#PathTwitter: A Positive Platform Where Medical Students Can Engage the Pathology Community

The positive impact of social media on pathology and medical students' perceptions of the specialty has been well documented in recent years. For example, in a 2017 article by Isom et al,1 the authors state that "[s]ocial media has exploded in popularity in recent years" and has enabled medical students, physicians, and other laboratory professionals worldwide to communicate, collaborate, network, and develop new ideas. Social media is used by residency programs to recruit medical students as well, the importance of which cannot be overstated after the COVID-19 pandemic.2 A national survey of 350 US allopathic (MD) fourth-year medical students published by McCloskey et al3 in 2020 showed that 94 (27%) students considered pathology for a career. Internet/social media was the second most commonly used resource used to research pathology, with 51% of students using it.3 The most frequently used social media platform that the survey respondents admitted to using was Student Doctor Network (SDN) (26%), while Reddit (Reddit, Inc.) was used by 17%.3 Unfortunately, the respondents felt "information on social media and perception of the pathology job market do not seem to be positive and few respondents agreed that pathology is a highly regarded specialty."3While these data may seem to contradict the positive influence social media has on pathology and medical student recruitment, a 2019 article by Jajosky et al4 may help explain the responses of the MD students in the previous study. In this article, Jajosky et al4 investigate how negative discussions about the pathology job market on SDN, a well-known social media website for medical students and physicians, may have contributed to fewer US medical student seniors choosing pathology residency in recent years. The authors argue that discussion threads, such as those titled "No Jobs!" and "WOW NO JOBS IN PATHOLOGY," are false claims since PathologyOutlines.com updates hundreds of US pathology- and pathologist-related job market listings frequently5 and likely deterred MD and possibly osteopathic (DO) seniors from pursuing pathology.6 In addition, negative comments on SDN, such as those describing pathology as "mindnumbingly boring" and "low pay" were also likely to deter students.4,6 Similar cynical comments can be found on Reddit, which is another popular online networking forum composed of various communities (eg, pathology, medical school).4,7,8 For example, a recent Reddit post titled "Cons of pathology" said that "cons of the field" include "less pay than other specialties," "bad job market," and "other specialties may look down on [pathologists]."9In light of this, and in response to Isom et al,1 how may social media have a positive impact on medical students' perceptions of pathology? The COVID-19 pandemic influenced many pathology departments and residency programs to become more active on social media platforms and develop social media pages.10,11 This likely occurred to aid in the virtual recruitment of students when in-person activities became discouraged at the start of the pandemic in early 2020.10 This was shown by a study of 138 pathology residency programs obtained from the Electronic Residency Application Service.10 Specifically, fewer than 10 pathology programs had Twitter (Twitter, Inc.) accounts in 2019, but this number spiked to 25 in 2020.10 Similarly, fewer than 5 pathology programs had Instagram (Meta Platforms, Inc.) accounts in 2019, but that number increased to more than 15 in 2020.10 Of the 132 Twitter, Instagram, and Facebook (Meta Platforms, Inc.) accounts by pathology programs, 46 (34.8%) were created after March 1, 2020.10 Remarkably, Twitter (n = 69 of 132, or ∼52.3%) is the most commonly established social media platform among pathology programs, when compared to Facebook (n = 34 of 132, or ∼25.8%) and Instagram (n = 29 of 132, or ∼22.0%).10 The survey studied by McCloskey et al, 3 in which no students had cited Twitter, Instagram, or Facebook as influential social media platforms toward their perceptions of pathology, was administered throughout spring 2019, approximately 1 year prior to the onset of the pandemic.The strong preference of pathology departments and residency programs for choosing Twitter, instead of Facebook or Instagram, during the pandemic begs the question of "why Twitter?" First, what is it? As described in an article by Gil12 in 2021, "Twitter is an online news and social networking site where people communicate in short messages called tweets." Tweets are "microblogs" of 280 characters or fewer that anyone with a Twitter account can like, comment, retweet, or quote.12 It is a "scan-friendly" media (ie, a user can easily scroll through hundreds of Tweets at a moment's notice). Its hundreds of millions of users can use tweets to tag or "cc" others (eg, @CaseyPSchukow)13 or apply hashtags to categorize their content (eg, #pathology).14 In accordance with current US privacy laws (Health Insurance Portability and Accountability Act of 1996), pathologists can both legally and ethically share deidentified images of pathology specimens (eg, histology slides) on social media, without specific patient consent.15,16 This is a common practice among pathologists who use Twitter to share interesting cases and generate discussion.16 Regarding medical student recruitment, pathology residency programs and departments can utilize pathology-focused hashtags, such as #Path2Path, to communicate with potential applicants virtually and address any misconceptions (eg, no jobs in pathology).4,10An exemplar of this virtual pathology Twitter community is #PathTwitter (or #pathtwitter), which is meant to "share ideas, research, educational content, and opportunities" and to make "pathology more accessible."17 Because of its ability to allow users to actively participate in live-tweeted cases, conferences, journal clubs, and other discussions, as explained by Towery et al18 in 2020, "#PathTwitter is a vibrant, supportive, and interactive community that has something to offer not just pathologists, but also the students who hope to follow in their footsteps." To support this claim, Towery et al18 surveyed MDs and DOs who matched into pathology residency in March 2020 and found that 86.7% (n = 13 of 15) stated that they would "recommend that upcoming applicants get involved in social media." Participating in this pathology online community allowed applicants to interact with faculty and residents from distant programs, too.18A follow-up survey by Towery et al18 through the Association of Pathology Chairs listserv showed that 73% (n = 22 of 30) of pathology faculty "viewed professional social media use at any career stage favorably or somewhat favorably." Similarly, a survey of participants using PathElective.com, a free virtual pathology elective founded by pathologists in 2020, showed that about half "engaged with the PathTwitter community on Twitter" and 99% felt #PathTwitter was useful.19 Although social media may not be for everyone, #PathTwitter has redefined virtual pathology socialization, and its community continues to grow and support its members. Currently, there is limited research that directly compares the influences of Twitter, Facebook, and Instagram among medical students in regard to pathology. Having said this, future studies on this topic may help pathologists, pathology departments and residencies, trainees, and medical students better understand the ways they can best utilize each social media platform to share, connect, and network. For anyone who is interested in joining Twitter or other social media platforms but does not know where to start, pathology social media experts such as Jerad M. Gardner, MD, dermatopathologist and bone–soft tissue pathologist at Geisinger Medical Center (Danville, Pennsylvania), have established helpful navigation guides.20In conclusion, #PathTwitter is a friendly and warm-hearted virtual community where medical students interested in pathology can actively engage in conversations with others in pathology. Although novices in social media use may feel that discussions on this platform are superficial, #PathTwitter promotes in-depth engagement and successful advocating for the field among medical students. Furthermore, its ability to provide collaboration with allied health fields and patients has been documented in many ways. Genuine, positive social media platforms such as #PathTwitter should be encouraged for interested medical students to learn more about pathology.