1. 2022;25;E1021-E1025A Cross-sectional Study of the Social Media Presence of ACGME-Accredited Pain Medicine Fellowship Programs: Time to Get Online?
   Cross-Sectional Study
   Alopi Patel, MD, Meg A. Rosenblatt, MD, Joshua Dumbroff, MD, Gabriel Irizarry, MD, Ghislaine Echevarria, MD, and Paul Shekane, MD.

BACKGROUND: Approximately 70% of Americans use social media platforms, and use of specific platforms, such as Instagram, Twitter, Snapchat, and TikTok, is especially common among adults under 30. The presence of social media accounts among residency and fellowship programs in academic medicine has been used to connect with other specialties, highlight achievements and research, disseminate information to the general public, and as a recruiting tool for applicants.

OBJECTIVES: The objective of this cross-sectional study was to evaluate the social media presence, specifically on Twitter and Instagram, of the Accreditation Council for Graduate Medical Education (ACGME)-accredited Pain Medicine fellowship programs. We hypothesized that programs with more fellows were more likely to have a social media presence, as well as more content pertaining to branding for recruitment purposes.

STUDY DESIGN: A cross-sectional study observing the social media presence of ACGME- accredited Pain Medicine fellowship programs.

METHODS: Two independent reviewers conducted searches for corresponding official pain programs and departmental accounts on Twitter and Instagram over the period of July 1, 2020 to June 31, 2021. For all social media accounts identified, number of posts (total and within the study period), followers, and date of first post were recorded. Each post was categorized as medical education, branding, or social.

RESULTS: Of the 111 ACGME-accredited Pain Medicine fellowship programs, 4 (3.6%) had both Twitter and Instagram accounts,10 (9%) only Twitter, 7 (6.3%) only Instagram, and 90 (81.1%) had neither. A significant association between the number of fellows and the odds of having an Instagram, but not Twitter, fellowship account was found (odds ratio 1.38, 95% confidence interval [CI]: 1.02,1.88; P = 0.038). Also, a linear relationship existed between the number of followers and tweets (B coefficient 3.7, 95% CI: 3.6, 3.8; P < 0.001).

LIMITATIONS: Limitations include that the data were collected during the COVID-19 pandemic, which may correlate to increased likelihood of social media usage. We were also limited by our ability to find all of the pain management fellowship program accounts on social media.

CONCLUSIONS: Less than 20% of the pain fellowship programs are currently utilizing Twitter and/or Instagram. When compared to primary anesthesiology residencies, social media presence among pain fellowships is much lower. By utilizing basic social media strategies, including image-based content posting, hashtags, and videos, programs can increase their engagement with the social media community, and increase their overall number of followers, thus expanding their potential reach to prospective applicants. Although social media can be an effective tool for branding purposes, it is vital to address the safe use of social media among all trainees.

KEY WORDS: Social media, pain management fellowship, Instagram, Twitter, social media in medicine, medical education