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Background The COVID-19 pandemic has disrupted traditional resident recruitment practices, requiring virtual interviews and new forms of outreach. Social media, such as Twitter, is one tool programs can use to connect with applicants. This study sought to assess changes in Twitter use during the COVID-19 pandemic among general surgery programs.Methods Twitter and residency program websites were queried for public Twitter accounts related to general surgery residency programs. Publicly available tweets for available accounts were reviewed for all posts for the period March 15, 2019-November 25, 2020. Thematic analysis of each tweet was performed, and engagement was determined by likes and retweets on each tweet.Results The number of programs with active Twitter accounts increased after the onset of COVID-19 pandemic, as did the number of tweets, likes-, and retweets-per-tweet. There was a significant increase in the number of tweets regarding resident promotion, program promotion, and virtual event promotion. Tweets received more likes-per-tweet if the subject was program promotion and resident promotion than tweets regarding virtual events. All results were statistically significant (P< .05).Discussion Twitter use and engagement with residency programs have increased significantly since pandemic onset. Engagement is highest for tweets regarding program and resident promotion as measured by likes-per-tweet and highest for program promotion and virtual events as measured by retweets-per-tweet. Given the nearly nationwide increase in Twitter engagement after pandemic onset, programs should consider the impact of Twitter as a means of communication with applicants and program branding.

The patient is a 48-year-old female, who underwent LAGB in Tijuana, Mexico, via bariatric medical tourism in 2008. She had no follow up after surgery. Subsequently had a port infection, for which the port was removed, but the band was left in place. Suffered with chronic abdominal pain for many years before the retained band was recognized. During band removal, it was discovered that she had complete band erosion. After removal, her symptoms resolved. This case demonstrates the issues with bariatric medical tourism. Specifically, because of the lack of appropriate follow up. Follow up and monitoring after surgery is important for preventing bariatric surgery complications and assisting with adequate weight loss. The other aspect of the case is the importance to recognize bariatric surgery complications. Port infection should warrant an investigation for potential intra-abdominal sources. Band erosion is uncommon but known complication of LAGB and requires band removal.