A PubMed query of the phrase “social media” yields 8,747 unique peer-reviewed articles. When the search is refined to “social media medical education” there are 578 articles. When “professionalism” is also added to the search string, there are only 31 article results. This suggests that very few authors are writing about the topic: Approximately 0.4% of the available peer-reviewed literature about social media pertains to how we doctors should use and consume social media in a responsible manner.
While there appears to be a dearth of peer-reviewed available literature, it is important to recognize that nearly every residency program in the United States has a compulsory educational didactic training module focused specifically on social media. At the 2013 Accreditation Council for Graduate Medical Education (ACGME) annual educational conference, the second item after “Budgeting Tips” was “The Use of Technology and Social Media.” So, if social media is a top priority, why is there so little written about it?
As someone who has been medically educated in concert with the expansion of social media (I started medical school in 2004, Facebook started in 2004; I started residency in 2008, Instagram launched in 2010), I have experienced the proverbial growing pains of a social media-focused generation.
During my education, I have witnessed both medical students and residents suffering the professional consequences of being active on social media networks. Posts of phrases or pictures that were thought to be benign were, in fact, flagrant violations of patient privacy. Photos that were thought to be interesting by some were viewed as utterly disturbing by those not involved and sometimes the social media fallout of a simple post yielded negative mass media coverage. I truly believe that the authors of such posts did not mean any harm, and instead were using social networks for what they were meant to be used for: connectivity among similar individuals.
Professional school and postdoctoral training can be grueling, isolating and difficult. Attempting to express oneself over a social platform may be a way of attempting to normalize a flood of new and challenging emotions. However, great care must be taken for not only what one posts but also how it is interpreted, given that social networks allow for a myriad of connections.
One of the best pieces of advice that I can give is the “icky test.” Try to imagine reading a post as the first thing you saw when you woke up and if you were not in the medical profession. If it feels “icky,” or wrong, or just like it is going “too far,” it is more than likely not appropriate to post online. Furthermore, imagine if you were your patient and you read the post before meeting you: Would you want to be your own patient?
As social media’s presence in our lives continues to expand, it is also important to recognize that online behavior becomes part of a user’s permanent, vast Internet identity. Unfortunately, your Internet identity may not be congruent with your actual identity, but when people search for your name, this may be what is found. This information is also easily accessible when people are doing research about you for residency, fellowship and future employment.
Social media is undoubtedly a wonderful resource for connecting with friends and family. However, there is a dearth of academic literature that guides online behavior and how to utilize social media for those in training, so we must rely on our gut feelings, as expressed by measures like the icky test. And above all, we all must recognize that everything that we touch, read or post on the Internet leaves an indelible mark that may be found by others.
Brian Levine is an endocrinology fellow. This article originally appeared in The American Resident Project.