use, as seen in Figure 3. Half (n=11) of respondents reported having a social media page. The most common social media platform to use was Instagram (50%), followed by Facebook (18%). No programs reported having a Twitter/X, TikTok, Twitch, or Pinterest account.
Resident Ranking. The survey ask inquired if programs look at prospective residents’ OSN prior to the match. Only 18.2% reported looking at applicants’ OSN (Figure 4).
The majority, 58.8%, reported that applicant OSN did not influence their ranking list (Figure 5).
View of Social Media. The survey also asked programs to convey if they felt social media had a positive or negative impact on a program (10 being positive). The majority reported that social media had a positive impact, as seen in Figure 6. The average ranking was 6.8.
There were a variety of responses when programs were asked why they did not have a social media account. The majority of responses were related to lack of resources for account management. Other responses included not seeing an indication for OSN accounts, or concern for HIPAA violations. A few programs reported interest in establishing an OSN presence and would like create accounts soon.
Discussion
Social media’s presence in the medical field continues to grow and expand. When analyzing the data in this study, Instagram was reported to be used in 50% of programs that responded, and in 100% of programs that utilized social media. A study by Gaini and colleagues found that neurology residency programs primarily used Instagram and Twitter/X.8 Bram and team reported that Instagram was the most popular platform in orthopedic residency programs, followed by Twitter/X.9 However, our study had 0 respondents that reported using Twitter/X. Previous published studies reported on the use of Twitter/X in medicine for sharing academic papers, interesting case studies, and distributing cross-disciplinary knowledge.10,11 We hypothesize that individual foot and ankle providers may be more likely than a residency program to create and use a Twitter/X account. However, we recommend future studies investigate the use of Twitter/X within the podiatric field.
A study by Strausburg and coworkers, found that the majority of medical students believed residency directors screened online social networks.6 In our present study, we found that 40.9% of residency programs do not visit prospective residents’ OSN. Go and colleagues reported that 17% of general surgery program directors visited OSN of prospective residents.7 This is similar to our analysis which reports 18.2% of respondents visiting OSN of prospective podiatry residents.
The average length of having social media among our respondents was 2.8 years, estimating the majority began in 2020. This is similar to previously published data from other specialties. Bram et al found 86.4% of such accounts were created after the onset of COVID-19 pandemic.9 Other researchers also reported an increase in OSN of residency programs after the COVID-19 pandemic.8,12 We hypothesize this is due to residency program adaptation to pandemic precautions and a desire for innovative routes to virtually share information about their programs.
One limitation of this study is our small sample size. We had only about 10% of residency programs respond and recognize that our results may not represent all programs. We structured the present study in a survey format to be able to ask individual programs their perspectives on OSN. With taking this approach, we are limited by the participation of program directors. Another limitation is response bias, as this was an online survey. No incentives were given for participation in the survey and therefore the participants who responded may have been more inclined to do so if they felt strongly about the subject of social networks.
This is the first study to our knowledge that investigates social media use in podiatric surgical residencies, as well as program director perspectives on applicants’ social media use. We found most programs had positive views regarding social media use and that rank was unaffected by an applicant’s OSN pages. We recommend applicants and programs continue to use social media platforms to inform and promote podiatric medicine to potential podiatric medical students, prospective residents, and the community.
Jennifer A. Kipp, DPM, is a resident physician in the Department of Orthopaedic Surgery and Rehabilitation at Wake Forest University School of Medicine in Winston-Salem, NC.
Bryanna D. Vesely, DPM, MPH, is a Fellow at Las Vegas Foot and Ankle Fellowship in Las Vegas, NV.
Ashleigh W. Medda, DPM, FACFAS, is an Assistant Professor in the Department of Orthopaedic Surgery and Rehabilitation at Wake Forest University School of Medicine in Winston-Salem, NC.
References
1. Oliver MG, Kelly K. Student perceptions and use of social media as residency program information. Fam Med. 2022;54(5):380-383. doi:10.22454/FamMed.2022.968351.
2. Rohde SC, White EM, Yoo PS. Residency program use of social media in the COVID-19 era: an applicant's perspective. J Surg Educ. 2021 Jul-Aug;78(4):1066-1068. doi: 10.1016/j.jsurg.2020.12.011. Epub 2020 Dec 17. PMID: 33358933.
3. Pillow MT, Hopson L, Bond M, Cabrera D, Patterson L, Pearson D, Sule H, Ankel F, Fernández-Frackelton M, Hall RV, Kegg JA, Norris D, Takenaka K; Council of Residency Directors Social Media Task Force. Social media guidelines and best practices: recommendations from the Council of Residency Directors Social Media Task Force. West J Emerg Med. 2014 Feb;15(1):26-30. doi: 10.5811/westjem.2013.7.14945. PMID: 24578765; PMCID: PMC3935785.
4. Langenfeld SJ, Cook G, Sudbeck C, Luers T, Schenarts PJ. An assessment of unprofessional behavior among surgical residents on Facebook: a warning of the dangers of social media. J Surg Educ. 2014;71(6):e28-e32. doi:10.1016/j.jsurg.2014.05.013.
5. Koo K, Ficko Z, Gormley EA. Unprofessional content on Facebook accounts of US urology residency graduates. BJU Int. 2017 Jun;119(6):955-960. doi: 10.1111/bju.13846. Epub 2017 Apr 9. PMID: 28393475.
6. Strausburg MB, Djuricich AM, Carlos WG, Bosslet GT. The influence of the residency application process on the online social networking behavior of medical students: a single institutional study. Acad Med. 2013 Nov;88(11):1707-12. doi: 10.1097/ACM.0b013e3182a7f36b. PMID: 24072117.
7. Go PH, Klaassen Z, Chamberlain RS. Attitudes and practices of surgery residency program directors toward the use of social networking profiles to select residency candidates: a nationwide survey analysis. J Surg Educ. 2012 May-Jun;69(3):292-300. doi: 10.1016/j.jsurg.2011.11.008. Epub 2012 Jan 14. PMID: 22483127.
8. Gaini RR, Patel KM, Khan SA, Singh NP, Love MN. A rise in social media utilization by U.S. neurology residency programs in the era of COVID-19. Clin Neurol Neurosurg. 2021 Aug;207:106717. doi: 10.1016/j.clineuro.2021.106717. Epub 2021 May 28. PMID: 34091422; PMCID: PMC9759490.
9. Bram JT, Jia L, Huffman W, Ahn J. Orthopaedic surgery residency program social media presence during the COVID-19 pandemic. JB JS Open Access. 2021 Oct 19;6(4):e21.00073. doi: 10.2106/JBJS.OA.21.00073. PMID: 34671711; PMCID: PMC8522873.
10. Kim D, Jung W, Jiang T, Zhu Y. An exploratory study of medical journal's twitter use: metadata, networks, and content analyses. J Med Internet Res. 2023 Jan 19;25:e43521. doi: 10.2196/43521. PMID: 36656626; PMCID: PMC9896359.
11. Mohammadi E, Thelwall M, Kwasny M, Holmes KL. Academic information on Twitter: A user survey. PLoS One. 2018 May 17;13(5):e0197265. doi: 10.1371/journal.pone.0197265. PMID: 29771947; PMCID: PMC5957360.
12. Yong TM, Pappas MA, Ray GS, McManus TG, Coe MP. Analyzing the proliferation of social media use among orthopaedic surgery residency programs. JB JS Open Access. 2021 Jul 19;6(3):e21.00017. doi: 10.2106/JBJS.OA.21.00017. PMID: 34291181; PMCID: PMC8291354.
