#Diversity: Conversations on Twitter about Women and Black Men in Medicine

Discussions about racism, ethnicity, sexism, discrimination, and diversity have increased within medicine, and their impact on the physician workforce, advancement, hiring, wage inequities, mistreatment, and scholarly output, to name a few. Most medical organizations have created policies and initiatives on diversity and inclusion, focusing on supporting underrepresented minorities. Similar discussions are taking place online, including on Twitter, via specific hashtags, such as #BlackMenInMedicine, #ILookLikeASurgeon. News reports suggested some of these hashtags were "trending." We set out to assess selected hashtags and analyze their spread, as well as whether or how health professional organizations publicized or amplified this emerging discourse on Twitter.

We computed tweet volume, retweet volume impressions, and spread for selected hashtags and for health-profession organizations.

The overall volume was average or below average when compared with all active Twitter users; however, the retweet percentage was 60%, suggesting high levels of engagement. There was modest spread of most of the messages containing the hashtags, with the exception of #ilooklikeasurgeon tweets, due to its relationship to the cover of a major nonmedical magazine. Spread for some hashtags, despite very low initial retweets, was increased due to retweeting by accounts with high volume of followers. Medical societies' contributions to dissemination were very minor.

Strengthening, deepening and, ultimately, expanding the conversation on diversity and inclusion in medicine on Twitter requires an intentional and strategic use of hashtags, photographs and links; Engaging "influencers" such as mainstream media and medical organizations is also critical to more widespread dissemination.