Sept. 22, 2009 — It is not uncommon for medical students to postunprofessional and even illegal information on social networking sites likeFacebook and media-sharing sites like YouTube, a survey of medical schoolsshows.
In an anonymous poll of student affairs administrators from schools acrossthe country, 60% said they were aware of incidents in which students had postedunprofessional content online and 13% said the incidents involved breaches ofpatient confidentiality.
Three of the incidents resulted in students being dismissed from medicalschool, but just half of the school administrators said they either hadpolicies in place or were developing policies to define inappropriate onlinecontent.
Federal law prohibits health care providers from disclosing a patient’shealth information unless the patient has given his or her consent to doso.
But study researcher Katherine C. Chretien, MD, of the Washington VA MedicalCenter, tells WebMD that online posts by medical students and residents ofteninclude descriptions of medical situations that could identify a patient, evenwhen the patient is not named.
The survey results were published this week in The Journal of theAmerican Medical Association.
“We need to do a better job of making medical students aware of what is andis not OK,” she says. “Keeping a patient’s name out of a post may not beenough.”
Most of the incidents reported by survey respondents did not involve illegalviolations of patient confidentiality, but instead were potentiallyembarrassing and damaging to the students themselves.
Forty-seven of the 78 responding medical school administrators were aware ofimproper student posts, and about half of these posts included profanity orracist or sexist language. Descriptions or pictures of intoxication or lewdbehavior were also common.
Of 36 specific examples of unprofessional posts provided, 10 were sexuallysuggestive, including sexually provocative photographs, sexually suggestivecomments, or requests for inappropriate friendships with patients viaFacebook.
Seven described or showed intoxication or illegal drug use.
In most cases the online transgression was reported to student affairs by amedical school faculty member or non-faculty trainee. Only two of the incidentswere reported by patients or family members of patients.
Pediatrics professor Lindsay Acheson Thompson, MD, says there is no doubtthat breaches of patient confidentiality are occurring more often than patientsrealize, but she says posts that are personally embarrassing and potentiallycareer damaging appear to be more common.
In a study reported in July 2008, Thompson and colleagues at the Universityof Florida examined the Facebook profiles of more than 800 medical students andresidents.
They found, among other things, photos of posters dressed as pimps orcross-dressing. One Facebook photo featured the physician-in-training wearing alab coat labeled “Kevorkian Medical Clinic.”
Some of the students and residents had joined Facebook groups that could beconsidered sexist, racist, or otherwise vulgar with names like PIMP — Party ofImportant Male Physicians.
Seven of 10 randomly chosen Facebook pages included photos of the student orresident drinking alcohol.
Thompson tells WebMD that the value of social networking sites like Facebookis clear for keeping in touch with former classmates, distant friends, andfamily.
“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 bein someone’s best interest when they are applying for residency.”
Slightly more than a third of the student affairs officials polled reportedthat their school had a policy in place to define appropriate and inappropriatecontent on social networking sites.
Thompson says she is working with colleagues at the University of Florida todevelop such a policy, but she adds the intent is not to censor students.
“Some schools are moving toward censorship — telling students theyshouldn’t use social networking sites like Facebook,” she says. “But that isnot very realistic in the world we live in today. We think it is important tohave a good policy, but I can’t tell you what that policy will look likeyet.”