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Background and Objectives: Academic promotion is critical in academic medicine. Traditionally, peer-reviewed journal articles have been at the core of advancement deliberations. With the increasing prominence digital content and social media, an increasing number of academics have begun linking their scholarly value with their online activities. It is unclear whether and how US academic medical institutions have updated their promotion criteria to reflect the changing environment and digital practices of faculty members. Methods: We reviewed publicly available advancement and promotion policies and faculty handbooks of 148 allopathic medical schools in the United States (April 2018 through September 2018), to see if social media was explicitly included in their scholarship criteria. Results: Of the 148 allopathic institutions only 12 (8.1%) stated that digital and social media products would be factored into the scholarship and/or other domains of the promotion application. There were no associations between acceptability of social media in the tenure process and schools’ characteristics. Conclusions: Digital media use has the potential to distribute scholarship widely. Including digital scholarship in promotion would help destigmatize the use of digital platforms and promote science dissemination to the public. Medical institutions should embrace new models of digital scholarship and lead the way in defining and ensuring quality.

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Scurvy is a clinical syndrome, resulting from ascorbic acid deficiency. Prevalence of the condition is now extremely low in the Western population and its diagnosis can be challenging without a high index of suspicion. When cases do present, they are often misdiagnosed initially. Therefore, a thorough history, physical exam, and laboratory evaluation are key to showing this now rare but extremely well-known disease. We report a case of scurvy manifesting as persistent non-healing lowerextremity ulcerations, initially mistaken for pyoderma gangrenosum. The patient responded to appropriate replacement therapy, but ulcers were slow to heal. As was the case in our patient, symptom reversal may require additional nutritional replacement. We encourage physicians to consider nutritional deficiencies in their differential diagnoses and highlight the incidence of malnutrition in the proper clinical setting to avoid diagnostic delay. K E Y W O R D Sascorbic acid, pyoderma gangrenosum, scurvy, ulcers, wound healing