• Brittany O Dulmage, Lisa Akintilo, Leah J Welty, Matthew M Davis, Maria Colavincenzo, and Shuai Xu.
• Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Medical Education Clinical Scholars Program, Northwestern University Feinberg School of Medicine, Chicago, Ill.
• Am. J. Med. 2018 Sep 1; 131 (9): 1130-1134.e6.

ImportanceResidency applicants often use social media to discuss the positive and negative features of prospective training programs. An examination of the content discussed by applicants could provide guidance for how a medical education faculty can better engage with prospective trainees and adapt to meet the educational expectations of a new generation of digital-native physicians.ObjectiveThe objective was to identify unstructured social media data submitted by residency applicants and categorize positive and negative statements to determine key themes.DesignThe study design was qualitative analysis of a retrospective cohort.SettingPublicly available datasets were used.ParticipantsThe participants were anonymized medical trainees applying to residency training positions in 9 specialties-dermatology, general surgery, internal medicine, obstetrics/gynecology, plastic surgery, otolaryngology, physical medicine and rehabilitation, pediatrics, and radiology-from 2007 to 2017.Main Outcomes And MeasuresAfter we developed a standardized coding scheme that broke comments down into major features, themes, and subthemes, all unstructured comments were coded by two independent researchers. Positive and negative comments were coded separately. Frequency counts and percentages were recorded for each identified feature, theme, and subtheme. The percent positive and negative comments by specialty were also calculated.ResultsOf the 6314 comments identified, 4541 were positive and 1773 were negative. Institution was the most commonly cited major feature in both the positive (n = 767 [17%]) and negative (n = 827 [47%]) comments. Geography was the most cited theme, and City, Cost of Living, and Commute were commonly cited subthemes. Training was the next most cited major feature in both positive (n = 1005 [22%]) and negative (n = 291 [16%]) comments, with Clinical Training being more commonly cited compared to Research Opportunities. Overall, 72% of comments from all were positive; however, the percent of comments that were positive comments varied significantly across the 9 specialties. Pediatrics (65%), dermatology (66%), and internal medicine (68%) applicants were more likely to express negative comments compared with the global average, but physical medicine and rehabilitation (85%), radiology (82%), otolaryngology (81%), and plastic surgery (80%) applicants were more likely to express positive comments.Conclusions And RelevanceThis qualitative analysis of positive and negative themes as posted by applicants in recent matching years is the first and provides new detailed insights into the motivations and desires of trainees.Copyright © 2018. Published by Elsevier Inc.

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