Social Media Presence of Orthopedic Surgery Residency Programs Associates with Program Ranking But is No Longer Associated with Increased Applicant Diversity

Social media utilization by orthopedic surgery residency programs increased by 355% from the 2019 to 2021 residency application cycles. Prior to the COVID-19 pandemic, literature demonstrated an association between social media presence and diversity of residency programs. The goal of this study is to investigate the associations between social media presence, diversity and program rank following the dramatic increase in residency program social media use during the COVID-19 pandemic. Social media platforms affiliated with all orthopedic surgery residency programs acknowledged by the Accreditation Council for Graduate Medical Education (ACGME) were identified via manual Google, Twitter and Instagram searches. Overall program rankings and research rankings were collected from the Doximity Navigator rankings list; a lower program rank denoted better-ranked programs (e.g., rank #1 represents the best program). Residency program demographics were collected through the Orthopedic Residency Information Network (ORIN) and binned into four quartiles to adjust for multivariable logistic regressions. Residency programs were categorized as “gender diverse” if either resident physicians were composed of ≥29.8% women, equivalent to one SD above the mean of 19.7% or if attending physicians were composed of ≥21.7% women, equivalent to one SD above the mean of 13.6%. Similarly, residency programs were categorized as “racially diverse” if either resident physicians were composed of ≥32.8% Underrepresented Minorities in Medicine (URiM), equivalent to one SD above the mean of 19.1% or if attending physicians were composed of ≥ 27.3% URiM, equivalent one SD above the mean of 13.8%. All data was collected during fall 2023. Confounding variables were controlled by regression analyses. Multivariable logistic regressions were used to further assess comparisons between presence of social media and program ranking, gender diversity and ethnic diversity. A total of 179 orthopedic surgery residency programs accredited by the ACGME were included in the ORIN database. Of the 179 programs, 145 (81.0%) programs had Instagram, 86 (48.0%) had Twitter, 81 (45.3%) had both Instagram and Twitter accounts and 29 (16.2%) programs had neither. Pearson Correlation Coefficient tests demonstrated a negative linear relationship between total number of social media platforms per program and overall program rankings (R2= -0.53, p<0.01) as well as research program ranking (R2=-0.49, p<0.01). Spearman Correlation Coefficient tests confirmed overall program ranking (R2=-0.55, p<0.01) and research program ranking (R2=-0.51, p<0.001) as the dataset did not follow bell curve distribution. Chi-Square tests of independence did not demonstrate a significant relationship between presence of social media and gender diversity (x2=0.17, p=0.68) and Fisher’s exact tests confirmed no statistical significance (p=1.00). Chi-Square tests of independence also did not demonstrate a relationship between presence of social media and racial diversity (x2=0.25, p=0.62) and Fisher’s exact tests confirmed no statistical significance (p=0.64). The COVID-19 pandemic greatly impacted social media use by orthopedic residency programs. Although prior literature demonstrated social media presence was associated with increased gender and racial applicant diversity, our findings show this association is no longer present. This may be due to the significant increase in social media use during the pandemic. Future research is encouraged to investigate alternative strategies to diversify orthopedic residency programs.