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Accessibility and Quality of Online Information Regarding Hand Surgery Fellowship
Richard M. Hinds, MD; Christopher Klifto, MD; Amish Naik, MD, PhD; Anthony Sapienza, MD; John T. Capo, MD
NYU Hospital for Joint Diseases, New York, NY

Introduction: The Internet is a popular resource for applicants researching fellowship programs. Despite its wide-spread use, there is no standardization of content, quality, and accessibility of training program information on the Internet. The purpose of the current investigation was twofold: 1) to assess the accessibility of hand surgery fellowship websites and 2) to evaluate the quality of information provided via program websites. We hypothesized that fellowship websites would demonstrate highly variable accessibility and poor quality in the presentation of program information online.
Methods: The American Society for Surgery of the Hand (ASSH) Fellowship Program Directory was queried for review of American Council for Graduate Medical Education (ACGME)-accredited hand surgery fellowship programs. Provided links to program websites were explored for accessibility and quality of information. Program website accessibility from outside the directory was assessed using a Google search. Accessible websites were reviewed for the presence of the following fellowship educational components: didactic learning (lecture series), journal club, research requirements, call responsibilities, rotation schedule, operative case descriptions, office/clinic time, required meetings/courses, and list of teaching faculty. Fellowship recruitment information was also assessed and included: program description, application requirements, link to NRMP website, program contact email, current and/or past fellows, and salary. A 2 test was used to compare website accessibility between the ASSH Fellowship Program Directory and the Google search.
Results: Eighty-one ACGME-accredited fellowship programs were included for analysis. The ASSH Fellowship Program Directory contained a link to 72 program websites. Of the 72 websites, 11 links connected to non-functioning websites, 6 links connected to websites without program information, 29 links required multiple steps to access program information, and 26 links directly connected to program information. An independent Google search produced 70 direct links, demonstrating significantly more direct links to program websites than the ASSH Fellowship Program Directory (86% vs 32%; P < 0.001). Of the remaining 11 websites not accessible via the Google search, 2 were accessed via the ASSH Fellowship Program Directory for a total of 72 accessible program websites. Of the 72 accessible program websites, only 19% (14/72) featured at least two-thirds of the assessed quality components. Figure 1 summarizes fellow education and recruitment information quality, respectively.
Conclusions: Hand fellowship websites demonstrate highly variable accessibility. The vast majority of hand fellowship program information presented online is poor. Hand fellowship programs and professional societies should undertake efforts to ensure that fellowship applicants have access to high quality online program information.

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