Resources

Social media serves as an ever-changing landscape for engagement with peers and colleagues, and its role within pulmonary and critical care medicine (PCCM) fellowships continues to evolve. These platforms serve as a modality to engage prospective fellows, highlight accomplishments, and elevate the visibility of the fellowship and institution. It also allows the fellowship to showcase their program’s culture and other “intangibles” including wellness efforts, social gatherings, and outreach projects(1). Feeling lost and overwhelmed by the prospect of keeping up with trainees who have essentially grown up in the alphabet soup of social media? Have no fear – here’s the TL;DR (that’s too long; didn’t read for those unfamiliar) version.

1. Go where the trainees are. Since the COVID-19 pandemic, there has been a transition to virtual interviews with subsequent emphasis on online recruitment strategies for most medical specialties. While more recent data is lacking, applicants in the post-pandemic era expressed that their first stop for gathering information is the program website(2-4). While websites present the most information about the program, they lack interactivity and vibrancy, and they are often difficult to update in real time without technical expertise.

Program surveys from other specialties have also demonstrated a shift toward multimedia-based accounts such as Instagram(3,5-12). Further, publicly-reportable data suggests that once-popular platforms such as X (formerly Twitter), and Facebook have declined in popularity among the current applicant demographic(13). Thus, Instagram is likely the go-to account platform for trainee and future applicant recruitment. However, the content shared will only enhance and supplement the program’s website rather than replace it. To amplify this symbiosis, program websites can highlight the fellowship’s Instagram account, and vice versa.

2. Know your institution’s policies. Institutions often have strict criteria for social media use for employees and/or departments, and these include the use of branding and oversight of content, among other regulations(14). Programs have circumvented institutional restrictions by creating “unofficial” accounts by specifying that the account does not represent the institution’s views in their description. In all circumstances, adherence to Health Insurance Portability and Accountability Act (HIPAA) regulations is non-negotiable(19), as patient privacy is paramount

However, institutions may also have resources that can benefit account management, such as access to paid social media management platforms, branding, or multimedia software. Existing policies and procedures can be adopted or adapted, thus minimizing the workload.

3. Define the Nuts and Bolts. There are many moving parts to deploying a successful social media presence. Specifically, tasks include:

• • Content generation
  • Determination for cadence of posts (daily, weekly, monthly)
  • Approval of posts
  • Determination of deployment to maximize audience and/or response (timing)
  • Scheduling or posting the content
  • Answering responses to posts
  • Analytics and quality improvement

The most challenging part is identifying who will be responsible for generating, approving, and posting content. Some programs opt for fellow-run accounts mainly to enhance comradery and to transparently convey the fellow experience. Others may prefer that program leadership, program coordinators, or faculty serve as gatekeepers. We suggest a combination approach to ensure adherence to institutional and professional standards and to ensure viability of the account as trainees graduate.

The workflow for content posting is also crucial. Instagram posts can be scheduled in advance, but genuinely interactive posts and videos must be posted in real-time. If a program has several platforms, then use of a management software or synchronized scheduled posts will be needed. Finally, consistency is also important, so a consensus on how to  decide in advance how to handle comments, direct messages, and/or spam comments should be established(15-16). A transparent system will minimize confusion if problems arise, and it can often be sourced from the parent institution’s policies.

4. Don’t work harder, work smarter when creating content. Content generation may seem arduous, but a systematic approach can help. Historically, published best practices recommend utilizing current medical education events, faculty and fellow awards and accomplishments, and publications(15). More recently, applicant surveys have revealed that posts regarding life outside the hospital were the most helpful(2). This can take the form of “Day in the Life” Or “Account Takeovers” in which current fellows share an unfiltered multimedia narrative of their day. Posts can also include faculty and fellow profiles, wellness initiatives, conferences, and social outings(17). Social media allows the program to highlight insights into living and working in the program’s geographic region. It can also showcase community service that may not be easily conveyed by the static information presented on a program’s website(18).

We highly recommend making the program’s current initiatives double as social media posts. A great summary slide from a noon conference can be posted as an infographic, and a clip from virtual grand rounds can double as a short-form video. For more examples, you can peruse any of our programs’ accounts – @nyulangonepccsm, @hfhpulmccmfellow, or @mcgovernpulmcc.

Creating a content calendar can help generate and schedule posts in advance to ensure a regular cadence; this can boost account visibility in many social media algorithms. Artificial intelligence (AI) can be a powerful tool for creating content calendars, suggesting ideas for posts, and even composing them.

5. Educate your trainees. Although most programs have rules for how to navigate social media, educating our trainees on appropriate personal use is vital. Social media can be a form of self-expression that allows for cultivating wellness, de-stressing and forging connections with others. However, young physicians entering the workforce should be counseled that their feeds could be discoverable by future patients, colleagues, workplaces, and other regulatory agencies. Additionally, social media can be addictive and time-consuming. In fact, algorithms are designed to keep users engaged for as long as possible, which often leads to amplification of content designed to evoke emotional responses. This can lead to social media use being deleterious to trainee’s emotional health as well.

In general, we recommend erring on the side of conservatism when cultivating an online presence using the 3 “P’s”.  Keep content:

• • Positive
  • Professional
  • Personal to one’s own circumstances

Institutions may also have additional guidance for their own employees’ personal social media use, which can also be referenced.

Navigating the alphabet soup of rapidly evolving social media platforms may seem like a challenging undertaking for busy programs, but engagement can reap multiple benefits, especially with the upcoming recruitment season. If your program is planning to get started, then we recommend creating an Instagram account, adopting existing institutional policies and procedures, utilizing AI and existing program initiatives to minimize the burden of content creation, and counseling trainees. Once your account is up and running, don’t forget to follow @APCCMPD!

References

1. Lee, E. et al. Virtual Residency Interviews during the COVID-19 Pandemic: The Applicant’s Perspective. South Med J 115, (2022).
2. Plack, D. L. et al. Postgraduate-Year-1 Residents’ Perceptions of Social Media and Virtual Applicant Recruitment: Cross-sectional Survey Study. Interact J Med Res 12, (2023).
3. Naaseh, A. et al. Evaluating applicant perceptions of the impact of social media on the 2020-2021 residency application cycle occurring during the covid-19 pandemic: Survey study. JMIR Med Educ 7, (2021).
4. Bernstein, S. A., Hodgins, G. E., Abu-Hamad, S., Gih, D. E. & Gold, J. A. Understanding the Use of Program Resources During Virtual Recruitment by Psychiatry Residency Applicants. Academic Psychiatry 47, (2023).
5. Lee, D. C., Kofskey, A. M., Singh, N. P., King, T. W. & Piennette, P. D. Adaptations in anesthesiology residency programs amid the COVID-19 pandemic: virtual approaches to applicant recruitment. BMC Med Educ 21, (2021).
6. Kim, Y. H., Ali, N. S. & Vidal, N. Y. Social media use in residency recruitment during the COVID-19 pandemic. Dermatology Online Journal vol. 27 Preprint at https://doi.org/10.5070/D327654053 (2021).
7. Baldwin, C. S., DeMarinis, A. R., Singh, N. P. & Khoury, C. A. Evaluation of Emergency Medicine Residency Programs’ use of social media in the setting of the COVID-19 pandemic. JACEP Open 3, (2022).
8. DeAtkine, A. B. et al. #ENT: Otolaryngology Residency Programs Create Social Media Platforms to Connect With Applicants During COVID-19 Pandemic. Ear Nose Throat J 102, (2023).
9. Pasala, M. S. et al. Family medicine residency virtual adaptations for applicants during COVID-19. Fam Med 53, (2021).
10. Fang, H. A. et al. An evaluation of social media utilization by general surgery programs in the COVID-19 era. Am J Surg 222, (2021).
11. LeDuc, R., Lyons, M. M., Riopelle, D., Wu, K. & Schiff, A. Social Media Utilization Trends in Orthopaedic Surgery Residency Programs During the COVID-19 Pandemic. Iowa Orthop J 41, (2021).
12. Clay Pruett, J. et al. Social Media Changes in Pediatric Residency Programs During COVID-19 Pandemic. Academic Pediatrics vol. 21 Preprint at https://doi.org/10.1016/j.acap.2021.06.004 (2021).
13. Jeffrey Gottfried, B. & Gottfried, J. American’s Social Media Use. Pew Foundation 31, 2024 (2024).
14. Pillow, M. et al. Social Media Guidelines and Best Practices: Recommendations from the Council of Residency Directors Social Media Task Force. Western Journal of Emergency Medicine 15, 26–30 (2014).
15. O’Glasser, A., Desai, S. S. & Cooney, T. G. Twelve Tips for Tweeting as a Residency Program. MedEdPublish 8, (2019).
16. Fick, L., Potini, Y. & Axon, K. Twelve Tips for Creating Your Program’s Social Media Footprint. MedEdPublish 8, 169 (2019).
17. Bhayani, R. K. et al. Twelve Tips for Utilizing Residency Program Social Media Accounts for Modified Residency Recruitment. MedEdPublish 9, (2020).
18. Lee, E. et al. Virtual Residency Interviews during the COVID-19 Pandemic: The Applicant’s Perspective. South Med J 115, (2022).
19. Santhosh, L., Carroll, C. L. & Seam, N. Tips and Traps for Trainees Traversing Social Media. ATS Sch 2, (2021).