Published on in Vol 4, No 2 (2021): Jul-Dec

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Assessment and Evaluation of Social Engagement in Dermatology Residency Programs on Instagram: Cross-sectional Study

Assessment and Evaluation of Social Engagement in Dermatology Residency Programs on Instagram: Cross-sectional Study

Assessment and Evaluation of Social Engagement in Dermatology Residency Programs on Instagram: Cross-sectional Study

Research Letter

1Department of Medicine, Staten Island University Hospital, Staten Island, NY, United States

2University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States

3Department of Dermatology, The George Washington School of Medicine and Health Sciences, Washington, DC, United States

4Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, United States

5Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, NY, United States

6Division of Dermatology, University of Kansas Medical Center, Kansas City, KS, United States

Corresponding Author:

Chapman Wei, MD

Department of Medicine

Staten Island University Hospital

475 Seaview Avenue

Staten Island, NY, 10305

United States

Phone: 1 7182268855


The majority of dermatology residency applicants could not complete away rotations or in-person interviews during the 2021 match cycle due to the COVID-19 pandemic [1]. Without these traditional in-person experiences, applicants needed new ways to get to know one another and learn about programs. Thus, many programs created or enhanced their social media accounts, specifically Instagram, providing an avenue for students to learn about their specific program [2]. By utilizing Instagram, students can be updated on departmental information and the program’s overall culture. In a survey study by Steel et al [3], 73% of respondents followed a plastics surgery residency social media account, with 86% using Instagram.

The Instagram engagement score (IES) is a tool that quantifies an Instagram account’s engagement [4]. It is the rate of the total number of likes and comments per the number of followers [4]. This study assessed the factors that influence the total follower count and IES of dermatology residency programs’ Instagram accounts.

Dermatology residency programs accredited by the Accreditation Council of Graduate Medical Education (ACGME) were identified using the ACGME Directory. Dermatology residency programs with Instagram accounts were identified and evaluated on March 6-7, 2021. Table 1 displays the evaluated variables. Posts were categorized as educational, departmental, academic and professional, social, or other. Univariate and multivariate analyses were performed (Table 2). Three authors independently collected data and resolved any discrepancies unanimously.

Of 145 programs, 78 (53.8%) had Instagram accounts, with 69 (88%) accounts that were active or posted content after November 2020. Other than posts, Instagram Stories Highlights was used most frequently (n=40, 51.3%). Most accounts (n=60) were created in 2020. The average total followers, total accounts following, and IES were 567.4 (SD 289.8), 186.5 (SD 251.1), and 9.06 (SD 3.4), respectively. The University of Miami had the most followers (n=2260) and the University of Kansas had the highest IES (IES=23.76). Program location and affiliation did not affect total followers or IES. Being top 10 on Doximity in terms of reputation (mean 870.9, SD 45.1 vs mean 537.5, SD 286.5; P=.003) and utilizing Instagram TV (mean 701.5, SD 429.0 vs mean 524.2, SD 215.9; P=.02) significantly increased total followers, but not IES.

Multivariate regression analyses showed that total accounts following (P<.001), account age (P<.001), and top 10 status on Doximity (P=.01) strongly correlated with a greater number of total followers (R2=0.75) (Table 2). Similarly, total followers (P<.001) and account age (P=.04) were moderately correlated with a greater IES (R2=0.42).

Instagram is a valuable platform for dermatology residency programs’ self-promotion and recruitment activities following COVID-19. Relative to Twitter and Facebook, Instagram is the ideal social media platform for recruitment because it offers the least amount of negative emotional content while providing positive entertainment, social interaction, and quick information [5]. Thus, dermatology residency programs can easily interact with potential applicants through their posts.

Table 1. Characteristics of dermatology residency programs’ Instagram accounts (N=78).
Categorical variables, n (%) 
 Active (posts more recent than November 2020)69 (88.5)
 Instagram Stories Highlights (photos or videos up to 15 seconds in length that are featured on the profile permanently)40 (51.3)
 Instagram Reels (15-30–second videos that can incorporate music or special effects)3 (3.8)
 Instagram TV (long-form videos up to 60 minutes in length)19 (24.4)
Location, n (%) 
 East North Central (IL, IN, MI, OH, WI)17 (21.8)
 East South Central (AL, KY, MS, TN)4 (5.1)
 Mid-Atlantic (NJ, NY, PA)9 (11.5)
 Mountain (AZ, CO, ID, MT, NM, NV, UT, WY)2 (2.6)
 New England (CT, MA, ME, NH, RI, VT)6 (7.7)
 Pacific (AK, CA, HI, OR, WA)8 (10.3)
 South Atlantic (DC, DE, FL, GA, MD, NC, SC, VA, WV)17 (21.8)
 West North Central (IA, KS, MN, MO, ND, NE, SD)8 (10.3)
 West South Central (AR, LA, OK, TX)7 (9.0)
 Territory (PR)0 (0)
Program affiliation, n (%) 
 Community3 (3.8)
 Community with university affiliation10 (12.8)
 University65 (83.3)
 Military0 (0)
Continuous variables, mean (SD); range 
 Account age (days) (as of March 07, 2021)346.8 (396.7); 6-2471
 Total followersa567.4 (289.8); 81-2260
 Total accounts following186.5 (251.1); 3-2045
 Total posts51.7 (57.0); 2-263
 Number of education posts3.1 (5.5); 0-25
 Number of departmental posts29.8 (37.1); 2-191
 Number of academic and professional posts7.8 (10.8); 0-50
 Number of social posts7.7 (8.6); 0-37
 Number of other posts3.2 (5.5); 0-26
 Instagram engagement score9.06 (3.4); 2.8-23.8

aOutcome of interest.

Table 2. Univariate and multivariate linear regression results: total followers or Instagram engagement score gained relative to study variables (P<.05 was considered statistically significant).
  P valueR2P valueR2
Total followers   0.749
 Account age<.0010.208.01 
 Total accounts following.0020.120<.001 
 Total posts<.0010.366.87 
 Educational posts.060.044.86 
 Departmental posts<.0010.430.90 
 Academic posts<.0010.239.86 
 Social posts.030.060.86 
 Other posts.010.084.77 
 Active (posts more recent than November 2020).08N/A.68 
 Instagram Stories Highlights.14N/A.66 
 Instagram Reels.64N/A.79 
 Instagram TV.02N/A.35 
 Doximity (top 10 reputation-wise).003N/A.01 
 Program location.54N/A.30 
 Program affiliation.58N/A.48 
Instagram engagement score   0.418
 Account age.440.008.04 
 Total followers<.0010.258<.001 
 Total accounts following.160.026.49 
 Total posts.020.071.61 
 Educational posts.850.000.60 
 Departmental posts.0080.089.60 
 Academic posts.070.043.61 
 Social posts.270.016.62 
 Other posts.280.016.65 
 Active (posts more recent than November 2020).30N/A.50 
 Instagram Stories Highlights.09N/A.28 
 Instagram Reels.90N/A.55 
 Instagram TV.51N/A.12 
 Doximity (top 10 reputation-wise).32N/A.16 
 Program location.94N/A.69 
 Program affiliation.35N/A.83 

We found several modifiable factors that may increase a program’s IES. Programs can indirectly increase their IES by following more accounts to increase the chances of likes and comments. In addition, programs should start utilizing tools like Instagram Stories Highlights, Instagram TV, and Instagram Reels.

This study has several limitations. The data were collected from only one social media platform because Instagram content was associated with more positive emotions compared to Twitter and Facebook, which is essential for marketing and recruitment [5]. This study is cross-sectional in design, which means the information presented may change over time.

Conflicts of Interest

None declared.

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IES: Instagram engagement score

Edited by R Dellavalle, T Sivesind; submitted 14.07.21; peer-reviewed by A Gu, T Quan; comments to author 24.07.21; revised version received 28.07.21; accepted 28.07.21; published 26.08.21


©Chapman Wei, Sophie Bernstein, Nagasai Adusumilli, Mark Marchitto, Frank Chen, Anand Rajpara. Originally published in JMIR Dermatology (, 26.08.2021.

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 work, first published in JMIR Dermatology Research, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.