WebMD Health News
Louise Chang, MD
Sept. 22, 2009 -- It is not uncommon for medical students to post
unprofessional and even illegal information on social networking sites like
Facebook and media-sharing sites like YouTube, a survey of medical schools
In an anonymous poll of student affairs administrators from schools across
the country, 60% said they were aware of incidents in which students had posted
unprofessional content online and 13% said the incidents involved breaches of
Three of the incidents resulted in students being dismissed from medical
school, but just half of the school administrators said they either had
policies in place or were developing policies to define inappropriate online
Federal law prohibits health care providers from disclosing a patient's
health information unless the patient has given his or her consent to do
But study researcher Katherine C. Chretien, MD, of the Washington VA Medical
Center, tells WebMD that online posts by medical students and residents often
include descriptions of medical situations that could identify a patient, even
when the patient is not named.
The survey results were published this week in The Journal of the
American Medical Association.
"We need to do a better job of making medical students aware of what is and
is not OK," she says. "Keeping a patient's name out of a post may not be
Most of the incidents reported by survey respondents did not involve illegal
violations of patient confidentiality, but instead were potentially
embarrassing and damaging to the students themselves.
Forty-seven of the 78 responding medical school administrators were aware of
improper student posts, and about half of these posts included profanity or
racist or sexist language. Descriptions or pictures of intoxication or lewd
behavior were also common.
Of 36 specific examples of unprofessional posts provided, 10 were sexually
suggestive, including sexually provocative photographs, sexually suggestive
comments, or requests for inappropriate friendships with patients via
Seven described or showed intoxication or illegal drug use.
In most cases the online transgression was reported to student affairs by a
medical school faculty member or non-faculty trainee. Only two of the incidents
were reported by patients or family members of patients.
Pediatrics professor Lindsay Acheson Thompson, MD, says there is no doubt
that breaches of patient confidentiality are occurring more often than patients
realize, but she says posts that are personally embarrassing and potentially
career damaging appear to be more common.
In a study reported in July 2008, Thompson and colleagues at the University
of Florida examined the Facebook profiles of more than 800 medical students and
They found, among other things, photos of posters dressed as pimps or
cross-dressing. One Facebook photo featured the physician-in-training wearing a
lab coat labeled "Kevorkian Medical Clinic."
Some of the students and residents had joined Facebook groups that could be
considered sexist, racist, or otherwise vulgar with names like PIMP -- Party of
Important Male Physicians.
Seven of 10 randomly chosen Facebook pages included photos of the student or
resident drinking alcohol.
Thompson tells WebMD that the value of social networking sites like Facebook
is clear for keeping in touch with former classmates, distant friends, and
"But students need to think carefully about the kinds of things they post,"
she says. "Even a photo as seemingly innocuous as drinking alcohol may not be
in someone's best interest when they are applying for residency."
Slightly more than a third of the student affairs officials polled reported
that their school had a policy in place to define appropriate and inappropriate
content on social networking sites.
Thompson says she is working with colleagues at the University of Florida to
develop such a policy, but she adds the intent is not to censor students.
"Some schools are moving toward censorship -- telling students they
shouldn't use social networking sites like Facebook," she says. "But that is
not very realistic in the world we live in today. We think it is important to
have a good policy, but I can't tell you what that policy will look like
SOURCES:Chretien, K.C. The Journal of the American Medical Association, Sept.
23/30; vol 302: pp 1309-1315.Katherine C. Chretien, MD, Medical Service, Washington DC VA Medical Center;
assistant professor of medicine, George Washington University School of
Medicine and Health Sciences, Washington D.C.Lindsay Acheson Thompson, MD, MS, assistant professor in pediatrics, health
policy and epidemiology, University of Florida.News release, Journal of the American Medical Association, Sept. 22,
2009.Thompson, L.A. Journal of General Internal Medicine, July 2008.Associated Press: "Med Students Oversharing on Facebook."
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