Instagram’s Influence on Radiology Today: Reviewing the Evolving Educational Journey from a Hospital to National Societies

Abstract

We define social media as an interactive online platform that allows users to communicate and exchange knowledge. Educational and medical profiles have slowly emerged on different social media platforms, helping to teach about and publicize diverse aspects of medicine. Radiology is one of the specialties that could potentially benefit the most from social media, as the radiologist tends to have little outside-the-hospital representation. Progressively, audiovisual content has been gaining ground on social networks: Facebook, Twitter, Instagram, Youtube, TikTok, etc. Instagram appears to be ideally suited for radiology given its image-based nature. In addition, Instagram can also be used as a tool to help radiologists share and discuss radiological images, improve communication with clinicians and patients, advertise themselves and their specialty, and humanize their profession. Nevertheless, legal matters and privacy issues should always be taken into account when using these tools. In this overview, we describe the development of social networks and communication tools in our own radiology department, focusing especially on our Instagram account, as it has had a wide impact on our hospital and radiology residents around the country. We will also provide a summary of the various social media platforms used for radiology education along with their pros and cons, including useful tips for safe and efficient use.

Background

Since the early years of the twenty-first century, social media has been the dominant method of mass digital communication [1]. Social media takes the form of online applications or websites that allow sharing of information via virtual communities, public posts, and personal direct messaging. These communication forums are becoming increasingly popular among both the general public and radiologists [2]. Some of the most prestigious radiological societies have already added social media to their teaching armamentarium, as a tool that can help share and discuss radiological images, improve communication with clinicians and patients, advertise themselves and their specialty, and humanize their profession [2].

The use of social media among radiological institutions contributes to greater visibility and engagement of radiologists in the online virtual community [2]. However, many radiologists are still unaware of the wide spectrum of useful information and interaction available via social media, and of the added value these platforms can bring to their daily practice [2].

At the time of writing, the five most used social media platforms worldwide by Monthly Active Users (MAUs) are Facebook (2.7 billion MAUs), YouTube (2 billion MAUs), WhatsApp (2 billion MAUs), Instagram (1.1 billion MAUs), and TikTok (0.69 billion MAUs) [3]. TikTok is the fastest growing social network [4, 5].

Instagram is an image-based social network launched in 2010 [6]. Its growth has been exponential in the recent years, growing from 0.09 billion MAUs in January 2013 to exceeding one billion MAUs as of the most recent data [7]. Instagram stories have been similarly well-received since their creation in 2016, reaching 0.5 billion MAUs in January 2019 [8].

Instagram has been used for both professional development and for education, and it is important to note the young age of its users [9]. Instagram is most popular among the age range of 25–34 years, followed in second place by 18–24 years, which correlates with the years spent in medical and pre-medical education [10, 11].

Instagram is an incredibly intuitive and easy-to-use platform [12]. Most social media networks were designed for content building on a computer; however, Instagram is a smartphone- and tablet-based program that easily allows on-the-go posts and usage. It is ideally suited for radiology education because its primary content consists of images, unlike other social media networks. One key feature about Instagram is that all posts require an image, unlike other social platforms which allow text-only posts [12].

Main Text

Development of Social Networks and Communication Tools in Radiology Departments

Emergency medicine was arguably the first medical specialty to adopt social media for the purpose of medical education. One pioneer in this area was Michael Cadogan, an emergency physician who coined the term Free Open-Access Medical Education (FOAM or FOAMed) to describe a movement in which altruistic practicing physicians provided educational resources to students; his early contributions included critical care podcasts and the blog Life in the Fast Lane, founded in 2007 [1, 13].

Around the same time, Twitter, a social media network based on microblogging, began gaining popularity and was used within the FOAM community, recognizing content with the hashtag #FOAMed. Accordingly, radiologists adopted the hashtag #FOAMRad [1]. Twitter initially had a limit of 140 characters per post, but since 2017, Twitter has allowed users to post messages, or “tweets,” of up to 280 characters in length. This microblogging structure facilitates short, direct communications that may also contain pictures, video, and links to documents or websites [2].

Other forms of social media, such as dedicated blogs, Facebook, YouTube, Instagram, and TikTok have also been used to share educational content:

• Blogs

  A “blog” is a personalized social media platform with design and parameters set primarily by the content provider. Unlike other platforms, a blog offers complete control of style, content, and method of content delivery. It resembles a personal website but uses a blog platform to create one’s own virtual space. Blogs generally consist of a chronological feed of posts, composed of a mix of text, images, and videos (Fig. 1) [1]. They were the first user-personalized spaces on the Internet, and they are largely intended for computer use rather than being optimized for mobile devices. Because blogs tend to be heavily text-based, they are less frequently used today and remain most relevant in the freelance writing and journalism sphere. One of the best-known blogs on radiology is that of AuntMinnie, who also commented about the poster that we presented at the 2019 RSNA congress and who served as an inspiration for this article [14].

• Facebook

  Facebook is the most popular social media platform today among the general public, including physicians [15]. It has the largest user base of any social media platform, with 2.7 billion active monthly users [3]. This social network is centered on text-based interactions with the ability to embed photos, links, and videos [1]. In addition to several radiological organizations and scientific journals, many educational pages, including Radiology Signs and LearningRadiology, can be found on Facebook [1].

• YouTube

  YouTube is a platform created for publishing videos. It allows users to upload, view, rate, and share videos. YouTube is popular among physicians who offer their material for educational purposes online, and some radiological societies, such as the Radiological Society of North America (RSNA), have successfully adopted this practice. YouTube has seen extensive use during the pandemic; for example, Radiopaedia founder and editor-in-chief Frank Gallard started the Isolation Tutorials series specifically as a response to the changing educational landscape. Clips of YouTube videos can be published on other social media platforms, such as Facebook or Instagram.

• Instagram

  While other forms of social media were initially designed for use on the computer and later adapted for use on tablets and smartphones, Instagram functions primarily as a mobile app with an image-centric design. As radiology is a specialty based on imaging interpretation, Instagram is an ideal content-sharing platform [1]. There are multiple popular radiology accounts on Instagram that provide great examples of how to teach radiology, including @ctisus_radiology, @thexraydoctor, @theradiologistpage, and @radiopaedia.

• TikTok

  TikTok has been the latest development in the evolution of social media. TikTok is a social network that was founded in 2016 in China. It centers around sharing short videos, up to a maximum of 60 s, although most videos are 15 s long [16]. Since its creation, this social network quickly gained popularity, becoming the most downloaded social application in the USA in September 2019 [17].

  This social network based on videos mainly focuses on dance, comedy, and lip-syncing, often with background music. As with other social networks, users can interact with each other not only through comments and likes, but also through posting response videos.

  Given its popularity, certain users have been encouraged to upload educational content in an informal format. Some radiologists have seen the great potential of this social network and have begun to upload content (Fig. 2).

Fig. 1.

Example of a blog page from a Radiology Department (Hospital Universitario Marqués de Valdecilla). Blogs can be customized with its own layout and content. Blogs content several components: (1) post title, (2) leading thumbnail, (3) link to content, (4) main text, (5) visits counter, and (6) other videos/content

Fig. 2.

Video on Tiktok about MRI defecography. (1) main video, (2) username, (3) post caption, (4) music attatched to video, (5) interaction icons—follow, like, comment and share buttons-

Development of Social Networks and Communication Tools in our Radiology Department

The radiology department at Hospital Universitario Marqués de Valdecilla (HUMV) has done our best to be proactive in using social networks and communication tools for self-promotion, communication, and education. We started with an email account in 2001, created as a method to improve the department’s management and organization. It allows communication of interesting events, coordination of work schedules, and reporting of incidents.

Our first experience with true social media began in 2007 with a Facebook account called “HUMV Radiology Residents.” “HUMV Radiology Residents” was a private Facebook group in which previous radiology residents informally shared cases of radiological interest, recommendations for books and articles to improve their knowledge, and questions and concerns about residency. It is currently in disuse and has been supplanted in recent years by a WhatsApp group.

Subsequently, in 2008, our department created a blog (Fig. 1). It was the first social media network intentionally created to advertise our radiology department, record the important milestones of our radiologists, and answer questions for medical students interested in pursuing radiology residency at our institution. Many of our current radiology attendings chose to do their residency in our center as a result of this platform, and our senior resident received an award from the hospital for this innovative idea.

With the widespread use of smartphones and communication apps, creating a group chat in WhatsApp was our next step in 2012. WhatsApp Messenger is a freeware app owned by Facebook that offers cross-platform messaging and voice over internet protocol (VOIP) service. It allows users to send text and voice messages, make voice and video calls, and share images, documents, user locations, and other media. Given the great popularity of this social network in Spain, the radiologists of our department created their own WhatsApp group as a tool to share interesting radiological cases, resolve concerns, and organize social events in an easy and casual way. Currently, this social network has supplanted the “HUMV Radiology Residents” Facebook group.

Finally, in 2019, we created our Instagram account (@rayos_valdecilla) (Fig. 3). It emerged as an initiative to modernize the department, bring radiology closer to society, humanize the figure of the radiologist, and document important events pertaining to the department, among other issues.

Fig. 3.

Instagram account. (1) Biography, (2) link to Linkin.bio, (3) Messaging, (4) Featured Stories, where those stories that we do not want to disappear after 24 h are collected, (5) main page with all posts, (6) Instagram TV, (7) posts in which we are tagged, (8) Reels

In the beginning, Instagram posts were made manually, without any pre-programming or automation. However, given that most views took place at certain times and days of the week, it was decided to use the external application Hootsuite. This helped with scheduling important events and aided in reaching a larger audience. Hootsuite is an application that allows users to schedule posts and coordinate multiple social networks at the same time. At present, it allows users to integrate Twitter, Facebook, Instagram, LinkedIn, and YouTube accounts.

Hootsuite has free and paid options, the latter being more geared toward companies. Its free version allows the management of three social networks and the programming of a maximum of 30 posts (Fig. 4).

Fig. 4.

Example of scheduling Instagram posts in Hootsuite. (1) access icon to the Hootsuite planning calendar, (2) thumbnails of the posts scheduled during the week, (3) magnified preview of one of the scheduled posts, (4) descriptive text of the post with Hashtags and mentions of other radiological education profiles

One of the problems we encountered when starting the account was that we did not know how to link our brief posts to more extensive coverage elsewhere on the internet, as Instagram does not allow users to include links by default. This fact became especially relevant when we recommended articles, because our followers wanted full access to them. We decided to use the Linkin.bio tool, a free tool provided by the company Later.

Later was founded in 2014 as the first Instagram post planner [18]. Its Linkin.bio tool redirects the user to a page with the same aesthetics as the main Instagram page, on which the linked content of each post can be accessed by selecting the desired image.

Because Later allows users to directly link to external content as well as schedule publications (Fig. 5) and stories in its paid version, we decided to leave Hootsuite aside to manage our Instagram only with Later.

Fig. 5.

Example of how to schedule a post on Later. (1) Thumbnail of the photo to be published, (2) post caption, (3) text box where to copy the Link to link to the post, (4) configuration of the post publication time

These have been the communication and social media tools used by our service to date (Fig. 6). Due to the constant evolution of social networks and their fluctuating popularity, we acknowledge that we must be flexible and open to new features and new platforms in the future.

Fig. 6.

The chronological evolution of different social media networks used by our department. In 2007, a private Facebook group was created to share cases of interest and radiological doubts. In 2008, the resident tutor created a service blog to collect events of interest and make our hospital known to students and/or residents. In 2012, given the popularity and easy availability of WhatsApp, a WhatsApp group was created where radiologists discussed cases of interest and organized events. Finally, in 2019, the Instagram account was created to reach a larger audience and modernize the Service

Instagram’s Impact on Our Department

Positive aspects

Negative aspects

• Greater visibility of our radiology department in our hospital • Increased knowledge about the existence of our department and the activities that we perform among other radiology departments at a national and international level • Greater understanding and appreciation of the radiologist’s work in the community • Greater recognition, nationally and internationally, of our radiology department and of the specialty of radiology • Greater humanization of the radiologist’s figure by other healthcare workers and society • Increase in the number of medical students and radiology residents who would like to know us better • Greater teamwork building among radiologists, technicians, and nurses. All workers have contributed to the development of the @rayos_valdecilla account

• The material that is uploaded is selected only by the administrator of the account, who decides the type of content and the posting pattern. This could lead to, depending on the tastes of the administrator, emphasizing certain subspecialties over others. • Content should be uploaded at peak times to cater to the audience. These times may be inconvenient for the administrator. However, this problem can be solved with the help of a publication scheduler • Only positive aspects of the service tend to be published • Increased exposure to criticism, as the service is directly exposed publicly • Aimed primarily at a younger audience

Instagram's Impact on Our Hospital

The creation of our Instagram account has made other departments in our hospital, such as radiation oncology and anesthesia, realize the benefits of showcasing their own work on social networks (Fig. 7). Many other departments are now considering creating their own accounts.

Fig. 7.

Overview of the impact of our Instagram account. At the regional level, other services within our hospital decided to create their own Instagram account following our example (@anestesia_humv and @oncoradio_vadecilla). Given the success of our account, we decided to create another account for Spanish radiology residents (@residentes.seram). The latter had a great impact, inspiring other prestigious radiological societies across the country to create their own accounts (@serveisoc_ and @mskserme)

Instagram’s Impact on our Country (Spain)

Following the success of @rayos_valdecilla, the creator of the account understood the impact social media could have nationally and collaborated with medical residents in other regions on a new account (@residentes.seram) that strives to represent all the medical residents of the Spanish Society of Medical Radiology (SERAM). From its inception, this account was managed with Later in order to distribute the work among residents, post more efficiently, and reach a larger audience by scheduling posts at the times and days that have the greatest influx of traffic to the profile. Being a national account, the impact was much greater, and a few months later, SERAM decided to add us as a recognized working group in their social networks [19].

Months after its creation, other radiological societies in the country took the initiative to create their own accounts, namely, the Spanish Society of Musculoskeletal Radiology (@mskserme) and the Spanish Society of Vascular and Interventional Radiology (@serveisoc_) (Fig. 7).

How to Create a Successful Instagram Account for Radiology Education

New forms of education and promotion have arisen since the beginning of the so-called social media era. Brands, public and private institutions, sports teams, organizations, political parties, and personalities use social media as a platform for self-promotion. In the case of education-based profiles on social media, the altruistic spread of knowledge is the main goal.

Radiology as a field can easily take advantage of social media, especially Instagram, as a platform. The following premises must be taken into account in order to develop a successful radiology Instagram account:

• Account preferences

  The account should be set to public mode rather than private so that potential followers can see the account content and decide if they are interested in following it.

• Personalized content based on your audience

  While there are multiple apps available that can provide analytic data on the followers of an account, switching from a “personal account” to a “professional account” automatically allows users to access “Insights on Instagram,” a feature that provides highly valuable information about the age, gender, and country of origin of your followers. Moreover, it provides statistics about the days and times of active app usage for the previous week and month; knowing such information helps you schedule and tailor your content to increase engagement. If you wish to have data covering a longer term, other applications external to Instagram are necessary, and these generally come with a price tag.

  At the time of writing the article, our Instagram following is made up of 67% women and 33% men. The age group that most visits our profile is 25–34 years (up to 57% of the total), followed by 35–44 years (up to 25%). Most views are registered in the evening, with the busiest time being between 6 and 9 p.m. (Fig. 8).

• Promoted posts

  Another feature of professional accounts on Instagram is the ability to promote posts, which involves paying a certain amount of money determined by the duration of the promotion in order to reach a given estimated number of users. A promoted post periodically appears in the feed of non-followers as an ad and helps reach a wider audience. It could be a valuable feature once a user has created a profile that represents an organization and has reached such a level of engagement and followers that introducing money in this app may result in a positive outcome. Although this option exists, we have not considered it necessary to our profile for the moment.

• Theme

  All content posted should relate to radiology education [12]. Videos and images should help students and colleagues learn about the interpretation of radiology, as well as keeping them up to date on the latest innovations in the field.

• Variety

  Images should have a degree of variety in order to promote the wide scope of present-day radiology. Posts may include multiple methods of imaging, such as CT, MRI, and x-ray, for a single disease process (Fig. 9). Other examples may include multiple imaging exams in a single patient. Radiology images can be accompanied by illustrations of anatomy or pathology along with key points for a better understanding of disease processes [12].

  Inclusion of advanced postprocessing images can also pique viewers’ interest.

• Regularity

  Followers prefer a regular posting pattern rather than a randomized one [20]. As people tend to check their social media more often on certain days of the week and at particular times, choosing the right time to post can help to increase the number of followers. To facilitate this, there exist multiple free programmers and other paid versions such as Later or Hootsuite (Figs. 4 and 5), as discussed above.

• Quality

  When posting, it is important to prioritize quality over quantity of images and videos. One of the recent benefits added to Instagram is that since 2015, Instagram no longer converts images and videos to a square format. While the square format is still ideal for previewing all of a user’s posts on their Instagram grid, posted images and videos can have up to a maximum ratio of 4:5 in portrait orientation and 1.91:1 in landscape orientation. In addition, both image and video posts can be made in high resolution, with a maximum of 1080 × 1350 pixels in portrait orientation and 1080 × 608 pixels in landscape orientation [21].

  It is important to note that for video uploads, Instagram’s default setting is autoplay with sound off [12]. This means that the viewer must remember to turn on the volume at the start of the video. Sometimes, when social media users are on the go or in public places and have no headphones available, synchronized subtitles represent a valid alternative that is becoming widespread among some brand and news accounts. It allows video consumption without the need for headphones, relying only on the image and subtitles. While regular video posts are limited to 1 min in length, longer videos can be uploaded through the new feature Instagram TV (IGTV) and Reels.

• Hashtags

  The hashtag creates a link from the posted image or video to other posts that have been captioned with the same hashtag. Therefore, when viewers search for a certain hashtag, it leads to an array of posts in the same category. Users can also follow a hashtag, allowing them to stay updated daily on the category they are following. Captioning with multiple hashtags increases the likelihood that a post will be viewed [12]. Hashtags also help categorize your content and engage with profiles similar to yours, creating a positive feedback loop with similar accounts. The ultimate result is gaining followers and reaching a greater audience.

  Although there is no standardized hashtag repository, there are more popular hashtags, which change over time and with the type of platform. Among the most frequent generic hashtags, it is worth highlighting #FOAMRad, #FOAMEd, and #Radiology, as previously mentioned [22]. There are also web pages that allow you to search for the most used hashtags in any field [23]. When using hashtags with multiple words, it is best to capitalize the first letter of each new word. For example, to tag a post “radiology cases,” the hashtag should be rendered “#RadiologyCases,” not “#radiologycases”. This allows screen-reader apps to correctly read the hashtag out loud and contributes to the overall accessibility of the social media space.

• Other limitations

  Each Instagram post allows a maximum of 10 images. In radiology, this does not usually represent a problem because the goal is to capture the user’s attention with the most representative images and concepts. A total of 20 accounts can be tagged in each post. The number of characters per post is limited to a maximum of 2200, within which up to 10 accounts can be mentioned and a total of 30 hashtags can be added. The character limit of the account bio is only 150, which forces one to create a profile with a simple and direct description [24].

• Instagram stories

  “Instagram stories” is a feature launched in 2016 that allows users to post images and video content in a continuous slideshow format that is only available for 24 h from the time of posting. Instagram story posts have a maximum ratio of 9:16 and resolution of 1080 × 1920 pixels. Instagram stories have quickly become one of the most popular features of the platform, allowing the display of more content while maintaining a clean main account. Stories can promote user interaction by allowing viewers to either free-write responses or select multiple-choice answers to quiz questions (Fig. 10).

  In our case, using the quiz functionality available on Instagram stories, we decided to carry out a survey using a mechanism similar to the Likert scale to quantify how interesting the content seemed to our followers. We got 40 responses with an overall result of 4.5/5 (Fig. 11).

  As we have already mentioned, Instagram stories allow free responses. We asked to what extent our account had affected the department. Responses included greater visibility for the service and social outreach, improved teamwork, and information for future residents.

• Instagram new features

  • Instagram TV: IGTV is a feature that was created in 2018 to allow uploading videos in both vertical and horizontal formats for public access [25]. Videos can be up to 15 min long when uploaded from a mobile device and up to 60 min long when uploaded from a computer [26]. The videos are saved in the form of thumbnails in the main profile of the Instagram account and in turn in the IGTV application itself. At present, IGTV is not a popular tool, and among radiological societies with an Instagram presence, these videos have few views.
  • Instagram Reels: this is the latest feature, launched in August 2020 [27], which allows uploading short videos of up to 30 s [28]. Reels emerged as the great competitor to TikTok, using an almost identical format. In fact, most of the videos found on Reels have previously been uploaded to TikTok. Reels has put IGTV on the back burner, and, though largely unexplored, may have an educational potential.

• Patient data

  When posting about patient cases, the images and accompanying text must be anonymized to protect patient identity, for both ethical and legal purposes. This is especially important when it comes to radiological studies, because in most cases, patient name and data are present on the images themselves.

Fig. 8.

Insights of Instagram. This is a feature aimed at company profiles that allows the user to analyze the number of visits, the accounts reached, and the demographic data of followers. (1) Header, which explains that the data analyzed is from the previous week; (2) percentage graph that collects the gender of the followers; (3) time bands with the highest profile views; (4) the city of origin of the followers; and (5) age distribution of followers

Fig. 9.

Post including multiple methods of imaging. This post depicts a small cell lung cancer in the left superior lobe on plain radiography (A), MRI (B) and CT (C), and a CT-guided biopsy (D)

Fig. 10.

Instagram as a teaching tool. A and B show two Instagram stories aimed at radiological education. A (1) perfusion maps of an ischaemic stroke, (2) multiple choice quiz related to previous images. B (3) volume rendered reconstruction of the circle of Willis in a patient with a thrombus in the right middle cerebral artery, (4) GIF, and (5) a panel that allows the user to interact with the account administrator

Fig. 11.

Example of an IG story aimed at objectively collecting the opinion of our followers. (1) Story imitating a Likert scale through the utilities offered by IG stories, posting the question: “Do you find the contents of this account interesting?” (2) Vision of the profile administrator of the results obtained during the voting. Forty users voted, with a very positive final score of 4.5/5

Uses of Instagram

• Teaching tool

  Instagram’s combination of images, drawings, videos, and comments makes it a perfect teaching tool. In addition, one of the most acclaimed teaching features is “Instagram stories.” Stories allow the content creator to insert polls, quizzes, and GIFs (Fig. 10) along with the posted images and videos to make learning as interactive and dynamic as possible.

• Communication tool

  Instagram allows users to communicate their ideas and exchange opinions by commenting on posts, sending private direct messages, and giving likes to both posts and comments from other users.

• Method to make the radiologist’s work more transparent

  Social networks remind clinicians that behind the radiological images that they use in their daily practice to assist patients, there is a team that performs the imaging and quality radiologists who report the findings. Instagram also allows patients to understand that radiological studies require a radiologist for accurate interpretation. Social media allows the figures of the radiologist and radiology technician to be humanized, as they oftentimes remain unseen.

• Opportunity to publicize our service, hospital, and region at a national and international level

  Instagram, like other social networks, acts as a perfect showcase to publicize the best aspects of a radiology department to the general public. In the medical field, it has the potential to reach across professional roles, from technicians, students, and residents to physicians. Specifically, it can inspire more medical students to pursue radiology as a specialty by reaching them early in their premedical and medical education.

Privacy Matters and Legal Concerns

Currently, radiologists are using free and accessible open cloud storage services and social media platforms to share radiological images, mostly due to convenience and lack of access to encrypted software. Unfortunately, these methods of storage risk exposure of private patient information, as they are public platforms and were not created for this purpose.

For this reason, some organizations have set stringent policies to protect patient information, such as prohibiting healthcare workers from taking pictures with personal mobile devices that have immediate access to social media [2]. In addition, many physicians are deterred from posting medically related information on social media sites such as Instagram, due to legal concerns and the potential repercussions that it could have on their careers. This is especially relevant in countries where medical doctors could lose their license for violating strict laws protecting patient information, such as the Health Insurance Portability and Accountability Act (HIPAA) in the USA.

There are also ethical concerns about posting a patient’s study, even anonymously, without their consent. Unfortunately, most patients are unaware that media containing their personal imaging may be used, and they should have the right to provide consent and thereby participate in the use of their images.

The General Data Protection Law (GDPR) promotes obtaining informed consent whenever possible, as well as the anonymization, pseudo-anonymization, and encryption of personal and demographic data [29].

The ideal solution would involve the development of clear guidelines and proper security mechanisms, which would allow the medical community to embrace the use of social media networks for medical education [30].

Conclusions

Over the last decade since Instagram was created, it has become one of the fastest growing social media networks. With the use of social media on the rise as a teaching tool in the field of medicine, Instagram’s modernity and its image-based nature make it the ideal platform for radiology education. In addition to teaching, it can be used as a way to promote interest in the field of radiology among aspiring pre-medical and medical students, especially as the majority of Instagram users correlate with this age range.

Radiology as a specialty can oftentimes be obscured by other fields which have more direct patient contact. Instagram can be used to showcase the work that the radiology team performs behind the scenes, humanizing the figure of the radiologist behind the imaging machine. By fully utilizing the features offered by the application, Instagram can help a small radiology department gain international recognition while also promoting teamwork within the department. At the University Hospital Marqués de Valdecilla, we have seen both benefits with our Instagram radiology account and plan to develop it further moving forward.

Currently, the largest obstacles deterring physicians from posting on social media are legal and ethical concerns. Laws regarding the protection of patient privacy differ in every country, and international laws have yet to be developed. Importantly, it is not only the publication of images that require attention in this area, but rather the storage of patient information on personal devices that is at equal risk of exposure. In the future, the development of guidelines and encrypted software to protect patient information is a necessary step in expanding the use of social media for medical education.

Declarations

Competing Interests

The authors declare no competing interests.