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There is scant insight into the presence of nuclear medicine (NM) and nuclear radiology (NR) programs on social media.
Our purpose was to assess Twitter engagement by academic NM/NR programs in the United States.
We measured Twitter engagement by the academic NM/NR community, accounting for various NM/NR certification pathways. The Twitter presence of NM/NR programs at both the department and program director level was identified. Tweets by programs were cross-referenced against potential high-yield NM- or NR-related hashtags, and tabulated at a binary level. A brief survey was done to identify obstacles and benefits to Twitter use by academic NM/NR faculty.
For 2019-2020, 88 unique programs in the United States offered NM/NR certification pathways. Of these, 52% (46/88) had Twitter accounts and 24% (21/88) had at least one post related to NM/NR. Only three radiology departments had unique Twitter accounts for the NM/molecular imaging division. Of the other 103 diagnostic radiology residency programs, only 16% (16/103) had a presence on Twitter and 5% (5/103) had tweets about NM/NR. Only 9% (8/88) of NM/NR program directors were on Twitter, and three program directors tweeted about NM/NR. The survey revealed a lack of clarity and resources around using Twitter, although respondents acknowledged the perceived value of Twitter engagement for attracting younger trainees.
Currently, there is minimal Twitter engagement by the academic NM/NR community. The perceived value of Twitter engagement is counterbalanced by identifiable obstacles. Given radiologists’ overall positive views of social media’s usefulness, scant social media engagement by the NM community may represent a missed opportunity. More Twitter engagement and further research by trainees and colleagues should be encouraged, as well as the streamlined use of unique hashtags.
Social media use among adults in the United States has increased substantially over the last decade, with the percentage of people who use at least one social media account doubling from 36% in 2009 to 72% in 2019 [
As a specialty, nuclear medicine (NM) and Molecular Imaging is complex as there are several pathways to achieve posttraining certification in NM or nuclear radiology (NR). Physicians and scientists—both those trained in radiology and those not trained in radiology—pursue the various training pathway options in the United States [
Although these two developments as described are separate, we propose that social media may represent an opportunity and serve as a resource that the academic NM/NR community can use for outreach efforts aimed at attracting future trainees. However, to our knowledge, there is very little information on the presence of NM and NR programs on social media, specifically Twitter.
Social media analytics tools such as Symplur allow codifying of data through ontology hashtags on Twitter [
Our purpose was to assess Twitter engagement by academic NM/NR programs in the United States, and to further characterize the value proposition of social media use in this specialty.
Institutional Review Board approval was deemed not necessary for this study as it is an internet-based study accessing publicly available information. We compiled a composite list of programs that offered NM residency, NR fellowships, and dual DR/NR pathways and radiology residencies for 2019-2020, obtained from the American Board of Medical Specialties, the American Board of Nuclear Medicine (ABNM), the Accreditation Council for Graduate Medical Education, and the Electronic Residency Application System [
In December 2019, a manual search for Twitter handles was done for each of these radiology programs, followed by consensus reconciliation by a radiology fellow and a radiology resident. The search process was iterative, using the “Search,” “Top,” and “People” features of Twitter. The Twitter presence of a training program was considered positive if the program had a Twitter handle (account) for the radiology department or radiology residents. If a program had additional Twitter handles specifically for its NM/NR division, it was noted separately. A manual search using the “Search” and “People” features was also done to identify individual Twitter handles of program directors for NM residencies, fellowship directors for NR fellowships, program directors for DR programs, and/or NR division chairs for those programs only offering DR/NR pathways. These individuals are collectively referred to as program directors throughout. A program director Twitter presence was considered positive if any of the above individuals meeting the definition of a program director had an individual Twitter account. For general radiology residency programs that do not offer NM/NR training pathways but have a NM/NR division, the NM division chiefs were considered as surrogates for a program director to measure Twitter presence (ie, if the division chair had a Twitter handle, it was considered equivalent to program director Twitter presence, even if the division did not offer NM or NR certification). The search was done by two people to improve yield and minimize data deletion.
We then conducted a search cross-matching all potential NM- or NR-related hashtags (
List of potential nuclear medicine and nuclear radiology hashtags queried to measure the Twitter presence of academic radiology programs.
Twitter hashtag | Reason selected |
#nucmed | Hashtag for nuclear medicine mentioned in the radiology ontology project |
#molrad | Hashtag for molecular imaging mentioned in radiology ontology project |
#nuclearmedicine | Full expansion of subspecialty |
#nuclearradiology | Full expansion of subspecialty |
#molecularimaging | Full expansion of subspecialty |
#petct | Popular hybrid imaging modality |
#petmri | Upcoming hybrid imaging modality |
#precisionmedicine | Used by Society of Nuclear Medicine and Molecular Imaging in its tweets to promote the field |
#precisionimaging | Used by Society of Nuclear Medicine and Molecular Imaging in its outreach tweets to promote the field |
#FOAM #nucmed | Hashtag used to promote Free and Open Access to Medical Education (FOAM) on Twitter, considered synonymous with education |
#FOAMrad #nucmed | Hashtag used to promote Free and Open Access Medical Education, considered synonymous with radiology trainee education |
For 2019-2020, 39 unique programs were included under NM residency, 15 under NR fellowship, and 34 under the DR/NR category. The 34 programs in the DR/NR category only offered the DR/NR pathway without NR fellowships. Thus, 88 radiology programs offered training pathways to certification in NM or NR. Of the other 103 radiology residencies, the residents may have only been exposed to NM rotations as part of their radiology residency, without a formal pathway for certification. The results for Twitter engagement by radiology programs and program directors are summarized in
Summary of Twitter activity related to nuclear medicine or nuclear radiology for radiology programs in 2019-2020.
Activity | NMa residency (n=39), n (%) | NRb fellowship (n=15), n (%) | Dual DRc/NR pathway (n=34), n (%) | Other radiology residencies (n=103), n (%) |
Radiology Twitter handle | 24 (62) | 8 (53) | 14 (41) | 16 (16) |
NM- or NR-specific Twitter handle | 3 (8) | 0 (0) | 0 (0) | 0 (0) |
Radiology handles tweeting about NM- or NR-related content | 13 (33) | 4 (27) | 4 (9) | 5 (5) |
Program directors with Twitter handles | 3 (8) | 4 (27) | 0 (0) | 0 (0) |
Program directors tweeting about NM- or NR-related content | 2 (5) | 1 (7) | 0 (0) | 0 (0) |
aNM: nuclear medicine.
bNR: nuclear radiology.
cDR: diagnostic radiology.
Out of all programs offering NM/NR training pathways, 46/88 (52%) had radiology accounts on Twitter but only 3/88 (4%) had an exclusive Twitter handle for NM or NR. Of these 88 programs, 21/88 (24%) had at least one tweet related to NM/NR. However, programs offering only DR/NR pathways were less likely to have tweeted about NM- or NR-related content (4/34, 9%) than NM residencies (13/39, 33%) and NR fellowships (4/15, 27%;
A content-based subanalysis of NM- and NR-related tweets in December 2019 cross-referenced against hashtags revealed 6 primary tweets by 3 programs for #nucmed, 5 of which were related to NM talks at the annual meeting of the Radiology Society of North America (RSNA), while the remaining tweet was related to department promotion. There were no tweets for the radiology ontology hashtag #molrad but there were 6 tweets/retweets by 6 departments for #molecularimaging, related to RSNA talks and department lectures (n=5) and department promotion (n=1). There were no tweets by academic NM/NR programs with other hashtags such as #precisionmedicine, #precisionimaging, #nuclearmedicine, #FOAMRad #nucmed, and #FOAMed #nucmed. There were also no tweets by NM/NR programs related to radiology education, patient education, research activities, and peer networking.
The brief survey sent to NM/NR faculty and staff via NMPDA contacts further characterized the status of social media use. Overall, one-third of the people contacted (15/45) responded to the survey. The majority of respondents (12/15, 80%) confirmed that they did not have a Twitter handle for their role in their training program; only 3 (20%) had Twitter handles. The majority (11/15, 73%) also confirmed that their programs did not have a unique Twitter handle for their radiology department or NM/NR divisions; only 4 respondents said that their programs had unique Twitter handles. When forced to rank the deterrents to engagement on Twitter, all the listed issues were considered relevant, with no dominant hurdle (
Forced ranking of reasons not to use Twitter.
Reason | Score (1=lowest, 5=highest) |
Limited resources (assistance from staff/time to do the work) | 3.3 |
Lack of clarity of value of social media in education | 3.6 |
Lack of expertise among the program director, associate program director, and coordinator | 3.4 |
Another Twitter handle already provides some coverage for this training program | 2.6 |
Negative prior social media experience in a professional setting | 2.7 |
Forced ranking of reasons for using Twitter.
Reason | Score (1=lowest, 5=highest) |
Perceived value of social media for the younger generation of trainees | 4.6 |
Free marketing | 2 |
Effective way to highlight your training program | 3.2 |
Networking with other programs/organizations | 2.2 |
Follow trends in education in your subspecialty | 2.9 |
This study aimed to measure Twitter engagement by academic NM and NR programs in the United States during 2019-2020. Despite 88 programs offering potential pathways to ABNM or ABR NR subspecialty certification, only 3 programs had exclusive handles for the NM division. Although just over half of the 88 programs (n=46, 52%) had a Twitter handle for the broader radiology department, less than one-fourth (n=21, 24%) of all programs tweeted about content related to NM or NR in 2019. The programs offering only DR/NR pathways tweeted about NM- and NR-related content much less than other NM residencies and NR fellowships. Other radiology residencies without NM or NR training pathways also had low Twitter presence (16/103, 16%) and lower Twitter activity related to NM or NR content. Additionally, only 8% (7/88) of NM/NR programs had a DR/NR program director available on Twitter. These findings indicate that there is a substantial missed opportunity for reaching out to or networking with future trainees, a group that has been shown to be open to using social media in their professional development. Although it may not always be possible—or may even be against existing institutional policies—to allow separate Twitter handles for individual divisions of a department (eg, NM/NR), the overall paucity of Twitter handles for academic NM/NR programs as well as general radiology programs is somewhat remarkable.
The findings of this study are particularly relevant given recent reports of the increasing workforce demand for NM professionals. When juxtaposed against the lack of early exposure and awareness of NM/NR training among medical students and even radiology residents [
A brief survey done after the analysis of the preliminary data attempted to elicit which common issues may be hurdles for the NM/NR academic community in increasing their social media presence. Although only one-third of people contacted (15/45) responded to the survey, the results are helpful to highlight both the challenges and the benefits to social media use. The respondents included program directors, associate program directors, faculty members, and program staff. The respondents confirmed our observation that most programs and program directors do not have unique Twitter handles for their programs. When asked to do a forced ranking of potential reasons to not use Twitter, lack of clarity on the value of social media, lack of expertise, and limited resources to engage on social media were commonly cited by the respondents (
Though our findings demonstrate the limited social media presence of academic NM/NR and DR/NR programs, the general trend of increased use of social media in health care suggests that this specialty may yet find value in increased social media engagement. There are some specific steps that can be taken to make social media use more valuable for the NM/NR community in the future: (1) streamlined consensus use of hashtags, (2) co-opt professional societies to lead the hashtag initiative, and (3) continue to study utilization of social media at the group level in NM/NR in the context of general health care–related use and provide ongoing feedback to our professional community.
Future work may consider each of these value propositions. As part of greater Twitter engagement by the academic NM/NR community, streamlining hashtags related to NM/NR (as summarized in
This study has several limitations. First, this is a preliminary study that only evaluated engagement on Twitter; other social media networks were not evaluated. We also did not compare the engagement of academic NM with other related specialties such as medical oncology, radiation oncology, and nuclear cardiology, which comprise the top three specialties allied with NM. However, we assessed the lack of engagement against the backdrop of the broad inherent possibility of potential professional interactions at large. We were only able to perform a content-based subanalysis for one month using the free version of Symplur and our search process was manual. We also did not assess the number of followers each program had, or the retweets or social media influence of tweets themselves. Although social media use is higher among younger trainees and medical students [
There is currently very little Twitter engagement by the academic nuclear medicine community. This is adequately corroborated by scan data of Twitter use and our attempt to survey faculty in the discipline. Although there are identifiable obstacles, the responses by NM faculty and staff as well as the general trend of increased social media use among medical students substantially support the perceived value in increasing social media engagement in imaging specialties. A more in-depth investigation in the future may further help us understand the barriers and benefits of social media use, and assess the impact of increased use on trainee recruitment and perceptions. Additionally, the value proposition of streamlining and growing social media engagement with targeted hashtags may be considered to promote the presence of both diagnostic and therapeutic aspects of this subspecialty for practitioners, trainees, and the public.
Survey questions.
American Board of Radiology
American College of Radiology
diagnostic radiology
nuclear medicine
Nuclear Medicine Program Directors Association
nuclear radiology
Radiology Society of North America
Society of Nuclear Medicine and Molecular Imaging
None declared.