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An Evaluation of Content and Accessibility of Hand Surgery Fellowship Websites
Jason Silvestre, BS1; J.Z. Guzman, BS2; Benjamin Chang, MD3; L. Scott Levin, MD4
1Perelman School of Medicine, Philadelphia, PA; 2Icahn School of Medicine, New York City, NY; 3Division of Plastic Surgery, University of Pennsylvania Health System, Philadelphia, PA; 4Department of Orthopedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA

Background: Hand fellowship programs compete for trainees in general, orthopedic, and plastic surgery residencies. These applicants use resources on the Internet to manage their fellowship applications. The purpose of this study was to evaluate the accessibility of information from commonly used databases and assess the content of HFWs.

Methods: Websites from eighty-one accredited hand surgery fellowships available during the 2014 academic year were eligible for study inclusion. Program lists from the Fellowship and Residency Electronic Interactive Database (FREIDA) and the Fellowship Program Directory of the American Society for Surgery of the Hand (ASSH) were assessed for program information and working links to HFWs. Available HFWs were evaluated for comprehensiveness in the domains of fellow education and recruitment. Website content was correlated with program characteristics. All statistical tests were two-tailed and P values less than 0.05 were considered significant.

Results: 15 plastic, 65 orthopedic, and 1 general surgery hand fellowships were analyzed. FREIDA had 12 working links to HFWs and ASSH had 34 (15% vs 42%, P<0.001). However, FREIDA had in-depth training statistics for 44 programs (54%), while ASSH had none. Links to HFWs did not vary by surgical specialty (p=0.655). Of the 81 accredited fellowships, 74 had HFWs (91%). 3 plastic and 4 orthopedic hand programs did not have an HFW (20% vs 6%, p=.118). As a whole, HFWs provided an average of 5.4 education and 4.9 recruitment variables. The majority of HFWs described commonly treated conditions (89%), affiliated sites (81%), academic conferences (69%), didactic instruction (68%), and journal clubs (64%). For recruitment, HFWs commonly had information on faculty (89%), eligibility (72%), application links (59%), fellows (42%), and previous graduates (34%). Orthopedic programs had more education content than plastic surgery programs (55% vs 44%, p=0.030). Programs in the South had more education content than programs in the Northeast (63% vs 47%, p=0.001), but not more than programs in the West or Midwest. Larger programs with more hand fellows had greater education content than those with only one fellow (57% vs 49%, p=0.042). Programs affiliated with highly ranked medical schools had less education content than their lower ranked counterparts (48% vs 56%, p=0.045). No differences existed in online recruitment content between programs.

Conclusions: Most accredited hand surgery fellowships lack readily accessible websites in commonly used databases. Furthermore, a paucity of online content suggests HFWs are underutilized as education and recruitment tools. Future opportunity may exist to utilize these resources more effectively.

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