Doctority: Plastic Surgery—An Informative Podcast for Applicants to Learn about Plastic Surgery Training Programs

Summary:

The COVID-19 pandemic limited the ability of medical students to participate in plastic surgery sub-internships and to attend residency interviews in person during the 2020–2021 match cycle. A podcast and accompanying online directory were created to introduce integrated plastic surgery residency programs to medical students from the perspective of current residents. Since July 2020, a total of 49 plastic surgery residents representing 42 programs have participated in the podcast. Topics of discussion included program logistics, faculty leadership, and aspects of resident lifestyle of interest to medical students and future residency candidates. The podcast has had a total of 5072 downloads (mean 121 downloads per episode). The majority of listeners (90%) were in the United States. Twenty-five plastic surgery applicants who participated in the 2020–2021 National Resident Matching Program match cycle responded to a feedback survey. Listeners reported that the podcast was useful for preparing for interviews, making rank lists, and learning about programs that they otherwise would not have considered. Most listeners (90%) ranked the podcast as one of their top three resources for learning about plastic surgery programs during the application and interview process. Future directions include completion of episodes for all integrated plastic surgery programs and expansion to other surgical subspecialties and plastic surgery fellowships.

INTRODUCTION

The COVID-19 pandemic limited the ability of medical students to participate in plastic surgery sub-internships and to attend in-person residency interviews during the 2020–2021 National Resident Matching Program (NRMP) match cycle, during which 329 applicants sought 187 PGY1 positions offered across 85 integrated plastic surgery residency programs.^1,2 This limitation led to the development of innovative educational resources and remote, asynchronous learning opportunities, such as virtual “meet-and-greet” webinars hosted by the American Council of Academic Plastic Surgeons (ACAPS), increased social media engagement by individual residency programs, remote sub-internship experiences, and an international virtual self-study plastic surgery curriculum.^3–7 Despite these efforts, it was still challenging for applicants to navigate the digital landscape and find information to evaluate and compare programs. The “Doctority: Plastic Surgery” podcast was created to address this need and provide a useful resource for plastic surgery residency candidates.

METHODS

Starting in May 2020, integrated plastic surgery residents were recruited via personal email or their residency program’s social media account to participate in podcast episodes. Residents were also asked to recruit residents from other programs to participate. Residents were asked a set of standardized questions to facilitate comparison across programs. Episodes were recorded remotely via Zoom videoconferencing, edited with Audacity, an audio recording and editing software, and hosted via Megaphone, a podcast-hosting service. An accompanying website (https://doctority.co) was created that contained all podcast episodes and an online program directory. The podcast was publicized via Instagram, Twitter, and an online public plastic surgery applicant spreadsheet created by the first author (JRS). In March 2021, a feedback survey was posted publicly on social media and sent via email or social media message to 2021 plastic surgery applicants from various medical schools who either followed the podcast on social media or had made their email addresses publicly available via the spreadsheet. (See appendix, Supplemental Digital Content 1, which displays the survey content. http://links.lww.com/PRSGO/B724.) This quality improvement project was reviewed by the Northwestern University institutional review board and determined not to meet the criteria for human subjects research.

RESULTS

As of March 2021, 49 plastic surgery residents representing 42 integrated plastic surgery programs participated in the podcast. (See figure, Supplemental Digital Content 2, which displays a map of locations of participating programs. http://links.lww.com/PRSGO/B725.) Discussion topics included logistics (number of months of different rotations, research support, electives, etc.), leadership (information about their program director and chief of the division or chair of the department), and important aspects of resident lifestyle (camaraderie, costs of living, home ownership, maternity/paternity benefits, local culture, etc). Episodes ranged from 17 to 49 minutes (mean 31.6, SD 8.2). The podcast had a total of 5072 downloads (mean 121 downloads per episode) and a total of 2514 unique listeners (Fig. 1). Although listeners were from 47 different countries, the majority (90%) were in the United States. (See table, Supplemental Digital Content 3, which shows a list of the 10 countries with the highest numbers of total downloads. http://links.lww.com/PRSGO/B726.)

Fig. 1.

Number of episode downloads per week over time. The first episode of the podcast was published in June 2020. The increase in downloads starting in December 2020 corresponds to the release of integrated plastic surgery residency interview invitations and continues throughout the interview season (December 2020–February 2021).

The survey link was sent to 43 applicants who either “followed” the podcast’s Instagram account (n = 16) or posted their email address on the spreadsheet (n = 27). It was also promoted publicly on Instagram and the spreadsheet for two weeks. Twenty-five plastic surgery applicants responded to the survey (resulting in a response rate of 7.6% of all 2021 applicants) (Table 1). Respondents reported listening to a mean of 12.7 episodes (SD = 9.1). The majority expressed that the podcast was useful in helping them prepare for interviews (100%), make their rank lists (91%), and learn about programs they otherwise would not have considered (79%) (Fig. 2). A smaller percentage reported that the podcast was influential in helping decide where to apply (33%) or interview (8%). Thirty-five percent reported that the “Doctority: Plastic Surgery” podcast was the most helpful resource to learn about programs, and 90% ranked it in their top three most helpful resources (Fig. 3). All respondents (100%) would recommend the podcast to a friend, and most (96%) recommended expanding to additional specialties.

Table 1.

Characteristics of Plastic Surgery Applicants Who Responded to the Feedback Survey (n = 25)

Listener Type	n	%
Medical student or physician who applied to plastics this cycle	25	100%
Referral Source	n	%
Plastics Applicant Google Spreadsheet	12	48%
Instagram	10	40%
Friend	3	12%
	Mean	SD
No. episodes listened to	12.7	9.1

The survey was publicized on social media (Instagram) and emailed to a cohort of matched plastic surgery applicants.

Fig. 2.

Responses of listeners to the statement: “The podcast helped me….” Listeners were able to indicate their agreement to the statements with a five-point scale from “strongly disagree” to “strongly agree.”

Fig. 3.

Listeners’ rankings of resources to learn about integrated plastic surgery programs, where 1 indicated the most helpful resource, and 8 indicated the least helpful resource.

In narrative responses, listeners praised the consistency of the standardized questions, the comprehensive information provided, the program directory design, and hearing directly from current residents. To improve, listeners suggested asking questions about diversity and inclusion, adding an anonymous comment section to the website, and interviewing multiple residents per program and/or faculty members.

DISCUSSION

Podcasting is a convenient method of sharing information that has been utilized in the application process and curriculum for both medical school and residency.^8–10 It is especially popular in emergency medicine, internal medicine, family medicine, and general surgery,⁸ and it has been identified as a promising educational tool during the COVID-19 pandemic.¹¹ Before the creation of “Doctority: Plastic Surgery,” podcasting had not been used to profile specific residency programs in plastic surgery.

Plastic surgery podcasting began with the publication of the podcast of the journal Plastic and Reconstructive Surgery (PRS) in 2006.¹² There are multiple educational plastic surgery podcasts currently available (“PRS Journal Club” and “PRS Global Open Keynotes”), podcasts sponsored by other journals (European Journal of Plastic Surgery, Journal of Plastic, Reconstructive, and Aesthetic Surgery), podcasts by individual surgeons (“Plain Talk about Plastic Surgery,” “Plastic Surgery Revision,” “Plastic Surgery Experts”) and resident-run podcasts (“The Loupe,” “The Resident Review,” “Quick Cuts”).¹³ Of note, other podcasts focus on plastic surgery education for trainees and laypeople, whereas “Doctority: Plastic Surgery” is unique in that it specifically targets plastic surgery applicants and provides comprehensive information about multiple programs through the perspective of current residents.

The podcast was demonstrated to be an effective educational tool for plastic surgery applicants. The personal interview style between a medical student and a resident allowed for candid conversation on topics relevant to applicants’ interests. The audio format of the podcast and streamlined website design provided a convenient way for medical students to prepare for interviews. In addition, the uniform interview structure facilitated program comparison. It was unsurprising that the podcast did not play a large role in the decision of where to apply or accept interviews, as students tend to apply to a large number of programs and weigh factors such as geographic preference strongly during that stage of the application process.¹⁴ From the feedback survey, the podcast’s true value was revealed as a principal resource in interview preparation and post-interview reflection before ranking.

Limitations include small sample size and the public distribution of the survey. The former issue reduces generalizability to all plastic surgery applicants, whereas the latter makes it difficult to verify whether the survey respondent listened to the podcast. In addition, by conducting the feedback survey after the match, it may have been more likely for matched applicants to respond than unmatched applicants, and match outcome could have influenced the perception of the podcast. These concerns could be mitigated by distribution of the feedback survey to a listserv of all plastic surgery applicants before the match results and/or the development of a podcast-specific listserv to distribute future quality improvement surveys.

Future directions include incorporation of listener suggestions, completion of episodes for all integrated plastic surgery programs, and expansion to provide residency information about plastic surgery fellowships and other specialties. Innovative methods of digital engagement like podcasting have the potential to benefit future generations of medical students even after the pandemic has resolved and help them make informed decisions as they proceed through the match process.