J. Dengler¹, R. Austin¹, K. Devon^2,4, J. Fish^{1,3 1}University of Toronto,Division Of Plastic & Reconstructive Surgery,Toronto, Ontario, Canada ²University of Toronto,Division Of General Surgery,Toronto, Ontario, Canada ³Hospital For Sick Children,Plastic & Reconstructive Surgery,Toronto, Ontario, Canada ⁴Women’s College Hospital,General Surgery,Toronto, Ontario, Canada

Introduction:
The use of online social networking (OSN) has become ubiquitous amongst medical trainees, and is continuing to grow. With its widespread use, residency training programs have started to incorporate OSN profile screening as an additional tool for evaluating applicants, a technique widely used in the hiring process of other professional industries. However, the value of screening residency applicants on social media websites remains undefined and controversial. The aim of our study was to prospectively examine the online social media presence of residency applicants before and after the residency match, and to characterize applicants’ perspectives on the use of OSN screening in the residency selection process.

Methods:
Two independent investigators searched several prominent social media websites (Facebook, Twitter, LinkedIn, Instagram, MySpace, and GooglePlus) to determine whether they could identify the OSN profiles of students applying to a single surgical residency program at the University of Toronto. The search was performed in three iterations: the first during the 2014/2015 Canadian residency matching process, the second after the residency match was finalized but prior to the start of residency training, and the third several months after the start of residency training. The degree to which profiles were publicly accessible was noted. After the last search was complete, applicants were surveyed on their OSN use as well as their OSN behaviour during the application cycle.

Results:
The most frequently used OSN website is Facebook, with 17% (8 of 46) of applicants being identifiable during the match compared to 39% after the match was complete. Only 7% of applicants were found on Instagram; this increased by 13% after the match was complete. The presence on Twitter and LinkedIn remained unchanged (13% and 45%, respectively). Moreover, the profile content on LinkedIn was limited to what was available in a candidate’s application. The majority of profiles were only identifiable when an applicant’s photo was used (72%). Moreover, identifying profiles of candidates with more common names was largely unsuccessful. Although inter-rater reliability of identifying profiles was adequate (kappa = 0.843), the search process was time consuming (average 10 minutes per candidate). Applicant survey responses are being actively collected and analyzed.

Conclusion:
This study suggests that residency applicants limit their public OSN presence during the application cycle, with a re-emergence of OSN use after residency spots have been secured. Moreover, the majority of OSN platforms are of low yield, and searches cannot be performed without photographic identification, which may pose ethical concerns. If OSN profiling is to become a standard part of the residency application process, searches must be limited to high-yield platforms, and guidance must be sought from other industries to maximize the efficiency of OSN profiling and to ensure an ethical practice.