Dear Editor,
Introduction
As a result of the COVID-19 pandemic, medical students approaching residency faced numerous challenges due to the social distancing requirements that became a necessity. Barriers included shortened clerkships, fewer in-person patient care experiences, canceled visiting student rotations, and difficulty engaging with residency programs on a personal level. Medical students had limited access to the interpersonal interactions between residents and faculty that forge connections and convey a realistic view of medical facilities and the surrounding area.
Social media offers a place for applicants to gain a better understanding of the “culture” of a program, without having to invest the time and money for a visit in person.1 Across surgical specialties, there has been an increase in residency program social media platform involvement to meet this demand, with integrated plastic surgery having a relatively large percentage of residency programs with social media presence compared to other surgical specialties. Since 2018, integrated plastic surgery residencies’ presence on social media has increased dramatically, with Instagram being the most utilized platform.2
The aim of this study was to elucidate the initial effect of the COVID-19 pandemic on integrated plastic residency program social media presence by evaluating programs’ posting history, follower count, and content posted surrounding the 2020–2021 virtual recruitment cycle.
Methods
A list of integrated plastic surgery residency programs was created using the American Council of Academic Plastic Surgeons (ACAPS) website. Instagram accounts for each program were found using program website listings and keyword searches. The virtual recruitment study period was defined by a start date of May 15th, 2020, and an end date of October 21st, 2020 to align with the ACAPS spring announcement of a virtual cycle through the fall revised application deadline. Data collected included post counts, dates, and types, quantitative usage of IG TV video reels and IG “Story Highlights,” and follower count.
Results
At the time of data collection, following the ERAS deadline, 76 (92.7%) of the 82 integrated plastic surgery residences had a program-specific Instagram account. Figure 1 shows the cumulative number of residency programs that had made their first post plotted against the date of this inaugural post. The average number of posts per day prior to the virtual application announcement was 0.1, which increased to 0.17 following the announcement—an additional ∼21 posts per month on average. Nearly half, 41.8% ± 3.53% of the total posts, were generated during the virtual recruitment period. For 21 programs, posts made during this period accounted for greater than 50% of their total posts.
Figure 1.
Cumulative number of integrated plastic surgery residency programs with first Instagram posts. Vertical dotted lines indicate the dates of the virtual recruitment study period (May 15, 2020 through October 21, 2020). Blue lines indicate the average number of Instagram posts per day for the periods prior to and following the announcement of a virtual cycle (0.1 and 0.17, respectively).
Integrated plastic surgery programs utilized a variety of post types on their Instagram accounts (Table 1 ) including both image series and videos. Multi-image content was the most common media used other than single image posts, with multi-image content comprising 36.7% of overall posts. Video posting was less common, with video posts responsible for 10.5% of total posts. Number of residency positions available was positively related to number of posts created and number of followers, with linear regression coefficients 6.91, p < 0.005 and 322.2, p < 0.005, respectively.
Table 1.
Integrated plastic surgery instagram use metrics.
| Data point/characteristic | Value |
|---|---|
| During study period: | |
| Programs making 1st post | 13 |
| Total posts | 2073 |
| Average posts per account | 27 |
| range 1–122 | |
| median 22 | |
| Mean followers per account | 1451 |
| range 378–4703 | |
| Follower:following ratio | 7.6 |
| range 0.44–131.4 | |
| Regression coefficients | |
| # Positions available & post volume | 6.91 (p < 0.005) |
| # Positions available & follower volume | 322.2 (p < 0.005) |
| Percentage of programs using various media types: | |
| Multi-image content | 94.7% |
| Video content | 51.3% |
| Instagram TV reels | 39.5% |
| Story Highlights | 65.8% |
Discussion
Integrated plastic surgery residencies are more active on Instagram than several other surgical specialties. This parallels the massive prevalence of social media use for marketing to patients within the field of plastic surgery.3 We have demonstrated an increase in social media activity that coincides with the transition to a virtualized application cycle, with almost half of all existing posts from integrated plastic surgery residencies occurring during the virtual applicant recruitment period. The number of residency positions was positively related to the number of posts and the number of followers, indicating that account owners may put more effort into their content if they are recruiting a larger number of residents.
Social platforms like Instagram offer programs the opportunity to reach applicants instantaneously, and in a way democratize dissemination of information. However, this is a one-way communication channel until viewers—presumably prospective applicants—contact programs via messaging or other routes. There may be a hesitancy to engage with residency programs on social media due to concerns that contact would draw attention to the applicant's own social media account;4 11% of general surgery program directors have lowered the rank or removed an applicant from the rank list due to their online presence.5
Throughout the past few years, social media has become an important way for integrated plastic surgery residency programs to reach medical students. Due to the COVID-19 pandemic, medical students’ ability to access information about residency programs via traditional methods was compromised, making digital media outreach more necessary. While the lasting implications of virtual cycles remain unclear, it is likely that social media will continue to be an integral component in how residencies market themselves to applicants. In the future, specific guidelines for residency programs, residency applicants, and engagement between the two will be necessary.
Ethical approval
Not required
Funding
None.
Declaration of Competing Interest
None declared.
Footnotes
Presented at the Ohio Valley Society of Plastic Surgeons Annual Meeting 2021 and the American Council of Academic Plastic Surgeons Annual Meeting 2022.
This study was exempt from institutional review board review.
References
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