RETRACTED: Prevalence of unprofessional social media content among young vascular surgeons
Authors: Jeffrey J Siracuse
Stephen J Raulli
Douglas W Jones
Thomas W Cheng
Alik Farber
Erica L Mitchell
Scott Hardouin
Journal: Journal of Vascular Surgery (2020)
Discipline: CLINICAL MEDICINE
Keywords: Professionalism; Social media; Trainee; Vascular surgery.
Affiliations: Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass., Division of Vascular Surgery, Salem Health Vascular & Endovascular Surgery, Salem, Ore.

Abstract:  This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the authors, the Editor-in-Chief and the Senior Editor of the Journal of Vascular Surgery. This article has been retracted in accordance with the Committee on Publication Ethics (COPE) Retraction Guidelines because the authors did not have permission to use the Association of Program Directors in Vascular Surgery (APDVS) directory of program directors and trainees to conduct research. In addition, the methodology, analysis and conclusions of this article were based on published but not validated criteria, judging a series of behaviors including attire, alcohol consumption, controversial political and religious comments like abortion or gun control, in which significant conscious and unconscious biases were pervasive. The methodology was in part predicated on highly subjective assessments of professionalism based on antiquated norms and a predominantly male authorship supervised the assessments made by junior, male students and trainees. The authors did not identify biases in the methodology, i.e., judging public social media posts of women wearing bikinis on off-hours as “potentially unprofessional”. The goal of professionalism in medicine is to help ensure trust among patients, colleagues and hospital staff. However, professionalism has historically been defined by and for white, heterosexual men and does not always speak to the diversity of our workforce or our patients. The Editors deeply regret the failures in the Journal’s peer review process which allowed this paper to be published. The Editors and the review process failed to identify errors in the design of the study, to detect unauthorized use of the data, and to recognize the conscious and unconscious biases plaguing the methodology. For this, we express our most sincere apology. 

Retracted: Yes

PubPeer comments:
 In this paper , currently in the spotlight on social media under the hashtag #MedBikini, the authors created social media platform accounts to specifically check on the public content posted by vascular surgery trainees. The accounts were checked by three male screeners, all authors on this paper. ![file] Accounts were screened for  clearly unprofessional or  potentially unprofessional content . ![file] I have concerns. * Many of the  clearly  unprofessional content criteria seem to be very subjective. How would one define  clear alcohol intoxication ? What is  inappropriate attire? What do they consider as  provocative posing ? These are not objective measurements. The authors fail to give a clear definition of their inclusion and exclusion criteria. This is not science, it is judgement. Could the authors please tell me the measurements of the bikinis and t-shirts they deemed inappropriate? How many inches from the collar bone was allowed to be not covered by fabric before it was inappropriate? When was a woman looking at the camera in a bikini doing  provocative posing ? * How is holding a glass of alcohol unprofessional? Let s hope that none of the authors will be ever spotted holding a glass of wine at a hospital reception or conference. * All three  screeners were of the same gender and similar age. This might result in biased opinions of what type of swimwear or Halloween costumes are  inappropriate , and might result in a particular bias towards what women are wearing. Looking at the tables in the paper, 71% of the screened social media accounts were owned by males, while women were found to have more  unprofessional content than males (30% vs 24%). Is this caused by screener bias? ![file] * Finally, and admittedly not a very objective measurement, checking out accounts from young students seems .... creepy. , 
 u201cThe Boston University School of Medicine institutional review board approved the study and informed consent was waived.u201d Why was informed consent waived if the subjects were humans? Isnu2019t ethics approval required for human subjects? From the methods section: u201cThere were a total of three screeners, and all content on each platform was screened by two separate investigators for prespecified material categorized as either (1) clearly unprofessional or (2) potentially unprofessional. S.H. was a 33-year-old male vascular fellow who performed searches on Facebook and Instagram. T.C. was a 28-year-old male research coordinator and medical school applicant who searched Facebook and Twitter. S.R. was a 37-year-old male medical student who searched Twitter and Instagram.u201d However, according to this news report, the authors created fake social media accounts in order to achieve this methodology, something which was not indicated in the methods section: https: www.huffpost.com entry medbikini-bikini-selfies-protest_n_5f1b4957c5b6128e6825c5f2 Was this part of the methodology given ethical approval by The Boston University School of Medicine institutional review board? , 
 The Journal has announced a retraction, appropriately through a tweet: https: twitter.com JVascSurg status 1286831352520888320 and by Facebook: https: www.facebook.com TheJVascSurg photos a.611986142331744 1381024778761206 Not sure if that is professional enough, because I do not see an official retraction notice (with a DOI), but here is a screenshot from the Facebook announcement. ![file] , 
 #2 The study did receive ethics board approval, hence  Boston University School of Medicine institutional review board approved the study BU IRB follows 45 CFR 46.102(i) and 21 CFR 56.102(i) when deciding if informed consent is required. Do you see anything in the methodology that would put the  subjects at greater than minimum risk? All of this information on their social media is available to the public. , 
 #3  I do not see an official retraction notice (with a DOI) Now on record: https: www.sciencedirect.com science article pii S074152141932587X  This article has been retracted at the request of the authors, the Editor-in-Chief and the Senior Editor of the Journal of Vascular Surgery.  This article has been retracted in accordance with the Committee on Publication Ethics (COPE) Retraction Guidelines because the authors did not have permission to use the Association of Program Directors in Vascular Surgery (APDVS) directory of program directors and trainees to conduct research. In addition, the methodology, analysis and conclusions of this article were based on published but not validated criteria, judging a series of behaviors including attire, alcohol consumption, controversial political and religious comments like abortion or gun control, in which significant conscious and unconscious biases were pervasive. The methodology was in part predicated on highly subjective assessments of professionalism based on antiquated norms and a predominantly male authorship supervised the assessments made by junior, male students and trainees. The authors did not identify biases in the methodology, i.e., judging public social media posts of women wearing bikinis on off-hours as u201cpotentially unprofessionalu201d. The goal of professionalism in medicine is to help ensure trust among patients, colleagues and hospital staff. However, professionalism has historically been defined by and for white, heterosexual men and does not always speak to the diversity of our workforce or our patients.  The Editors deeply regret the failures in the Journalu2019s peer review process which allowed this paper to be published. The Editors and the review process failed to identify errors in the design of the study, to detect unauthorized use of the data, and to recognize the conscious and unconscious biases plaguing the methodology. For this, we express our most sincere apology. , 
 Reference rot for reference #11. 11. American Board of Medical Specialties. Based on core competencies. American Board of Medical Specialties. Available at: https: www.abms.org board-certification atrusted-credential based-on-core-competencies . Accessed June 6, 2018. The website now reads  Sorry, that page doesn t exist! ,