Regional anesthesiology and acute pain medicine (RA/APM) fellowships have become one of the most popular fellowships accredited by the Accreditation Council for Graduate Medical Education (ACGME). The American Society of Regional Anesthesia and Pain Medicine (ASRA) has a website that hosts a slew of information that is frequently updated on all RA/APM fellowship programs in one centralized source. As the number of applicants and programs continues to increase, the clear need for pertinent information about programs becomes paramount.1 Applicants are increasingly using web-based resources to make informed decisions about programs.2 Chu et al2 found that 98% of anesthesiology applicants used program websites during the application process, but the websites contained only 46% of sought applicant-important information. This letter is intended to quantitatively assess the accessibility, or presence, of information provided by the ASRA directory and their respective RA/APM fellowship websites and to provide guidance on what website aspects can be improved.
We acquired a list of ACGME-accredited and nonaccredited RA/APM programs from the ACGME Directory and the ASRA Directory in April 2020. The variables that were assessed in both the ASRA Directory and RA/APM fellowship websites can be found in Table 1, using website aspects studied by Chu et al. to guide us on assessing applicant-pertinent information.2 Fellowship website variables were stratified into 3 domains for evaluation: general program overview, application information, and program education.
Table 1.
Characteristics of Regional Anesthesia and Acute Pain Management Fellowship Websites
| Category | Present | Percent |
|---|---|---|
| Accreditation status | 35 | 40 |
| Functional website | 84 | 97 |
| 1 Click from Google | 81 | 93 |
| ASRA website: Functional ASRA link | 62 | 71 |
| ASRA website: Email/contact information | 87 | 100 |
| ASRA website: Program director | 86 | 99 |
| ASRA website: No. of positions | 87 | 100 |
| Program addressa | 78 | 93 |
| Program directora | 76 | 90 |
| Number of available positionsa | 50 | 60 |
| Salarya | 34 | 40 |
| Program descriptiona | 84 | 100 |
| Name of current fellowsa | 29 | 35 |
| Name of past fellowsa | 15 | 18 |
| Past fellow current employera | 6 | 7 |
| Application requirementsa | 82 | 98 |
| Application deadlinea | 42 | 50 |
| How-to-apply descriptiona | 76 | 90 |
| Didacticsa | 37 | 44 |
| Journal club/conferencesa | 37 | 44 |
| Rotation schedulea | 26 | 31 |
| Clinic/office responsibilitiesa | 73 | 87 |
| Previous researcha | 11 | 13 |
| Call responsibilitya | 12 | 14 |
| Types of acute pain procedures or advanced traininga | 38 | 45 |
| Case log numbersa | 6 | 7 |
Abbreviation: ASRA, American Society of Regional Anesthesia and Pain Medicine.
a Assessing out of 84 websites instead of 87.
At the time of analysis, 87 programs were evaluated. In the ASRA website, only 62 programs had functional website hyperlinks, while all programs included email/contact information and number of positions. From an internet-based search for each fellowship website, 84 programs were easily accessible within 1 click from Google search and had a functional fellowship website. Thus, while more frequent updates can be a solution, allowing a method to alert the ASRA website that there may not be a functional website hyperlink is also recommended.
Upon evaluating 84 functional RA/APM websites, we found certain aspects absent in 50% or more websites that may be pertinent to include for applicants to make more informed decisions. In the program overview domain, RA/APM programs may provide information about the current and past fellowship class for applicants. While information such as salary and past fellow employer whereabouts may be private and sent to applicants selected for interviews, this additional information can be helpful to applicants that are looking at every opportunity to find a program that aligns with their future career goals. In the application information domain, we recommend websites to list any deadlines so that applicants can timely provide programs their best application. In the education domain, we found many website aspects that have potential to be present. RA/APM fellowship applicants may find information regarding didactics, journal club/conferences, rotation schedule, research opportunities, call responsibilities, procedural training experience, and case logs helpful for decision-making.
These suggestions for RA/APM fellowship website improvement may be helpful for a program’s presence during COVID-19. As the pandemic has necessitated virtual interviews, an online presence has become more critical for both applicants and fellowship programs. Without an in-person way for applicants to learn about programs or programs to learn about applicants, many fields have studied how to best connect with applicants during this time. This challenge has led to critical need for robust technological platforms. Vining et al3 showed that multiple forms of electronic data collection including virtual interview forms, and website video content enhanced a program’s online presence. With social isolation and quarantine, improved program websites could greatly support their online presence and help applicants make well-informed decisions in the era of virtual interviews.
Not only do websites guide decision-making, appropriate and updated information for regional medicine fellows may be especially valuable in cost-savings. Financial burdens of the interview process are a premium importance to all parties, even beyond COVID-19’s economic impact.3 Both applicants and programs could save from total application costs, travel, interview expenses, and investment of time. Faculty interviews could be considered an opportunity cost and are important as they are conducting interviews rather than performing patient management. Certain programs may permanently move to virtual interviews to continue the cost-effective nature of both residency and fellowship application process. Fellowships could further decrease costs because more informed applicants could increase selectivity, decreasing the raw number of applications reviewed.
This Letter to the Editors was intended to provide an assessment of the RA/APM fellowship websites and delineate what website aspects can be improved to allow current and future applicants to make the most informed decision possible, especially during the Coronavirus pandemic. In the future, RA/APM fellowship websites may be a valuable tool in maintaining a fellowship’s online presence. Given that the information provided on webpages can help applicants make more informed decisions and that virtual interviews will change how applicants learn about programs, some RA/APM fellowship programs should update and provide more easily accessible information in a more user-friendly platform. These changes have potential to improve recruitment, as well as reduce associated costs.
Footnotes
Contribution note: K.T.N. and F.R.C. contributed equally to the work.
Funding sources: None.
Conflicts of interest: J.S.B. is co-Editor-in-Chief of the Journal.
References
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