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Representation of Global Health Initiatives in Plastic Surgery Training: A Social Media Analysis
Alexandra I. Naides, BFA, Kailash Kapadia, MD, Jena Salem, BA, Margaret Dalena, BS, David Cohen, BA, Haripriya S. Ayyala, MD, Edward S. Lee, MD
Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers-New Jersey Medical School, Newark, NJ

Background: Over the last several years various social media platforms have been used to increase collaboration, education, and research internationally. The purpose of this study was to evaluate how plastic surgery residency programs use social media to promote global surgery education, research, and collaboration.
Methods: A full list of active integrated residency programs was obtained from the American College of Academic Plastic Surgeons website. A total of 82 programs were identified. Instagram, Facebook, and Twitter were searched for active accounts. Only accounts dedicated to plastic surgery programs or had a significant amount of resident related content were included. Inclusion criteria included posts relating to global health, global surgery, mission trips, international plastic surgery education, and global surgery research. Caption language was analyzed and classified as either “resident education in global surgery,” “an individual's interest in global surgery,” “research in global surgery,” “visiting international professor,” or “global collaboration.” Image content was then assessed for “images with patients,” “images with other surgeons/residents,” “images of international location,” a combination thereof, “other,” or “none.” Hashtags, number of “likes,” number of comments, and number of “shares” for each post were also recorded.
Results: Instagram was by far the most used by plastic surgery residency programs with a total of 76 programs having accounts compared to only 32 programs and 33 programs having Facebook and Twitter accounts, respectively. There was no significant difference in the proportional number of posts relating to global surgery across the three platforms (p=0.1911). On all three social media platforms, the majority of posts, fell into the category of “international collaboration” with 42.5%, 50.7%, and 48.8% on Instagram, Facebook, and Twitter, respectively. None of the caption categories examined showed a significantly different proportion of posts across the three platforms. Image analysis showed a significant difference in the proportional representation across the three platforms in the categories of “images with other surgeons/residents” (p=0.0196) “images with patients” (p=0.0082), combination (p=0.0225) and other (p=0.0114). Instagram had significantly more “likes” and comments on global surgery posts compared to the other platforms (p<0.0001). A total of 800, 140, and 42 hashtags were used in global surgery posts on Instagram, Facebook, and Twitter, respectively.
Conclusion:: While social media offers programs an easy way to promote global surgery research, collaboration, and education with a wider audience, it is being underutilized for this purpose as evident by the relatively lower number of postings on each platform relating to this content.


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