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

Philip M Lee^1*, Eli M Snyder¹, Hyeong Jun Ahn², Sudarsan Murali³, Dawn Laporte³, Amiethab Aiyer³

¹University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
²University of Hawaii, Department of Quantitative Health Sciences, Honolulu, HI, USA
³John Hopkins University Department of Orthopedics, Baltimore, Maryland, USA

*Correspondence author: Philip M Lee, BS, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA;
Email: [email protected]

Citation: Lee PM, et al. Social Media Presence of Orthopedic Surgery Residency Programs Associates with Program Ranking But is No Longer Associated with Increased Applicant Diversity. J Ortho Sci Res. 2025;6(1):1-7.

Copyright^© 2025 by Lee PM, et al. All rights reserved. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Table 1: Relationship between social media presence and gender / racial diversity.

Discussion

Within the past decade, there has been an increase of social media use for tasks such as  medical practice marketing, patient education and referral generation [5-7]. Within a medical education perspective, social media is being used with a goal of attracting diverse residency program applicants [15,16]. This current study demonstrated that 83.8% of institutions had at least one form of social media including Instagram and Twitter. Although this study demonstrates a relationship between social media presence and better overall program rankings, there is no longer an association between social media presence and residency program diversity when compared to studies prior to the COVID-19 pandemic [17].

Diversity within Orthopedic Surgery

All medical specialties have directed effort towards diversifying their fields. Literature has demonstrated advantages to diverse physician populations, not only in improved quality of patient care and communication, but also maximization of revenue generation [3,4]. In the early 2000’s, the percentage of female orthopedic surgery residents rose at the slowest rate compared to all medical specialties in the United States, while the percentage of URiM residents trended downwards [24]. In 2017, orthopedic surgery continued to have the lowest percentage of female residents at 14.0%, as well as the lowest percentage of African American and Hispanic residents at 4.1% and 2.7% of orthopedic trainees respectively [24,25]. Diversity should be increased in order to effectively care for patients of all cultural, ethnic and socioeconomic backgrounds [9].

Prior literature has focused on identifying factors contributing to the lack of diversity in the field of orthopedic surgery. One component was the pool of applicants to orthopedic surgery residency programs, which was predominated by males of Caucasian and Asian descent [24]. This is further supported by another study which demonstrated the proportions in which female and URiM applicants applied to versus matched into orthopedic surgery residency programs were consistent with the overall application – match ratio [26]. In other words, the lack of diversity in orthopedic surgery was from a lack of diverse applicants. This prompted strategies in improving diversity by attracting a more diverse applicant pool, such as female and URiM applicants.

Social Media’s Role in Improving Diversity of Residency Programs

Within the past two decades, social media has incorporated itself as a cornerstone of medicine, both in practice and in medical education. Novel examples of social media’s utility include medical researchers sharing new literature with other scientists, as well as physicians educating their followers and promoting their practice [6,7,27,28]. Within medical education, medical schools and residency programs have utilized social media to promote their institutions and national surveys of surgical residency directors have even reported that applicants’ social media greatly assists in their selection process [5,14,29,30].

Social media’s growing role in the field of medicine was only augmented by the COVID-19 pandemic. Between the 2019 to 2021 application cycles, orthopedic residency programs reported a 355% increase in social media utilization for institutional promotion [17]. During national surveys, a majority of institutions reported social media to be “extremely important” or “very important” when compared with utility from previous year [17]. Additionally, orthopedic residency program directors reported one of the biggest changes in selection criteria included virtual information session attendance, describing virtual rotations attendance as “extremely” or “very important” [31].

As in-person events shut down, orthopedic residency programs depended more on virtual platforms, with 83.8% of residency programs now utilizing social media compared to 39.7% in 2021 [17]. The combination of increased utilization and increased importance of social media and online platforms during the COVID-19 pandemic may have created a ‘diluting’ effect. Although social media may be used to attract a diverse applicant pool, the dramatic increase in orthopedic residency program social media use during the pandemic may have affected existing associations [8-10]. Future research should focus on developing alternative strategies to create a more diverse training environment.

Limitations

This study has several limitations. First, the retrospective nature of this study limits the findings to correlation rather than causation. Furthermore, this study was limited to the accuracy and completeness of the ORIN dataset which relies on self-reported data from orthopedic residency programs. As each program is responsible for updating their respective data, some programs may have included more up to date information than others; however, data was provided no earlier than 2021. Additionally, the ORIN dataset only included 179 of the 203 accredited programs and did not have complete demographic information for every program, subsequently being excluded during statistical analysis. This may have affected distribution of results. Despite these limitations, the ORIN database provided data directly from program administrators, useful to explore the association between social media presence and diversity of orthopedic surgery residency programs. Another potential limitation to this study is utilizing the Doximity database, as other ranking systems such as BlueRidge and USNWR may rank institutions differently. However, prior research has shown Doximity rankings are associated with academic performance and productivity [32-37].

Conclusion

Social media has become a cornerstone of both medical education and practice. Prior literature demonstrated social media may be an effective tool for diversifying residency programs, especially within the field of orthopedic surgery. This study demonstrates that although social media presence does correlate with overall program rankings, there is no longer an association between social media presence of orthopedic surgery residency programs and increased program diversity, following the significant increase in social media utilization during the COVID-19 pandemic. Future research is recommended to investigate additional strategies to effectively increase program diversity. 

Conflict of Interests

The authors declare that they have no conflict of interest in this paper.

Funding/Sponsorship

Not applicable

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