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.

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.