Student Perceptions and Use of Social Media as Residency Program Information

The traditionally in-person format for the residency Match was altered in 2021, replaced with a virtual format. New formats may alter how medical students and residency programs approach the Match system, allowing for innovation. One area for growth is social media—internet-based platforms providing users a space to share and/or interact with one another’s content—though the efficacy and value of using it to convey residency program information are unclear and warrant further investigation.^1,2

The proportion of programs with a social media presence varies between specialties; studies show social media use in graduate medical education (GME) in its infancy.^3-7 Professional organizations are recommending programs establish a social media presence, given that medical students frequently use social media, even to research residency programs.^{2,3, 6-10} Residency social media pages can be difficult to find, and the available content is inconsistent across programs and specialties.^6-9

Little is known about whether or how students applying to family medicine are utilizing social media as a source of information about residency programs. The 2020-2021 Match cycle’s virtual format led to prolific innovation in graduate medical education recruitment. Even as pandemic-era regulations are relaxing, our field could retain valuable progress in accessibility and recruitment.¹²

This study had two purposes: (1) evaluating fourth-year medical student perceptions about perceived preparedness for the virtual Match, and (2) assessing applicant utilization of social media content.

Our family medicine residency program (FMRP) is at a Midwestern, urban academic medical center. This study was a cross-sectional descriptive survey of FMRP applicants who accepted interviews during the 2020-2021 National Residency Match Program (NRMP) cycle. We collected data via an anonymous electronic survey distributed via email.

We created a novel, 26-item electronic survey, due to a lack of preexisting validated tools. Survey content included demographics, sentiments about the virtual Match, and sentiments about social media use as information gathering. “Official” social media represents content released by the organization it describes. We sent initial survey distribution emails within 14 days after each applicant’s scheduled interview date, and a reminder was emailed to all applicants after the season’s final interview. We calculated descriptive statistics using Microsoft Excel. This study was approved by the University of Kansas Medical Center Institutional Review Board.

All 138 applicants that scheduled an interview were contacted. We received 83 responses; eight were excluded due to incomplete responses (75 completed surveys, 54% response rate). Ten applicants cancelled their interview, but their data could not be excluded due to participant anonymity. Respondent characteristics are summarized in Table 1.

Applicants reported being worried about the virtual Match process (Figure 1); 64% worried about getting enough information to decide to interview with a residency program, and only 52% felt they have enough options of individual sources of information about programs. Almost all (87%) participants worried about having enough information to know how to rank programs. Only 16% of applicants felt confident that the virtual format would not influence their Match outcomes.

The top-three information sources applicants used (Figure 2) were official residency program websites, program databases, and opinions/knowledge from peers. Official program social media was the fourth most-used source (63%). Within social media at the FMRP, applicants used Instagram most often (75%), followed by Facebook (25%), then Twitter (23%).

Survey items also interrogated applicant perspectives on the role of social media as an information source in the residency application process (Table 2). Only 36% felt they could determine individual fit with a program without visiting in person. About half (55%) of respondents agreed, however, that social media shows the personality of programs, distinct from other resources. Most applicants (60%) agreed that social media content could change their consideration of a program. Only a minority of applicants (25%) reported social media already having affected a decision to apply to a program. Social media increased the confidence in their residency choice in many (40%) of participants. Most applicants (57%) disagreed that social media could replace the information provided by completing visiting medical student rotations or in-person interviews.

A majority of participants worried they would have enough information to choose their residency program, and few were confident that the virtual 2020-2021 NRMP residency application cycle would not impact their outcomes. Social media was the fourth most-utilized source of information about programs, and, thus, should not be ignored as a recruitment opportunity. While few students used social media content as a deciding factor for whether they apply, it helped them feel more confident in their choices.

Instagram is currently the preferred platform, although this is likely to change as applicant demographics and media preferences evolve. Social media reached many students, being the fourth most-used source of information about residency programs. Though social media is better at illuminating some elements of a program (such as “personality,” the gestalt impression of a program’s culture and/or values), applicants do not perceive that social media replaces in-person contact, nor did it seem overwhelmingly influential in ranking or applying to a program.

This study has limitations. Our results are from one Midwestern, academic medical center residency program, and may not generalize to all programs. Despite anonymity, applicants may not have responded candidly during the high-stakes process. Nonresponse bias is also possible with our 54% response rate.

Future work examining frequency of social media use, attitudes at different institutions, or variation between demographic subgroups would be valuable. Additionally, further delineation of which social media content applicants find helpful would promote more impactful social media engagement. Residency programs should develop best practices for social medical content and trainee engagement.

Family medicine residency programs must prepare for future virtual residency Match cycles, as the post-COVID pandemic era has likely changed the interview process forever. Data-informed practices would not only improve the efficacy of social media as a recruiting platform, but also help applicants feel more confident about their choices about family medicine programs.