A Four-Year Analysis of #OrthoTwitter Use During Match Week: Can X Be a Potential Equalizer for Students Left Unmatched?

Background The orthopedic surgery match has changed. Since the COVID-19 pandemic, orthopedic surgery candidates and residency programs have used #Orthotwitter to promote, advocate, and educate their followers. This study aimed to evaluate changes in the use of #OrthoTwitter and #OrthoMatch during Match Week over a four-year period, including trends in author type, post content, institutional affiliation, engagement, and posting activity, with particular attention to posts involving unmatched applicants. Methodology The top tweets containing the hashtags #Orthotwitter and/or #OrthoMatch during the 2021, 2022, 2023, and 2024 Match Week were reviewed and collected. Tweets between the years 2021, 2022, 2023, and 2024 were compared using the chi-square test. Differences in engagement between author type and content were analyzed using the Kruskal-Wallis H test. Results Of the 370 tweets in total, 25.6% (n = 92) were from 2024, 24.5% (n = 93) from 2023, 25% (n = 95) from 2022, and 23.7% (n = 90) from 2021. Over the course of four years, medical students (47.7%, n = 179) tweeted the most during #Orthotwitter Match week, followed by attendings (26.6%, n = 100), and third-party organizations (9.6%, n = 36). Conclusions #Orthotwitter over the course of the past four years has shifted from a focus on the thoughts of attendings and third-party organizations to medical students. Students are likely to share a negative match result, and third-party organizations and attendings are likely to tweet resources for unmatched orthopedic surgery candidates. As the #Orthomatch continues to evolve, we anticipate that Twitter can become a potential equalizing platform for students who are left unmatched on Match Day.