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Table of Contents
Year : 2022  |  Volume : 33  |  Issue : 1  |  Page : 14-18

#UroSoMe: Growth and innovation of the social media landscape of urology residency programs and applicants during the COVID-19 pandemic

Department of Urology, SUNY Downstate College of Medicine, Brooklyn, New York, USA

Date of Submission05-Jun-2021
Date of Decision14-Jul-2021
Date of Acceptance26-Jul-2021
Date of Web Publication02-Mar-2022

Correspondence Address:
Mr. Aaron J Huang
Department of Urology, SUNY Downstate College of Medicine, 450 Clarkson Avenue, Brooklyn 11203, New York
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/UROS.UROS_83_21

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Purpose: The purpose of this study was to determine the impact of COVID-19 on the urology residency application cycle on social media engagement and account creation by urology residency programs and applicants. Materials and Methods: A list of accredited urology residency programs was taken from the Electronic Residency Application Service, excluding military-sponsored programs. Twitter, Instagram, and Facebook accounts of programs and applicants were then identified through Google and individual platform searches. Results: One hundred and nineteen out of 140 urology programs had Twitter accounts, with 29 created in 2020. Urology program Instagram accounts had the largest growth rate in 2020 of 227.8%. Almost all urology programs that had Instagram or Facebook accounts also had a Twitter account. Urology programs promoted a total of 277 virtual events on Twitter, 83 on Instagram, and 48 on Facebook. Sixteen subinternships were promoted on Twitter, two on Instagram, and two on Facebook. In the 2021 match, 136 of the 237 matched applicants on Twitter made their accounts in the year leading up to the match and 42 of the 162 matched applicants on Twitter created their Twitter accounts during the 2019 cycle. Conclusion: The number of urology programs on Twitter and Instagram increased in 2020 at a faster rate than previous years. Many programs used their accounts to promote virtual events and subinternships. Applicants who matched in 2021 made Twitter accounts during their application year at a higher rate than the previous application cycle. During the COVID-19 pandemic, urology programs and applicants utilized social media, especially Twitter, to engage and learn about each other.

Keywords: COVID-19, social media, urology residency application, virtual events

How to cite this article:
Huang AJ, Heard JR, Sharma IK, Gold FE, Gdara O, Weinstein C, Kashani M, Winer AG. #UroSoMe: Growth and innovation of the social media landscape of urology residency programs and applicants during the COVID-19 pandemic. Urol Sci 2022;33:14-8

How to cite this URL:
Huang AJ, Heard JR, Sharma IK, Gold FE, Gdara O, Weinstein C, Kashani M, Winer AG. #UroSoMe: Growth and innovation of the social media landscape of urology residency programs and applicants during the COVID-19 pandemic. Urol Sci [serial online] 2022 [cited 2022 Dec 4];33:14-8. Available from: https://www.e-urol-sci.com/text.asp?2022/33/1/14/338937

  Introduction Top

The COVID-19 pandemic has drastically affected the residency application process. Travel restrictions and cancelation of in-person external site rotations have forced students and residency programs to adapt in unprecedented ways.[1] In competitive surgical subspecialties, such as urology, program directors value away rotations as a means of assessing applicants; therefore, many prospective applicants complete these rotations.[2],[3] They facilitate the application process by allowing the program staff to assess students; the rotations also allow students to enhance their applications while determining their compatibility with the program.[3],[4],[5],[6] Furthermore, urology is relatively unique in that many students do not have substantial experience until after the core clerkships of the 3rd year. Thus, students rely heavily on their 4th-year away rotations to confirm their interest in the field and gain exposure to different programs.[5] Adding more virtual programming is a suggested option to address concerns over the absence of in-person interactions and lack of exposure and opportunity.[7] Such programming would allow more applicants to participate and lead to greater equity in student exposure to different programs by eliminating travel barriers and other socioeconomic factors.[8] The use of social media has continued to grow in the field of urology in recent years, and applicants have already used social media in the match process to compare themselves to other students.[9] Therefore, social media was primed to become the medium of choice for virtual interactions in the match process. This study analyzes the use of social media as a means for residency programs and applicants to interact during the COVID-19 pandemic.

  Materials and Methods Top

We used a list of accredited urology residency programs from the Electronic Residency Application Service, excluding military-sponsored programs, and identified 140 residency programs. We found Twitter, Instagram, and Facebook accounts for each program through Google searches for “[program name] urology” and searched on each social media platform. The 2020 and 2021 list of matched applicants was obtained from urology residency program websites and Twitter accounts. Data collection of social media accounts occurred from January 11 to January 31, 2021, and data collection of applicant information occurred from February 9 to February 11, 2021. We only included interactive events targeting 4th-year medical students from the start of 2020 to the 1st day of data collection. This excluded virtual symposiums, premade videos about the campus or program, and grand rounds. All graphs and tables were generated on Microsoft Word and GraphPad Prism 9.0 (San Diego, CA). This study did not require approval from the SUNY Downstate Health Sciences University College of Medicine Institutional Review Board because of exemption as education research (category 1).

  Results Top


Out of the 140 urology residency programs in the U. S., 119 (85.0%) had a dedicated Twitter account at the time of data collection [Table 1]. Further, 107 (89.9%) out of the 119 programs with Twitter accounts held interactive virtual sessions (e.g., open houses, town halls, and question and answer sessions) for the applicants to learn more about their respective programs. Of the 119 programs with Twitter accounts, 29 (24.4%) were created in 2020 [Figure 1], which equals to an account growth of 32.2% compared to the annual growth of 20%–25% observed in the previous 3 years.
Table 1: Urology social media use

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Figure 1: Share of total urology residency programs with social media accounts by year, with number representing percent growth in number of programs over previous year

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Of the 140 programs, 64 (45.7%) had Instagram accounts. Among those, 30 (46.9%) promoted interactive virtual sessions. Of the 64 programs with Instagram accounts, 41 (64.1%) were created in 2020. This increase was equivalent to an account growth rate of 227.8% over the previous 3 years, growing at a 38.5%–80% rate. Only 5 (7.8%) of the 64 programs had an Instagram account as their only form of social media, while 58 of the 64 programs (90.6%) also had Twitter accounts.


Of the 140 programs, 40 (28.6%) had Facebook accounts; of the 40 programs, 16 (40%) promoted virtual sessions for applicants on their Facebook pages. Of the 40 programs with Facebook accounts, 5 (12.5%) were created in 2020. No program had a Facebook account as their only form of social media, and all 40 programs with Facebook accounts (100.0%) also had Twitter accounts.

Virtual experiences

Urology programs promoted 277 virtual events on Twitter, 83 on Instagram, and 48 on Facebook [Figure 2]. Sixteen subinternships were promoted on Twitter, two were promoted on Instagram, and two were promoted on Facebook. One was exclusively promoted on Instagram and another exclusively on Facebook. The ratio of virtual events per program was 2.328 on Twitter, 1.297 on Instagram, and 1.200 on Facebook. The median number of virtual events promoted on social media was two events on Twitter and zero on Instagram and Facebook.
Figure 2: Frequency distribution of urology social media accounts promoting virtual events in 2020, excluding virtual subinternships

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In 2021, 357 applicants matched into urology residency programs; of these, 237 (66.4%) had Twitter accounts [Table 2]. The median number of tweets from these applicants was 24, with a minimum of 0 and a maximum of 18,100 tweets. Further, 15 accounts (6.3%) posted Tweetorials. With regard to the 237 applicants with Twitter accounts, 136 accounts (57.4%) were made during 2020. In the 2020 match, 353 applicants matched to urology programs, of whom 162 (45.9%) had Twitter accounts and 42 (25.9%) were created in 2019. The median number of tweets by those applicants was 29, with a minimum of 0 and a maximum of 6070 tweets. None of these accounts posted (0.0%) Tweetorials.
Table 2. Applicant twitter accounts in past two application cycles

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  Discussion Top

Social media usage has grown both globally and in the field of urology.[10],[11],[12],[13],[14],[15],[16] With the disruptions of traditional academic experiences, such as away rotations and in-person interviews due to the COVID-19 pandemic, social media has played a new and essential role in the urology match process. This study described changes in social media usage in the match process, most notably conveyed by the number of new social media accounts created by residency programs in 2020. We observed more significant growth in the number of residency programs on Twitter in 2020 from previous years, in addition to an increase of over 200% in the number of residency Instagram accounts in 2020 [Figure 1]. Facebook participation, however, remained low among urology departments. Notably, almost all of the programs with Instagram (90.6%) and Facebook (100.0%) accounts also had Twitter accounts, suggesting that Twitter is the primary platform of choice for urology residency programs. While Twitter is predominant, Instagram has emerged as a secondary platform. This increased Instagram usage could be due to its similar format to Twitter, allowing applicants to view a brief detail of highlighted events.

Further, many programs utilized social media to advertise virtual events allowing applicants to learn about and interact with their programs. There were 277 interactive virtual experiences promoted on Twitter, 83 on Instagram, and 48 on Facebook, with some overlap. In this study, we found that a large majority of programs on Twitter promoted virtual events (89.9%), while those on Instagram (46.9%) and Facebook (40.0%) promoted virtual events to lesser degrees. In addition, residency programs promoted 18 unique virtual subinternships, primarily on Twitter. These findings suggest that residency programs employ broader social media applications to communicate directly with applicants and promote virtual mediums of interaction.

The notable increase in the social media presence of urology residency programs as a means to help students learn about their programs has been warranted. Questions remain, however, about the effectiveness of a purely virtual experience with the residents and the program. A recent survey of 238 urology applicants found that students felt COVID-19 restrictions led to decreased exposure to residency programs, and they were worried about its impact on obtaining effective letters of recommendation.[17] Another survey of applicants reported that resident interactions and city tours, considered the most important to the program experience, could not be replicated virtually.[18] With these limitations in mind, many urology departments have attempted to tailor their events to be more interactive in an effort to be as open as possible about their programs.

Despite concerns about virtual experiences and their quality as substitutes for in-person events, there has been an emphasis on providing opportunities for applicants to gain greater insight into individual programs. In particular, researchers found through survey responses that virtual grand rounds and other interactive group sessions were an effective way to help applicants learn more about the program and for the program to evaluate the applicant better.[19] Furthermore, when thinking about virtual events, many students showed great interest in small group and one-on-one communications with the programs.[17] This desire has been largely met as many programs limit the capacity of certain virtual events while increasing the number of events to allow as many applicants the same opportunities as possible. These efforts provide the applicants with an adequate substitute for past in-person events while also providing sufficient experiences with the program.

Urology applicants have also largely turned to Twitter to engage with residency programs. We found that 237 of the 357 matched applicants in 2021 had Twitter accounts. A majority (57.4%) created their accounts during 2020, a significant increase compared to 25.9% of the 2020 matched applicants who created their Twitter accounts in the year leading up to the match. These findings continue to illustrate that Twitter is the predominant social media platform in urology. Its use in the match process grew more in 2021 than in the previous year, likely because of the COVID-19 pandemic. In addition, the median number of tweets per applicant was 24, with 11 accounts not tweeting, indicating that many applicants utilized Twitter to learn about programs and their virtual events rather than interact through tweeting.

While these data act as a preliminary cross-sectional sampling of social media usage by urology programs and applicants, further studies can determine which platform attracted additional applicants and how they made the discovery (e.g., through home program director or word of mouth). Additional research may also examine how virtual experiences affected urology applicants' rank lists or even decisions to apply to urology. Two studies have suggested that a consequence of canceled away rotations has been decreased exposure in urology, which may have diminished applicants' interest in the field.[4],[20] Another topic of study is the potential positive association between the number of interactive events held by a program and the number of applications received. Further, future research should examine if applicant diversity increased in 2020 compared to previous years because a few programs held virtual sessions specifically for underrepresented minorities.

Potential limitations of this study include undercounting of virtual events and social media account exclusion through the utilized search criteria. These could have led to the underestimation of the actual number of virtual events reaching the applicants. We attempted to mitigate the former by conducting our search through Google and searching within each platform. It is difficult to attribute the spike in social media account creation in the area of urology to COVID-19 alone or to the general increasing trend of using social media platforms across all fields. Overall, the growth in social media accounts and content across multiple platforms in 2020 likely represents an effort by residency programs and applicants to replace interactions limited by the COVID-19 pandemic.

  Conclusion Top

Because of the COVID-19 pandemic and the subsequent ban on away rotations and in-person interviews, residency programs have had to pivot to the use of social media and virtual programming to reach applicants. This study demonstrates that the number of urology program accounts on Twitter and Instagram created in 2020 grew faster than in any previous year, likely as a consequence of the COVID-19 pandemic. This study did not look at other social media platforms considering that the platforms included in this study were by far the most popular within urological residency programs. These platforms help promote and inform applicants about various virtual events, including open houses and subinternships. Furthermore, urology applicants who matched in 2021 were more likely to have Twitter accounts and to have made their account in the year leading up to the match than in the previous application cycle. This work may catalyze research on the types of social media contents that provide the greatest utility for applicants and whether social media is an effective tool to compensate for limited in-person activities due to the COVID-19 pandemic.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

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  [Figure 1], [Figure 2]

  [Table 1], [Table 2]


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