Date of Award

January 2021

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Peter S. Yoo

Abstract

This study sought to characterize the effect of the COVID-19 pandemic on general surgery residencies’ use of social media and its effect on current applicants. A 2-part, mixed-methods cross-sectional study was performed using public Instagram and Twitter accounts of residencies and departments within general surgery and comparison surgical sub-specialties and using online anonymous surveys distributed to residencies’ accounts and to a convenience sample of current general surgery applicants. Among 332 general surgery residencies, as of mid-January 2021, 185 (55.7%) had a residency account and 87 (26.2%) that had a department account on Instagram (161 [48.5%] vs. 26 [7.8%], respectively) and/or Twitter (99 [29.8%] vs. 84 [25.3%], respectively); 124 (37.3%) lacked accounts on both Instagram and Twitter. Prior to the pandemic, Twitter predominated general surgery residencies’ and departments’ social media presence. Toward the beginning of the pandemic, residency account creation surged on Instagram, followed by and to a lesser extent on Twitter. Regressions of the change in the share of general surgery residencies and departments on social media showed that the interaction effect of the pandemic and peri-residency application season could explain residencies’ accelerated adoption of social media (adjusted R2s of 0.74 and 0.52 for Instagram and Twitter, respectively). A dummy variable for the pandemic-application interaction effect were large and significant at p≤0.01 for general surgery residencies on Instagram and Twitter; the pandemic dummy was also large and significant (p=0.03) for general surgery residencies on Instagram. The pandemic and pandemic-application interaction effect similarly affected residencies’ social media utilization and audience engagement. In contrast, departments’ adoption and utilization of social media was largely unaffected by the pandemic. Account administrators for recently-active residency Instagram accounts were survey, there were 18 complete responses (response rate 13.5%). The majority of accounts were solely resident-run. Trainee recruitment was uniformly a primary purpose of the account. A majority of respondents indicated that, in response to the COVID-19 pandemic, the accounts were created and/or their posting frequency increased. There were 52 complete applicant responses. 65% reported using Instagram and/or Twitter to research residency programs. Applicants viewed a median of 50% (IQR 20-62.5%) of the accounts for their prospective programs, if those programs had an account. The accounts primarily had a positive effect on applicants’ impressions of programs. These findings suggest that as a result of the pandemic, the role of social media – particularly residency accounts on Instagram – in the 2021 residency application and selection process is larger than ever before. Residencies and applicants may treat residencies’ social media as a substitute for in-person interactions.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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