Vascular surgery took the national stage during the last week of July as outraged medical professionals across the country responded to a visual abstract posted on Twitter which highlighted a study recently published in the Journal of Vascular Surgery (JVS). In short, the study by Scott Hardouin, MD, et al, entitled “Prevalence of unprofessional social media content among young vascular surgeons,” missed the mark.
Its authors suggest the intent was to “empower surgeons” to be cognizant of their social medial footprint available to the general public, including patients and potential employers.
Their “goal was to evaluate the extent of unprofessional social media content among recent vascular surgery fellows and residents,” and they went on to define “professionalism” with a subjective scoring system that demonstrated their own biases, supporting the following as “clearly unprofessional content.”
They wrote: “Health Insurance Portability and Accountability Act (HIPAA) violations, intoxicated appearance, unlawful behavior, possession of drugs or drug paraphernalia, and uncensored profanity or offensive comments about colleagues/work/patients.”
Meanwhile, “potentially unprofessional content” also cited included “holding/consuming alcohol, inappropriate attire, censored profanity, controversial political or religious comments, and controversial social topics.”
These categories were based on previously published studies of “unprofessional” social media content among general surgery and urology residents.1, 2 The methodology was flawed, and some might suggest unethical as three trainees created fake social media accounts to “study” the 2018 accounts of new vascular surgery graduates (graduating classes of 2016 and 2017). While the study had Institutional Review Board (IRB) approval, the “studied” individuals “waived consent.”
The authors further cited that “inappropriate attire included pictures in underwear, provocative Halloween costumes, and provocative posing in bikinis/swimwear… Controversial social comments were largely limited to comments centered around specific stances on abortion and gun control.”
Labeling these posts “potentially unprofessional” perhaps garnered the most backlash from social media, prompting the viral #Medbikini response on Twitter and Instagram, as countless women and men then posted pictures of themselves in bikinis or other casual attire in mutual support of such “unprofessional” behavior.
Many have criticized that the study unfairly targeted women and other minorities in vascular surgery, potentially deepening inequities that have been slow to change despite years of efforts from our leadership.
The abstract passed through the program committee of a major vascular surgery society, was presented to a group of vascular surgeons at a national meeting, and then went through the peer review process for publication in our leading journal approximately six months ago. We feel this was a lapse in judgement, and clarified—yet again—the need to address gender and ethnic disparities in our specialty.
The Association of Program Directors in Vascular Surgery (APDVS) was indirectly associated with this study, as our directory was used to compile a list of graduating vascular surgery trainees from 2016 to 2018. We have already posted a statement on SVSConnect confirming that the APDVS was not involved in the planning, nor the conduct of this study, and immediately removed the internal, password-protected list roster of program directors and trainees.
Additionally, all future access to program director and trainee information will be limited to requests for research, which will be vetted by the issues committee and the appropriate APDVS committee for educational value, with final approval by the APDVS Executive Board (as has been previously the case).
The Executive Board would like to further extend our statement and broadly declare that we support our trainees’ excellence, independence and their diversity. The rising generation of vascular surgeons has been raised in the digital era of social media and, perhaps more than any cohort of surgeons, they are most aware of their online presence.
The system needs to mature and adapt, and the APDVS is committed to supporting and moving forward critical cultural and educational efforts that support our diverse workforce of current program directors, vascular surgery trainees, and rising recruits. Diversity is powerful, and our trainees more than anyone should have a supportive training culture to thrive.
The APDVS and its program directors have often been an advocate for these priorities. And while strides have been made by many within our field of vascular surgery, we recognize the monumental work ahead in enhancing surgical culture in the name of patient care, addressing healthcare disparities, prioritizing vascular surgeon well-being, and optimizing surgical education for all current and rising vascular surgery trainees. As such, the APDVS re-avows its commitment to aiding and supporting all vascular surgery program directors and trainees with these vital missions.
- Koo K., Ficko Z., Gormley E.A. Unprofessional content on Facebook accounts of U.S. urology residency graduates. BJU Int. 2017;119(6):955-60.
- Langenfeld S.J., Cook G., Sudbeck C., Luers T., Schenarts P.J. An assessment of unprofessional behavior among surgical residents on Facebook: a warning of the dangers of social media. J Surg Educ. 2014;71(6):e28-32.
The APDVS Executive Board writing team was made up of Murray Shames, MD, Jason Lee, MD, Malachi Sheahan III, MD, Dawn M. Coleman, MD, and William Robinson, MD.