The Impact of Social Media Presence on Primary Care Sports Medicine Fellowship Recruitment: A Cross-Sectional Study

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Woolridge, Cooper Bloyd, Madelynn Taylor, Nicolas Hatamiya, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4468497/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 22 Jul, 2025 Read the published version in BMC Medical Education → Version 1 posted 4 You are reading this latest preprint version Abstract Background The COVID-19 pandemic limited in-person recruitment opportunities for many training programs at academic medical centers. This study aimed to determine the prevalence of social media use among Primary Care Sports Medicine (PCSM) fellowship programs and to investigate the impact of social media on recruitment. Additionally, potential barriers to social media interaction between programs and applicants were examined. Methods A cross-sectional study was conducted using publicly available online sources to identify PCSM fellowship programs and corresponding social media accounts. PCSM Fellowship directors were surveyed regarding their program's use of social media. Prospective PCSM Fellowship Applicants and current fellows were surveyed to determine their interaction with PCSM fellowship social media accounts and how social media influenced their perception of the programs. Results A total of 211 PCSM fellowship programs were identified on the American Medical Society for Sports Medicine (AMSSM) website, of which 83% had a social media presence. The most commonly used platforms were Instagram (43%), Facebook (30%) and Twitter (24%). Among the surveyed fellows and applicants, 95% reported using social media, with 35% reported following PCSM accounts. Of those who did not follow, the most common reason was lack of awareness of these accounts. 22% of respondents indicated that social media positively influenced their perception of a program and its rank list position, while the remainder reported a neutral effect. 47% of the fellowship directors reported their program did not have official guidelines for appropriate social media use. Lack of time, resources, and oversight were identified as the most common barriers to social media use. Conclusions A majority of PCSM fellowship programs, fellows, and applicants are present on social media. Social media presence can positively impact an applicant’s view of a program. However, applicants’ lack of awareness of these accounts may serve as a barrier for interaction. The development of universal guidelines for appropriate social media use may help increase adoption and utilization of social media platforms for PCSM fellowship recruitment, particularly during times when in-person recruitment opportunities are limited. Graduate Medical Education Social media Recruitment Fellowship Primary Care Sports Medicine Figures Figure 1 Figure 2 Figure 3 Figure 4 Background The COVID-19 pandemic significantly affected the recruitment process of many academic medical centers' training programs. In-person recruitment opportunities including campus tours and on-site interviews were limited due to federal and hospital regulations, driving program leadership to develop novel strategies to engage with prospective applicants. This includes the use of social media as a means of promoting their training programs and attracting qualified applicants. (Plack 2023). Prior research has shown that these programs increased their social media presence in response to the COVID-19 pandemic; for example, a study of orthopedic surgery program directors showed that 79% of respondents reported generating increased social media content in response to COVID-19 restrictions (Butler, 2022). Social media use by academic training programs has expanded over the last decade for a variety of purposes, including medical education, engagement with the general public, and disseminating program and trainee accomplishments (O’Glasser, Desai and Cooney, 2019; Fick, Potini and Axon, 2019; Azoury et al., 2020 ). Many individuals in this generation of applicants, having grown up in the digital era, are accustomed to using social media as a means to discover information, and may be more apt than prior generations at utilizing social media when seeking knowledge about a medical training program (Fick, Potini and Axon, 2019). The positive impact of social media on the perception and intended rank position of programs has been previously established for applicants seeking positions in medical residency programs, with cited benefits including helping the program highlight its culture, camaraderie among trainees, faculty, and staff, and other intangible aspects of the program (Fuller 2022, O’Glasser, Desai and Cooney, 2019). However, the prevalence and impact of social media use in fellowship programs, specifically Primary Care Sports Medicine (PCSM) fellowship programs, have not been published. In this study, we aimed to determine the prevalence of social media use in PCSM fellowship programs, its impact on recruitment, and potential barriers to social media interaction between programs and applicants. Methods A complete list of primary care sports medicine fellowship programs was collected from the American Medical Society of Sports Medicine (AMSSM) website. Information on the prevalence of social media accounts created and managed by primary care sports medicine fellowship programs was gathered in September 2022 using publicly available online sources including Google search engine as well as social media website search functions on Instagram, Twitter, LinkedIn, Facebook, and YouTube. This study also utilized anonymous survey instruments with a cross-sectional approach to query PCSM fellowship directors, PCSM fellows and recent fellowship graduates, and PCSM program applicants. regarding their interaction with PCSM fellowship social media accounts and how social media influenced the perception of the programs during their application process. The first survey was disseminated through individual outreach to all fellowship directors of each primary care sports medicine fellowship program in the United States of America, as identified through AMSSM, which sought to identify program directors’ current use of and comfort level with utilizing social media as a recruitment tool for their program. A second survey with the intention to garner applicant perspectives on social media for recruitment was disseminated to current fellows through individual outreach to all program coordinators of each primary care sports medicine fellowship program, who were then asked to send the survey to the fellows in their program. This survey was also disseminated to recently graduated fellows and current fellowship applicants by posting a request to complete the survey on AMSSM social media pages and research platforms. The second survey queried trainee’s interaction with PCSM fellowship social media accounts, and how social media influenced the perception of the programs during the application process. Surveys were distributed from September to November 2022. Approval for this study was obtained through the University of California, San Francisco Institutional Review Board. Results Social Media Use by PCSM Fellowship Programs We identified 211 PCSM fellowship programs listed on the American Medical Society for Sports Medicine (AMSSM) website. Of these, 83% had a social media presence. The most used social media platforms were Instagram (43%), Facebook (30%), and Twitter (24%). 67 programs (32%) had at least one social media account that was specific to their PCSM fellowship program. An additional 107 PCSM fellowship programs were highlighted in institutional or departmental social media accounts that were not directly run by faculty, staff, or fellows within the fellowship. Prospective Applicant, Current or Recent Fellow Survey Results Fifty-eight individuals who identified as a current fellowship applicant, current fellow, or recent fellowship graduate completed the survey from a variety of primary specialties and socioeconomic backgrounds (see Fig. 1 ). Of those, 95% reported using social media. Approximately half of respondents reported utilizing social media for professional use and education, in addition to personal use. While most respondents were connected to friends and family on social media, 29% reported connecting with professional organizations on social media and 25% reported connecting with medical organizations. 90% of survey respondents reported using the fellowship website when researching information about fellowship programs during their fellowship application process, while 19% used social media to research programs. When asked what information trainees wanted to see on social media, the most reported responses included: sideline coverage opportunities (n = 23) fellow lifestyle including hobbies, out-of-hospital activities, and information about the city in which the fellowship program is located (n = 19), and fellowship curriculum including didactics, clinical rotations, and clinical sites (n = 16). In total, 35% of respondents reported following PCSM accounts. Lack of awareness of these accounts was the most common reason for not following them. Of the respondents who followed PCSM accounts, 22% reported that social media positively influenced their perception of a program and its rank list position. PCSM Fellowship Program Director Results Seventy fellowship directors responded to the survey intended to gather information on program director’s current use of and comfort level with utilizing social media as a recruitment tool for their program. 47% of respondents reported that their program did not have official guidelines for appropriate social media use. The most reported barriers for social media use included lack of time (32%), resources (13%), and oversight (11%). Discussion Our study found that the majority of PCSM fellowship programs, fellows, and applicants are present on social media. The prevalence of social media use in PCSM fellowship programs is high, with 83% of programs having a social media presence. However, only 35% of respondents (current, past and prospective PCSM fellows) reported following PCSM accounts, indicating a lack of awareness of these accounts among prospective applicants. Despite the limited use of PCSM social media accounts, our study found that social media presence can positively influence applicants' perception of a program and its rank list position. Of the respondents who followed PCSM accounts, 22% reported a positive effect on their perception of the program. This finding aligns with prior research on the positive impact of social media presence on applicant perception of a program (Butler, 2022, Fuller, 2022, Brinkman, 2022). For example, a study conducted on first year residents demonstrated that 68% (39/57) of the respondents agreed or strongly agreed that their perception of a program was positively influenced by the residency program’s social media account (Plack, 2023). Our study also identified potential barriers to social media use in PCSM fellowship programs, including lack of time, resources, and oversight. This finding aligns with prior research which also demonstrated barriers such as insufficient protected time, insufficient IT support to host a platform, and a lack of knowledge among faculty of how to utilize social media (Khadpe, 2019). Nearly half of the fellowship directors reported not having official guidelines for appropriate social media use, which could contribute to the lack of engagement with social media platforms. However, there is increasing interest in the use of social media for recruitment purposes; a survey of radiology showed that 38% of 132 associate PDs report social media use and roughly a quarter felt that program Facebook pages would be of value (Sterling, 2017, Deloney 2012). Future research and the development of social media guidelines can potentially facilitate social media growth by programs by improving program directors’ level of comfort with these platforms. By following guidelines such as those proposed below, graduate medical education programs can leverage social media platforms effectively for trainee recruitment while upholding principles of patient privacy, professionalism, and diversity, equity, and inclusion. Several limitations should be taken into account when interpreting the results of this study. The convenience sampling methods used to recruit participants may have biased responses towards those who are more likely to use social media or rely on electronic resources to guide decision-making. Therefore, the findings may not be generalizable to all PCSM fellowship applicants and programs. Additionally, the limited survey response rate from both program directors and fellows/applicants (25% and 16.8%, respectively) may have introduced nonresponse bias and affected the representativeness of the sample. However, reassuringly, the study demographics closely matched that of the American Medical Society of Sports Medicine population of primary care sports medicine physicians for gender and race/ethnicity (see Fig. 5 in Appendix ). Conclusions There has been increased attention on virtual recruitment of graduate medical education programs and social media has been shown to positively impact applicants’ perception of programs. Our study is the first to evaluate the impact of social medical use in the recruitment of PCSM fellows.l. A majority 83% of PCSM fellowship programs had a social media presence, with Instagram, Facebook, and Twitter being the most commonly used platforms, respectively. Social media presence may positively influence the perception of a program, while lack of awareness may serve as a barrier for interaction. The development of universal guidelines for appropriate social media use may help increase utilization of social media platforms for PCSM fellowship recruitment, particularly during times when in-person recruitment opportunities are limited. List Of Abbreviations PCSM primary care sports medicine Declarations Ethics approval and consent to participate : UCSF IRB-approved Consent for Publication: Not applicable Availability of data and materials: All data generated or analyzed during this study are included in this published article [and its supplementary information files]. Competing interests: The authors declare that they have no competing interests Funding: Not applicable Authors' contributions: TW formulated and disseminated the survey and was a major contributor in writing the manuscript. CP and MT extracted data on primary care sports medicine fellowship program use of social media platforms. CdB and NH assisted with the editing of the survey and manuscript draft. All authors read and approved the final manuscript. Acknowledgements: The authors would like to acknowledge Primary Care Sports Medicine fellowship program coordinators for assisting with the distribution of surveys to fellows and program directors. References Abcejo AS, Kraus MB, Long TR, Plack DL, Renew JR, Sharpe EE. Postgraduate-Year-1 Residents’ Perceptions of Social Media and Virtual Applicant Recruitment: Cross-sectional Survey Study. Interact J Med Res. 2023;12(1):e42042. Azoury SC, Mazzaferro DM, Piwnica-Worms W, Messa CA 4th, Othman S, Stranix JT, Serletti JM, Kovach SJ, Fosnot J. An Update on Social Media in Academic Plastic Surgery Training Programs: The Rising Trend of Likes, Shares, and Retweets. Ann Plast Surg. 2020;85(2):100–104. 10.1097/SAP.0000000000002289 . PMID: 32079812. Brinkman JC, Deckey DG, Tummala SV, Hassebrock JD, Spangehl MJ, Bingham JS. Orthopaedic Residency Applicants’ Perspective on Program-Based Social Media. JB JS Open Access. 2022;7(2):e2200001. 10.2106/JBJS.OA.22.00001 . Butler A, Berke C, Zareef U, et al. Social Media and the Orthopaedic Surgery Residency Application Process. Cureus. 2022;14(4):e23933. 10.7759/cureus.23933 . Coe MP, McManus TG, Pappas MA, Ray GS, Yong TM. Analyzing the Proliferation of Social Media Use Among Orthopaedic Surgery Residency Programs. JB JS Open Access. 2021;6(3):e2100017. Deloney LA, Deitte LA, Mullins ME, Robbin MR, Rozenshtein A. What program directors think: Results of the 2011 Annual Survey of the Association of Program Directors in Radiology. Acad Radiol. 2012;19:1583–8. Dunn T, Brinkman J, Gorlin A, Harbell MW, Milam AJ, Patel S. Influence of Social Media on Applicant Perceptions of Anesthesiology Residency Programs During the COVID-19 Pandemic: Quantitative Survey. JMIR Med Educ. 2023;9:e39831. 10.2196/39831 . Fick L, Potini Y, Palmisano K. (2019). Twelve Tips for Creating Your Program's Social Media Footprint. MedEdPublish. 8. 10.15694/mep.2019.000169.1 . Fuller CC, Brinkman JC, Deckey DG, Lu PG, Mishra N, Tummala SV, et al. General Surgery Residency Applicants’ Perspective on Social Media as a Recruiting Tool. J Surg Educ. 2022;79(6):1334–41. Irwin TJ, Eberlin KR, Helliwell LA, Lin SJ, Ortiz R, Riesel JN. The Impact of Social Media on Plastic Surgery Residency Applicants. Ann Plast Surg. 2021;86(3):335–9. Joo PY, Grauer JN, Moran J, Ready J, Rubin LE, Wilhelm C. Orthopaedic Program Reputation and Association With Social Media Utilization and Engagement. J Am Acad Orthop Surg Glob Res Rev. 2022;6(11):e2200095. 10.5435/JAAOSGlobal-D-22-00095 . Khadpe J, Repanshek Z, Singh M, et al. Barriers to Utilizing Social Media Platforms in Emergency Medicine Residency Programs. Cureus. 2019;11(10):e5856. 10.7759/cureus.5856 . Lee M, Fung CC. Trainee’s Perceptions and Practices on Social Media at One Internal Medicine Program and Its Potential Uses in Graduate Medical Education. MedEdPublish (2016). 2019;8:116. 10.15694/mep.2019.000116.1 . Malyavko A, Kim Y, Harmon TG, et al. Utility of Social Media for Recruitment by Orthopaedic Surgery Residency Programs. JB JS Open Access. 2021;6(3):e2100076. 10.2106/JBJS.OA.21.00076 . O'Glasser A, Desai SS, Cooney TG. Twelve Tips for Tweeting as a Residency Program [version 1]. MedEdPublish. 2019, 8:156 ( https://doi.org/10.15694/mep.2019.000156.1 ). Pearson D, Bond MC, Cooney R. Recommendations from the Council of Residency Directors (CORD) Social Media Committee on the Role of Social Media in Residency Education and Strategies on Implementation. West J Emerg Med. 2015;16(4):510–5. 10.5811/westjem.2015.5.25478 . Pruett JC, Deneen K, King TW, Kozar T, Singh NP, Turner H, et al. Social Media Changes in Pediatric Residency Programs During COVID-19 Pandemic. Acad Pediatr. 2021;21(7):1104–7. Renew JR, Gorlin A, Ladlie B, Long T. The Impact of Social Media on Anesthesia Resident Recruitment. J Educ Perioper Med. 2019;21(1):E632. Sterling M, Bishop TF, Leung P, Wright D. The Use of Social Media in Graduate Medical Education: A Systematic Review. Acad Med. 2017;92(7):1043–56. Walk CT, Gerardo R, Parikh PP. Increasing Social Media Presence for Graduate Medical Education Programs. Am Surg. 2023;89(5):2108–10. 10.1177/00031348211031848 . Xie DX, Dedmon MM, Haynes DS, O’Connell BP, Yawn RJ. Evaluation of Social Media Presence of Otolaryngology Residency Programs in the United States. JAMA Otolaryngol Head Neck Surg. 2018;144(9):802–6. 10.1001/jamaoto.2018.1447 . Additional Declarations No competing interests reported. Supplementary Files Appendix.docx Cite Share Download PDF Status: Published Journal Publication published 22 Jul, 2025 Read the published version in BMC Medical Education → Version 1 posted Editorial decision: Revision requested 21 Jun, 2024 Editor assigned by journal 19 Jun, 2024 Submission checks completed at journal 19 Jun, 2024 First submitted to journal 23 May, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4468497","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":317162702,"identity":"d864907a-9197-4bc2-9d40-0e271cde7137","order_by":0,"name":"Tiana S. 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Check all that apply.”\u003c/em\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4468497/v1/96e7853e421c2bfd929e2b2c.png"},{"id":59699059,"identity":"27889a7a-207f-431b-a1dd-71ebe284220b","added_by":"auto","created_at":"2024-07-05 03:58:12","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":127459,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eSample guidelines for appropriate social media use by graduate medical education programs\u003c/em\u003e\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-4468497/v1/1702f4f03790842f086922c3.png"},{"id":87756896,"identity":"e029d1bc-f627-4860-9823-ba57071fe47f","added_by":"auto","created_at":"2025-07-28 16:10:15","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":837895,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4468497/v1/ba3c0b07-2e00-43e1-92e9-470a2e4b53f0.pdf"},{"id":59699330,"identity":"4f162b1c-9f0d-4786-8ea4-491184172607","added_by":"auto","created_at":"2024-07-05 04:06:12","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":23417,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix.docx","url":"https://assets-eu.researchsquare.com/files/rs-4468497/v1/37c11067a976f690e90f394f.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Impact of Social Media Presence on Primary Care Sports Medicine Fellowship Recruitment: A Cross-Sectional Study","fulltext":[{"header":"Background","content":"\u003cp\u003eThe COVID-19 pandemic significantly affected the recruitment process of many academic medical centers' training programs. In-person recruitment opportunities including campus tours and on-site interviews were limited due to federal and hospital regulations, driving program leadership to develop novel strategies to engage with prospective applicants. This includes the use of social media as a means of promoting their training programs and attracting qualified applicants. (Plack 2023). Prior research has shown that these programs increased their social media presence in response to the COVID-19 pandemic; for example, a study of orthopedic surgery program directors showed that 79% of respondents reported generating increased social media content in response to COVID-19 restrictions (Butler, 2022).\u003c/p\u003e \u003cp\u003eSocial media use by academic training programs has expanded over the last decade for a variety of purposes, including medical education, engagement with the general public, and disseminating program and trainee accomplishments (O\u0026rsquo;Glasser, Desai and Cooney, 2019; Fick, Potini and Axon, 2019; Azoury et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Many individuals in this generation of applicants, having grown up in the digital era, are accustomed to using social media as a means to discover information, and may be more apt than prior generations at utilizing social media when seeking knowledge about a medical training program (Fick, Potini and Axon, 2019).\u003c/p\u003e \u003cp\u003eThe positive impact of social media on the perception and intended rank position of programs has been previously established for applicants seeking positions in medical residency programs, with cited benefits including helping the program highlight its culture, camaraderie among trainees, faculty, and staff, and other intangible aspects of the program (Fuller 2022, O\u0026rsquo;Glasser, Desai and Cooney, 2019). However, the prevalence and impact of social media use in fellowship programs, specifically Primary Care Sports Medicine (PCSM) fellowship programs, have not been published. In this study, we aimed to determine the prevalence of social media use in PCSM fellowship programs, its impact on recruitment, and potential barriers to social media interaction between programs and applicants.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eA complete list of primary care sports medicine fellowship programs was collected from the American Medical Society of Sports Medicine (AMSSM) website. Information on the prevalence of social media accounts created and managed by primary care sports medicine fellowship programs was gathered in September 2022 using publicly available online sources including Google search engine as well as social media website search functions on Instagram, Twitter, LinkedIn, Facebook, and YouTube.\u003c/p\u003e \u003cp\u003eThis study also utilized anonymous survey instruments with a cross-sectional approach to query PCSM fellowship directors, PCSM fellows and recent fellowship graduates, and PCSM program applicants. regarding their interaction with PCSM fellowship social media accounts and how social media influenced the perception of the programs during their application process. The first survey was disseminated through individual outreach to all fellowship directors of each primary care sports medicine fellowship program in the United States of America, as identified through AMSSM, which sought to identify program directors\u0026rsquo; current use of and comfort level with utilizing social media as a recruitment tool for their program. A second survey with the intention to garner applicant perspectives on social media for recruitment was disseminated to current fellows through individual outreach to all program coordinators of each primary care sports medicine fellowship program, who were then asked to send the survey to the fellows in their program. This survey was also disseminated to recently graduated fellows and current fellowship applicants by posting a request to complete the survey on AMSSM social media pages and research platforms. The second survey queried trainee\u0026rsquo;s interaction with PCSM fellowship social media accounts, and how social media influenced the perception of the programs during the application process. Surveys were distributed from September to November 2022. Approval for this study was obtained through the University of California, San Francisco Institutional Review Board.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eSocial Media Use by PCSM Fellowship Programs\u003c/h2\u003e \u003cp\u003eWe identified 211 PCSM fellowship programs listed on the American Medical Society for Sports Medicine (AMSSM) website. Of these, 83% had a social media presence. The most used social media platforms were Instagram (43%), Facebook (30%), and Twitter (24%). 67 programs (32%) had at least one social media account that was specific to their PCSM fellowship program. An additional 107 PCSM fellowship programs were highlighted in institutional or departmental social media accounts that were not directly run by faculty, staff, or fellows within the fellowship.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eProspective Applicant, Current or Recent Fellow Survey Results\u003c/h2\u003e \u003cp\u003eFifty-eight individuals who identified as a current fellowship applicant, current fellow, or recent fellowship graduate completed the survey from a variety of primary specialties and socioeconomic backgrounds (see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Of those, 95% reported using social media. Approximately half of respondents reported utilizing social media for professional use and education, in addition to personal use. While most respondents were connected to friends and family on social media, 29% reported connecting with professional organizations on social media and 25% reported connecting with medical organizations.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e90% of survey respondents reported using the fellowship website when researching information about fellowship programs during their fellowship application process, while 19% used social media to research programs. When asked what information trainees wanted to see on social media, the most reported responses included: sideline coverage opportunities (n\u0026thinsp;=\u0026thinsp;23) fellow lifestyle including hobbies, out-of-hospital activities, and information about the city in which the fellowship program is located (n\u0026thinsp;=\u0026thinsp;19), and fellowship curriculum including didactics, clinical rotations, and clinical sites (n\u0026thinsp;=\u0026thinsp;16).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eIn total, 35% of respondents reported following PCSM accounts. Lack of awareness of these accounts was the most common reason for not following them. Of the respondents who followed PCSM accounts, 22% reported that social media positively influenced their perception of a program and its rank list position.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePCSM Fellowship Program Director Results\u003c/h3\u003e\n\u003cp\u003eSeventy fellowship directors responded to the survey intended to gather information on program director\u0026rsquo;s current use of and comfort level with utilizing social media as a recruitment tool for their program. 47% of respondents reported that their program did not have official guidelines for appropriate social media use. The most reported barriers for social media use included lack of time (32%), resources (13%), and oversight (11%).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur study found that the majority of PCSM fellowship programs, fellows, and applicants are present on social media. The prevalence of social media use in PCSM fellowship programs is high, with 83% of programs having a social media presence. However, only 35% of respondents (current, past and prospective PCSM fellows) reported following PCSM accounts, indicating a lack of awareness of these accounts among prospective applicants.\u003c/p\u003e\n\u003cp\u003eDespite the limited use of PCSM social media accounts, our study found that social media presence can positively influence applicants\u0026apos; perception of a program and its rank list position. Of the respondents who followed PCSM accounts, 22% reported a positive effect on their perception of the program. This finding aligns with prior research on the positive impact of social media presence on applicant perception of a program (Butler, 2022, Fuller, 2022, Brinkman, 2022). For example, a study conducted on first year residents demonstrated that 68% (39/57) of the respondents agreed or strongly agreed that their perception of a program was positively influenced by the residency program\u0026rsquo;s social media account (Plack, 2023).\u003c/p\u003e\n\u003cp\u003eOur study also identified potential barriers to social media use in PCSM fellowship programs, including lack of time, resources, and oversight. This finding aligns with prior research which also demonstrated barriers such as insufficient protected time, insufficient IT support to host a platform, and a lack of knowledge among faculty of how to utilize social media (Khadpe, 2019). Nearly half of the fellowship directors reported not having official guidelines for appropriate social media use, which could contribute to the lack of engagement with social media platforms.\u003c/p\u003e\n\u003cp\u003eHowever, there is increasing interest in the use of social media for recruitment purposes; a survey of radiology showed that 38% of 132 associate PDs report social media use and roughly a quarter felt that program Facebook pages would be of value (Sterling, 2017, Deloney 2012). Future research and the development of social media guidelines can potentially facilitate social media growth by programs by improving program directors\u0026rsquo; level of comfort with these platforms. By following guidelines such as those proposed below, graduate medical education programs can leverage social media platforms effectively for trainee recruitment while upholding principles of patient privacy, professionalism, and diversity, equity, and inclusion.\u003c/p\u003e\n\u003cp\u003eSeveral limitations should be taken into account when interpreting the results of this study. The convenience sampling methods used to recruit participants may have biased responses towards those who are more likely to use social media or rely on electronic resources to guide decision-making. Therefore, the findings may not be generalizable to all PCSM fellowship applicants and programs. Additionally, the limited survey response rate from both program directors and fellows/applicants (25% and 16.8%, respectively) may have introduced nonresponse bias and affected the representativeness of the sample. However, reassuringly, the study demographics closely matched that of the American Medical Society of Sports Medicine population of primary care sports medicine physicians for gender and race/ethnicity (see Fig. \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e in \u003cspan class=\"InternalRef\"\u003eAppendix\u003c/span\u003e).\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThere has been increased attention on virtual recruitment of graduate medical education programs and social media has been shown to positively impact applicants\u0026rsquo; perception of programs. Our study is the first to evaluate the impact of social medical use in the recruitment of PCSM fellows.l. A majority 83% of PCSM fellowship programs had a social media presence, with Instagram, Facebook, and Twitter being the most commonly used platforms, respectively. Social media presence may positively influence the perception of a program, while lack of awareness may serve as a barrier for interaction. The development of universal guidelines for appropriate social media use may help increase utilization of social media platforms for PCSM fellowship recruitment, particularly during times when in-person recruitment opportunities are limited.\u003c/p\u003e"},{"header":"List Of Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePCSM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eprimary care sports medicine\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e: UCSF IRB-approved\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication:\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eAll data generated or analyzed during this study are included in this published article [and its supplementary information files].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u0026nbsp;\u003c/strong\u003eTW formulated and disseminated the survey and was a major contributor in writing the manuscript. CP and MT extracted data on primary care sports medicine fellowship program use of social media platforms. CdB and NH assisted with the editing of the survey and manuscript draft. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e The authors would like to acknowledge Primary Care Sports Medicine fellowship program coordinators for assisting with the distribution of surveys to fellows and program directors.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbcejo AS, Kraus MB, Long TR, Plack DL, Renew JR, Sharpe EE. Postgraduate-Year-1 Residents\u0026rsquo; Perceptions of Social Media and Virtual Applicant Recruitment: Cross-sectional Survey Study. Interact J Med Res. 2023;12(1):e42042.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAzoury SC, Mazzaferro DM, Piwnica-Worms W, Messa CA 4th, Othman S, Stranix JT, Serletti JM, Kovach SJ, Fosnot J. An Update on Social Media in Academic Plastic Surgery Training Programs: The Rising Trend of Likes, Shares, and Retweets. Ann Plast Surg. 2020;85(2):100\u0026ndash;104. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/SAP.0000000000002289\u003c/span\u003e\u003cspan address=\"10.1097/SAP.0000000000002289\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 32079812.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrinkman JC, Deckey DG, Tummala SV, Hassebrock JD, Spangehl MJ, Bingham JS. Orthopaedic Residency Applicants\u0026rsquo; Perspective on Program-Based Social Media. JB JS Open Access. 2022;7(2):e2200001. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2106/JBJS.OA.22.00001\u003c/span\u003e\u003cspan address=\"10.2106/JBJS.OA.22.00001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eButler A, Berke C, Zareef U, et al. Social Media and the Orthopaedic Surgery Residency Application Process. Cureus. 2022;14(4):e23933. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7759/cureus.23933\u003c/span\u003e\u003cspan address=\"10.7759/cureus.23933\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCoe MP, McManus TG, Pappas MA, Ray GS, Yong TM. Analyzing the Proliferation of Social Media Use Among Orthopaedic Surgery Residency Programs. JB JS Open Access. 2021;6(3):e2100017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDeloney LA, Deitte LA, Mullins ME, Robbin MR, Rozenshtein A. What program directors think: Results of the 2011 Annual Survey of the Association of Program Directors in Radiology. Acad Radiol. 2012;19:1583\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDunn T, Brinkman J, Gorlin A, Harbell MW, Milam AJ, Patel S. Influence of Social Media on Applicant Perceptions of Anesthesiology Residency Programs During the COVID-19 Pandemic: Quantitative Survey. JMIR Med Educ. 2023;9:e39831. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2196/39831\u003c/span\u003e\u003cspan address=\"10.2196/39831\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFick L, Potini Y, Palmisano K. (2019). Twelve Tips for Creating Your Program's Social Media Footprint. MedEdPublish. 8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.15694/mep.2019.000169.1\u003c/span\u003e\u003cspan address=\"10.15694/mep.2019.000169.1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFuller CC, Brinkman JC, Deckey DG, Lu PG, Mishra N, Tummala SV, et al. General Surgery Residency Applicants\u0026rsquo; Perspective on Social Media as a Recruiting Tool. J Surg Educ. 2022;79(6):1334\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIrwin TJ, Eberlin KR, Helliwell LA, Lin SJ, Ortiz R, Riesel JN. The Impact of Social Media on Plastic Surgery Residency Applicants. Ann Plast Surg. 2021;86(3):335\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJoo PY, Grauer JN, Moran J, Ready J, Rubin LE, Wilhelm C. Orthopaedic Program Reputation and Association With Social Media Utilization and Engagement. J Am Acad Orthop Surg Glob Res Rev. 2022;6(11):e2200095. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5435/JAAOSGlobal-D-22-00095\u003c/span\u003e\u003cspan address=\"10.5435/JAAOSGlobal-D-22-00095\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhadpe J, Repanshek Z, Singh M, et al. Barriers to Utilizing Social Media Platforms in Emergency Medicine Residency Programs. Cureus. 2019;11(10):e5856. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7759/cureus.5856\u003c/span\u003e\u003cspan address=\"10.7759/cureus.5856\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee M, Fung CC. Trainee\u0026rsquo;s Perceptions and Practices on Social Media at One Internal Medicine Program and Its Potential Uses in Graduate Medical Education. MedEdPublish (2016). 2019;8:116. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.15694/mep.2019.000116.1\u003c/span\u003e\u003cspan address=\"10.15694/mep.2019.000116.1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMalyavko A, Kim Y, Harmon TG, et al. Utility of Social Media for Recruitment by Orthopaedic Surgery Residency Programs. JB JS Open Access. 2021;6(3):e2100076. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2106/JBJS.OA.21.00076\u003c/span\u003e\u003cspan address=\"10.2106/JBJS.OA.21.00076\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eO'Glasser A, Desai SS, Cooney TG. Twelve Tips for Tweeting as a Residency Program [version 1]. 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Social Media Changes in Pediatric Residency Programs During COVID-19 Pandemic. Acad Pediatr. 2021;21(7):1104\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRenew JR, Gorlin A, Ladlie B, Long T. The Impact of Social Media on Anesthesia Resident Recruitment. J Educ Perioper Med. 2019;21(1):E632.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSterling M, Bishop TF, Leung P, Wright D. The Use of Social Media in Graduate Medical Education: A Systematic Review. Acad Med. 2017;92(7):1043\u0026ndash;56.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWalk CT, Gerardo R, Parikh PP. Increasing Social Media Presence for Graduate Medical Education Programs. Am Surg. 2023;89(5):2108\u0026ndash;10. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1177/00031348211031848\u003c/span\u003e\u003cspan address=\"10.1177/00031348211031848\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXie DX, Dedmon MM, Haynes DS, O\u0026rsquo;Connell BP, Yawn RJ. Evaluation of Social Media Presence of Otolaryngology Residency Programs in the United States. JAMA Otolaryngol Head Neck Surg. 2018;144(9):802\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1001/jamaoto.2018.1447\u003c/span\u003e\u003cspan address=\"10.1001/jamaoto.2018.1447\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Graduate Medical Education, Social media, Recruitment, Fellowship, Primary Care Sports Medicine","lastPublishedDoi":"10.21203/rs.3.rs-4468497/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4468497/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe COVID-19 pandemic limited in-person recruitment opportunities for many training programs at academic medical centers. This study aimed to determine the prevalence of social media use among Primary Care Sports Medicine (PCSM) fellowship programs and to investigate the impact of social media on recruitment. Additionally, potential barriers to social media interaction between programs and applicants were examined.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted using publicly available online sources to identify PCSM fellowship programs and corresponding social media accounts. PCSM Fellowship directors were surveyed regarding their program's use of social media. Prospective PCSM Fellowship Applicants and current fellows were surveyed to determine their interaction with PCSM fellowship social media accounts and how social media influenced their perception of the programs.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 211 PCSM fellowship programs were identified on the American Medical Society for Sports Medicine (AMSSM) website, of which 83% had a social media presence. The most commonly used platforms were Instagram (43%), Facebook (30%) and Twitter (24%). Among the surveyed fellows and applicants, 95% reported using social media, with 35% reported following PCSM accounts. Of those who did not follow, the most common reason was lack of awareness of these accounts. 22% of respondents indicated that social media positively influenced their perception of a program and its rank list position, while the remainder reported a neutral effect. 47% of the fellowship directors reported their program did not have official guidelines for appropriate social media use. Lack of time, resources, and oversight were identified as the most common barriers to social media use.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eA majority of PCSM fellowship programs, fellows, and applicants are present on social media. Social media presence can positively impact an applicant\u0026rsquo;s view of a program. However, applicants\u0026rsquo; lack of awareness of these accounts may serve as a barrier for interaction. The development of universal guidelines for appropriate social media use may help increase adoption and utilization of social media platforms for PCSM fellowship recruitment, particularly during times when in-person recruitment opportunities are limited.\u003c/p\u003e","manuscriptTitle":"The Impact of Social Media Presence on Primary Care Sports Medicine Fellowship Recruitment: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-05 03:58:07","doi":"10.21203/rs.3.rs-4468497/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-06-21T06:20:11+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-06-19T11:28:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-19T11:25:43+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2024-05-23T17:49:57+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f27daefe-abf8-4add-ba4b-1437e68bed10","owner":[],"postedDate":"July 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-28T16:07:52+00:00","versionOfRecord":{"articleIdentity":"rs-4468497","link":"https://doi.org/10.1186/s12909-025-07640-7","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2025-07-22 15:57:31","publishedOnDateReadable":"July 22nd, 2025"},"versionCreatedAt":"2024-07-05 03:58:07","video":"","vorDoi":"10.1186/s12909-025-07640-7","vorDoiUrl":"https://doi.org/10.1186/s12909-025-07640-7","workflowStages":[]},"version":"v1","identity":"rs-4468497","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4468497","identity":"rs-4468497","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}