Improving Transparency in the Residency Application Process: Survey Study.

BACKGROUND: Increasing numbers of residency applications create challenges for applicants and residency programs to assess if they are a good fit during the residency application and match process. Applicants face limited or conflicting information as they assess programs, leading to overapplying. A holistic review of residency applications is considered a gold standard for programs, but the current volumes and associated time constraints leave programs relying on numerical filters, which do not predict success in residency. Applicants could benefit from increased transparency in the residency application process. OBJECTIVE: This study aims to determine the information applicants find most beneficial from residency programs when deciding where to apply, by type of medical school education background. METHODS: Match 2023 applicants voluntarily completed an anonymous survey through the Twitter and Instagram social media platforms. We asked the respondents to select 3 top factors from a multiple-choice list of what information they would like from residency programs to help determine if the characteristics of their application align with program values. We examined differences in helpful factors selected by medical school backgrounds using ANOVA. RESULTS: There were 4649 survey respondents. When responses were analyzed by United States-allopathic (US-MD), doctor of osteopathic medicine (DO), and international medical graduate (IMG) educational backgrounds, respondents chose different factors as most helpful: minimum United States Medical Licensing Examination (USMLE) or Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Step 2 scores (565/3042, 18.57% US-MD; 485/3042, 15.9% DO; and 1992/3042, 65.48% IMG; P<.001), resident hometown region (281/1132, 24.82% US-MD; 189/1132, 16.7% DO; and 662/1132, 58.48% IMG; P=.02), resident medical school region (476/2179, 22% US-MD; 250/2179, 11.5% DO; and 1453/2179, 66.7% IMG; P=.002), and percent of residents or attendings underrepresented in medicine (417/1815, 22.98% US-MD; 158/1815, 8.71% DO; and 1240/1815, 68.32% IMG; P<.001). CONCLUSIONS: When applying to residency programs, this study found that the factors that respondents consider most helpful from programs in deciding where to apply differ by educational background. Across all educational groups, respondents want transparency around standardized exam scores, geography, and the racial or ethnic backgrounds of residents and attendings.

Comparison of Electronic Health Record Messages to Mental Health Care Professionals Before vs After COVID-19 Pandemic.

This qualitative improvement study examines the change in electronic health record messaging from patients to mental health professionals before vs after the COVID-19 pandemic.

Assessment of the Dissemination of COVID-19-Related Articles Across Social Media: Altmetrics Study.

BACKGROUND: The use of social media assists in the distribution of information about COVID-19 to the general public and health professionals. Alternative-level metrics (ie, Altmetrics) is an alternative method to traditional bibliometrics that assess the extent of dissemination of a scientific article on social media platforms. OBJECTIVE: Our study objective was to characterize and compare traditional bibliometrics (citation count) with newer metrics (Altmetric Attention Score [AAS]) of the top 100 Altmetric-scored articles on COVID-19. METHODS: The top 100 articles with the highest AAS were identified using the Altmetric explorer in May 2020. AAS, journal name, and mentions from various social media platforms (Twitter, Facebook, Wikipedia, Reddit, Mendeley, and Dimension) were collected for each article. Citation counts were collected from the Scopus database. RESULTS: The median AAS and citation count were 4922.50 and 24.00, respectively. TheNew England Journal of Medicine published the most articles (18/100, 18%). Twitter was the most frequently used social media platform with 985,429 of 1,022,975 (96.3%) mentions. Positive correlations were observed between AAS and citation count (r2=0.0973; P=.002). CONCLUSIONS: Our research characterized the top 100 COVID-19-related articles by AAS in the Altmetric database. Altmetrics could complement traditional citation count when assessing the dissemination of an article regarding COVID-19. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/21408.

Understanding the Use of Program Resources During Virtual Recruitment by Psychiatry Residency Applicants.

OBJECTIVE: This study aims to understand the residency resources used by psychiatry applicants who applied during the first two virtual recruitment seasons, match 2021 and 2022. METHODS: Between January 27, 2022, and February 24, 2022, a non-probabilistic sample of psychiatry residents from the match 2018 through match 2022 cycles were asked to complete a survey via email and social media. Due to the continuation of virtual recruitment post-pandemic, an analysis of psychiatry residents in the match 2021 and 2022 cycles was conducted. Questions assessed the use of recruitment resources, including websites, the Fellowship and Residency Electronic and Interactive Database, virtual open houses, video tours, away rotations, and social media platforms. Descriptive statistics and chi-square analyses were used. RESULTS: Psychiatry residents from the match 2021 and 2022 cycles completed the survey (n = 605), with 288 US allopathic medicine doctors (47.6%), 178 (29.4%) international medical graduates, and 139 (23.0%) osteopathic medicine doctors. More than half of respondents (n = 347, 57.4%) reported that the virtual interview season increased the number of programs they intended to apply to. Most respondents (n = 594, 88.3%) reported attending one or more psychiatry virtual open houses and 84.6% (n = 512) followed psychiatry residency programs on at least one social media platform. Program websites were reported to be the most influential digital platform for both applying and ranking. CONCLUSION: Understanding the influence of recruitment resources is essential for residents and program leadership to optimize time and resources to assist applicants with their decision-making.

Evaluating Diversity and Inclusion Content on Graduate Medical Education Websites.

Websites are important tools for programs to provide future residency applicants with freely accessible information regarding their program, including diversity, equity, and inclusion (DEI) initiatives. OBJECTIVE: To describe the variability of DEI content in residency programs and compare DEI website content by specialty. METHODS: Using the 2021 Accreditation Council for Graduate Medical Education (ACGME) list of residency programs, residency training websites were identified and evaluated. Information was extracted from program websites as indicators of DEI content. Chi-square analysis and one-way ANOVA were chosen to assess for statistical differences. RESULTS: In total, 4644 program websites representing 26 specialties were assessed. Among all the programs, the average DEI completeness of a program website was 6.1±14.6% (range 0-100%). While 6.2% of all programs had a diversity webpage, only 13.3% included a commitment to DEI, and few programs (2.7%) provided information about underrepresented in medicine (URiM) faculty. CONCLUSIONS: Graduate medical education programs can enhance information for current and prospective applicants about DEI initiatives on their websites. Including DEI initiatives on residency websites may improve diversity recruitment efforts.

Higher 2-Year Cumulative Incidence of Mental Health Disorders Following Antibiotic Spacer Placement for Chronic Periprosthetic Joint Infection following Total Joint Arthroplasty.

BACKGROUND: The relationship of chronic periprosthetic joint infection (PJI) treatment on the development and relapse of mood disorders remains largely unreported. This study aims to compare the incidence of different mental health disorders following antibiotic spacer placement for chronic PJI when compared to aseptic revisions and primary procedures. METHODS: Patients who underwent antibiotic spacer for septic total hip and knee arthroplasty (PJI THA/TKA) were identified in the PearlDiver Database using Current Procedure Terminology (CPT) codes for hip and knee antibiotic spacers. Patients who underwent aseptic revision and primary-THA/TKA were also identified using CPT codes. The incidences of depressive, anxiety, bipolar, psychotic, and stress disorders were identified within 2 years following the index procedures via Kaplan-Meier Analysis. RESULTS: The risk of depressive (hazard ratio (HR): 1.5; P < .001) and stress (HR: 1.5; P < .001) disorders were significantly higher in those who underwent PJI-THA when compared to aseptic revision, with the added risk of bipolar when compared to primary THA. The risk of depressive (HR: 1.6; P < .001), stress (HR: 1.4; P < .001), bipolar (HR: 1.3; P < .001), and psychotic disorders (HR: 1.5; P = .003) were significantly higher in those who underwent PJI-TKA when compared to aseptic revision, with the added risk of anxiety when compared to primary TKA. CONCLUSION: Patients who undergo spacer placement for septic-THA/TKA have a disproportionately higher incidence of mental health disorders within 2 years following surgery when compared those undergoing aseptic revisions and primary procedures. Due to this higher risk, physicians should strongly consider collaborative care with psychiatrists or mental health professionals. LEVEL OF EVIDENCE: III.

The Impact of a Virtual Orthopaedic Surgery Symposium on Medical Students: Increasing Awareness and Knowledge of the Field.

Orthopaedic surgery has become an increasingly popular field of residency training for medical students. Many institutions offer elective time to explore areas of interest through clinical rotations and research; however, most of these opportunities are reserved for senior medical students. The purpose of this study was to evaluate the impact of a dedicated medical student orthopaedic surgery symposium to increase awareness about the field and to assess students' interest and knowledge of orthopaedic surgery before and after the symposium. Methods: Medical students were invited to submit orthopaedic surgery-related research to a free, 1-day virtual symposium held in April 2022. Abstracts were reviewed and selected from 9 different orthopaedic surgery subspecialty categories. Survey assessments were sent to medical students to complete before and after the symposium. The surveys included questions related to participant demographics as well as interest and knowledge about the field of orthopaedic surgery. Statistical analyses were completed to compare the participants' responses before and after the symposium. Results: In total, 962 medical students registered for the 4-hour symposium. Of these, 58.5% completed the presymposium survey and 48.0% completed the postsymposium survey. 13.3% of the respondents reported being "very knowledgeable" about the various orthopaedic surgery subspecialties before the symposium, which increased to 18.4% after the symposium. 46.9% of the participants stated that they were "knowledgeable" about the daily life of an orthopaedic surgery resident before the symposium, which increased to 67.3% after the symposium. Similarly, the percentage of respondents who reported that they were "very knowledgeable" about the residency match process increased from 12.2% presymposium to 22.4% postsymposium. Conclusions: As interest in pursuing a career in orthopaedic surgery increases, medical students will continue to seek information, mentorship, and opportunities to present their research in preparation for residency applications. Our study demonstrated that a large-scale, national, virtual orthopaedic surgery symposium provided a platform to augment medical students' knowledge of the field, present their research, and interact with faculty members. Level of Evidence: Level V.

Do Orthopedic Surgery Residency Program Web Sites Address Diversity and Inclusion?

Background: Orthopedic surgery is one of the least diverse medical specialties. Other medical specialties have employed diversity-related initiatives to increase the number of students underrepresented in medicine (URM). Furthermore, with the suspension of visiting student rotations during the COVID-19 pandemic, medical students used residency program Web sites as a main source of program-specific information. Aims/Purpose: The purpose of this study was to measure the extent to which orthopedic surgery residency program Web sites describe diversity and inclusion initiatives. Methods: The Electronic Residency Application Service (ERAS) was used to identify U.S. orthopedic surgery residency programs. The programs' Web sites were reviewed, and data on commitments to diversity and inclusion were collected. Descriptive statistics of these data were generated. Results: There were 192 residency programs identified and 3 were excluded from the analysis due to lack of Web sites. Of the remaining 189 residency program Web sites, only 55 (29.10%) contained information on diversity and inclusion. Information on a commitment to improving diversity and inclusion was the most prevalent data point found among program Web sites, although it was found on only 15% of program Web sites. Conclusion: Orthopedic surgery residency programs rarely address topics related to diversity and inclusion on their program Web sites. An emphasis on opportunities for URM students and initiatives related to diversity and inclusion on program Web sites may improve URM outreach and serve as one method for increasing URM matriculation into orthopedic surgery.

Utilization of Instagram by Psychiatry Residency Programs in a Virtual Recruitment World.

OBJECTIVE: Many psychiatry residency programs use Instagram to provide information about their program. This study assesses the content and engagement on psychiatry residency program Instagram accounts. METHODS: A full list of psychiatry programs was gathered from the American Medical Association Fellowship and Residency Electronic Interactive Database (FREIDA). FREIDA was used to collect demographic information about a program. Program Instagram accounts were reviewed and assessed for content, and engagement scores were analyzed. Univariate and multivariate regression was used to analyze the information collected from the Instagram accounts. RESULTS: There are 109 (42.9%) psychiatry residency programs with Instagram accounts; 99 (90.8%) accounts were opened in 2020. Analysis of the content of posts revealed posts with the following themes: 50.5% were departmental, 21.9% were social, 14.9% were other, 10.1% were academic and professional, and 2.6% were educational. Using multivariate regression, a higher total number of followers was correlated with the total number of accounts followed (p ≤ 0.001) and Instagram stories (p = 0.047) (R2 = 0.579). Engagement score was correlated with a total number of followers (p ≤ 0.001), program size (p = 0.048), and whether an account was active (p = 0.003) (R2 = 0.450). CONCLUSION: Results demonstrate that 2020 led to an increase in the number of psychiatry residency program Instagram accounts and engagement with followers. Instagram provides a way to further promote a program, yet there is room for improvement to diversify the content.

Utility of Social Media for Recruitment by Orthopaedic Surgery Residency Programs.

BACKGROUND: As the use of social media continues to rise, the presence of social media accounts among orthopaedic surgery residency programs can foster connections with other specialties, highlight departmental achievements, and be a resource for applicants to learn more about the program. This study evaluated the current utility and landscape of social media, with an emphasis on the use of Instagram, in orthopaedic surgery residency programs in the United States. METHODS: A cross-sectional study of orthopaedic surgery residency Instagram accounts was performed. The Instagram accounts were evaluated for the number of followers, number of accounts following, and number of posts. Instagram posts were further categorized into academic, departmental, education, and COVID-19-related content. In addition, a search was performed to identify the presence of Twitter and Facebook accounts among orthopaedic surgery residency programs. Bivariate and multivariable logistic regression models were used to analyze the data in this study. RESULTS: Of the 192 orthopaedic surgery residency programs evaluated, 108 programs (56%) had an Instagram account, 65 programs (34%) had a Twitter account, and 58 programs (30%) had a Facebook account. Of the 108 programs with an Instagram account, 92 accounts (85%) were created in 2020. A higher Doximity ranking of a program was positively associated with the presence of an Instagram account (p < 0.001). A significant correlation was found between the number of posts and the Instagram engagement score (p = 0.018). The majority of Instagram posts contained departmental content (54%) followed by social (13%) and COVID-19-related (10%) content. CONCLUSIONS: The presence of orthopaedic surgery residency programs on social media has grown significantly in the year 2020. With the presence of more than 50% of residency programs on Instagram, this can be a useful resource for prospective applicants and other healthcare professionals to gain insight into the activities of orthopaedic surgery residency programs across the United States.

Child and Adolescent Psychiatry Fellowship Program Website Content and Accessibility.

OBJECTIVE: When child and adolescent psychiatry fellowship applicants are applying to programs, many will use fellowship websites to gather information. This study assesses the accessibility and content available on child and adolescent fellowship websites. METHODS: Using the Electronic Residency Application Service (ERAS) list of child and adolescent fellowship programs for 2020, 139 child and adolescent fellowship training websites were compiled. Information on websites was evaluated within the following three categories: program overview, application information and recruitment, and educational opportunities. A total of 22 criteria were evaluated within these three categories. Descriptive statistics were used to analyze the websites. RESULTS: A list provided by ERAS and a Google search identified child and adolescent fellowship program websites. Analysis of content revealed most websites included an overview of the program (97.8%), but fewer included information such as the number of fellowship spots (51.5%), salary (45.5%), application deadline (41.0%), and call responsibility (19.4%). CONCLUSION: Results suggest there is room for improvement in the comprehensiveness and accessibility of child and adolescent fellowship websites. Especially during a time when much of the programmatic information will be obtained virtually due to COVID-19, it is critical that fellowship websites are uniformly curated so applicants can more easily find information about programs.

Assessing the Dissemination of COVID-19 Articles Across Social Media With Altmetric and PlumX Metrics: Correlational Study.

BACKGROUND: The use of social media assists in the distribution of COVID-19 information to the general public and health professionals. Alternative-level metrics (ie, altmetrics) and PlumX metrics are new bibliometrics that can assess how many times a scientific article has been shared and how much a scientific article has spread within social media platforms. OBJECTIVE: Our objective was to characterize and compare the traditional bibliometrics (ie, citation count and impact factors) and new bibliometrics (ie, Altmetric Attention Score [AAS] and PlumX score) of the top 100 COVID-19 articles with the highest AASs. METHODS: The top 100 articles with highest AASs were identified with Altmetric Explorer in May 2020. The AASs, journal names, and the number of mentions in various social media databases of each article were collected. Citation counts and PlumX Field-Weighted Citation Impact scores were collected from the Scopus database. Additionally, AASs, PlumX scores, and citation counts were log-transformed and adjusted by +1 for linear regression, and Spearman correlation coefficients were used to determine correlations. RESULTS: The median AAS, PlumX score, and citation count were 4922.50, 37.92, and 24.00, respectively. The New England Journal of Medicine published the most articles (18/100, 18%). The highest number of mentions (985,429/1,022,975, 96.3%) were found on Twitter, making it the most frequently used social media platform. A positive correlation was observed between AAS and citation count (r2=0.0973; P=.002), and between PlumX score and citation count (r2=0.8911; P<.001). CONCLUSIONS: Our study demonstrated that citation count weakly correlated with AASs and strongly correlated with PlumX scores, with regard to COVID-19 articles at this point in time. Altmetric and PlumX metrics should be used to complement traditional citation counts when assessing the dissemination and impact of a COVID-19 article.