ObjectiveTo characterize unprofessional content on public Facebook accounts of contemporary US urology residency graduates. MethodsFacebook was queried with the names of all urologists who graduated from US urology residency programmes in 2015 to identify publicly accessible profiles. Profiles were assessed for unprofessional or potentially objectionable content using a prospectively designed rubric, based on professionalism guidelines by the American Urological Association, the American Medical Association, and the Accreditation Council for Graduate Medical Education. Content authorship (self vs other) was determined, and profiles were reviewed for selfidentification as a urologist. ResultsOf 281 graduates, 223 (79%) were men and 267 (95%) held MD degrees. A total of 201 graduates (72%) had publicly identifiable Facebook profiles. Of these, 80 profiles (40%) included unprofessional or potentially objectionable content, including 27 profiles (13%) reflecting explicitly unprofessional behaviour, such as depictions of intoxication, uncensored profanity, unlawful behaviour, and confidential patient information. When unprofessional content was found, the content was self-authored in 82% of categories. Among 85 graduates (42%) who self-identified as a urologist on social media, nearly half contained concerning content. No differences in content were found between men and women, MD and DO degree-holders, or those who did or did not identify as a urologist (all P > 0.05). ConclusionThe majority of recent residency graduates had publicly accessible Facebook profiles, and a substantial proportion contained self-authored unprofessional content. Of those identifying as urologists on Facebook, approximately half violated published professionalism guidelines. Greater awareness of trainees' online identities is needed.Keywords social media, professionalism, unprofessional behaviour, residency, graduate medical education IntroductionSocial media encompasses a diverse group of Internet platforms that facilitate the creation and dissemination of original and shared content. The personal and professional use of social media among urologists continues to rise. A 2013 survey of American Urological Association (AUA) members estimated that 74% of respondents had a social media account [1]. Of these, Facebook was the most popular among attending urologists (89%) and urology trainees (98%). Most urologists characterized their social media use as being for personal reasons, rather than professional or business purposes [2].The AUA has encouraged social media engagement and has published Social Media Best Practices [3]. These Best Practices support courteous, professional behaviour online by urologists and specifically indicate that members' online activities 'should be consistent with the AUA's professional Code of Ethics'. AUA members are reminded in the statements that the content urologists generate and share on social media may influence perceptions of the specialty. Non-US societies have also disseminated similar guidelines on urol...

Most urologists maintained public Facebook accounts after the transition to practice, and about half of these contained unprofessional or potentially objectionable content. Amidst their increasing self-identification as urologists on social media, the majority of practising urologists had posted concerning content, which could have an impact on their professional identities and public perceptions of the specialty.

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Robotic surgery continues to increase in popularity and prevalence. The adoption of robotic technology has generated controversy and frequent media coverage. We evaluate recent reports of surgical robotics in the lay press to characterize its objectivity. LexisNexis and Factiva consumer news databases were queried for articles pertaining to robotic surgery published during 2010-2015 in the three highest circulation national (US) newspapers as well as New England regional newspapers. Two independent reviewers performed content analysis and assessed headline bias with strong reliability (mean κ = 0.96). 82 articles met inclusion criteria. Urological and gynecologic procedures were the most cited (54 and 57%, respectively). Commonly discussed aspects of robotic surgery included increased cost (45 articles, 55%), increased complications (38 articles, 43%), and easier recovery (32 articles, 39%). A minority of headlines (45%) had a neutral or unbiased tone. National newspapers were significantly more likely to report robotic surgery unfavorably by discussing disadvantages of the technology, only quoting surgeons with negative opinions, or citing scientific studies discrediting the robot (all p < 0.05). Of the 27 news articles that referenced published research studies, all 27 quoted studies reported the disadvantages of robotic surgery, while only 7 (26%) cited findings favoring robotic approaches. News reports about robotic surgery in the popular press contain a high proportion of negative bias. Non-neutral headlines and emphasis on research unfavorable to robotics were common. Clinicians should be aware of these reporting biases, which may affect patients' perceptions of robotic surgery.

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