Physicians have dramatically increased social media use in recent years. Twitter has been heralded as a means to connect a broader learning community, engage with colleagues, initiate mentorship and sponsorship, and to amplify trainees. A residency program-linked Twitter account affords unique opportunities to champion residents while promoting the program and its affiliated faculty and institutions. However, while the scholarship of Twitter usage is expanding, the current literature specific to residency programs is limited. We draw from our experience tweeting as an internal medicine program to share more broadly applicable advice. With these practical tips, creating, maintaining, and sustaining a residency program twitter account can be feasible, fulfilling, and successful.