According to a new study, a large number of US medical schools have reported instances of medical students posting unprofessional, even illegal information on social networking sites (Facebook) and media-sharing sites (YouTube), including instances of violating patient confidentiality. It seems few schools have developed policies for dealing with such transgressions.

An anonymous survey was sent to 130-medical schools in the Association of American Medical Colleges, with researchers receiving 78-responses, out of which 47- schools (60%) reported instances of students posting unprofessional content online, while 13% described the incidents as a breach of patient confidentiality.

Student use of profanity, frankly discriminatory language, depiction of intoxication, and sexually suggestive material were commonly reported, as a result of three such incidents, students were dismissed from medical school. However, the study found only 50% of the school administrators had policies in place, or were in the process of developing policies that defined appropriate and inappropriate online content adequately.

According to federal law, healthcare providers require the patient’s consent before being able to disclose information about the patient’s health.

Talking to WebMD, study researcher Katherine C. Chretien, MD, Washington VA Medical Centre says, often the online posts of residents and medical students describe medical situations making the patient easily identifiable, even without the patient’s name being revealed.

Of the 78-medical school administrators responding to the poll, 47 said they knew of improper student posts, with half of them including profanity, racist or sexist language, while descriptions or pictures of intoxication or lewd behavior were not uncommon.

Out of the 36-unprofessional post examples provided, 10 of them were sexually suggestive, with sexually provocative photographs, sexually suggestive comments, even requests for inappropriate friendships with patients via Facebook, including describing or showing intoxication or illegal drug use.

Online transgression in most cases was reported by a medical school faculty member or non-faculty trainee, with only two incidents reported by patients or their family members.

Undoubtedly, breaches of patient confidentiality are occurring more often than patients realize, however, such posts can also prove to be personally embarrassing and damage careers of medical students or residents responsible for the posts.

A July 2008 study wherein the Facebook profiles of over 800 medical students and residents were examined revealed, among other things, photos of cross-dressing or doctors dressed as pimps, one Facebook photo showed a medical student wearing a lab coat labeled ‘Kevorkian Medical Clinic’, some students and residents had joined Facebook groups, not only considered sexist, racist, with some with vulgar names like PIMP short for Party of Important Male Physicians. Seven of the 10 randomly chosen Facebook pages showed pictures of students or residents drinking alcohol.

This only drives home the point how necessary it is for medical schools to develop a policy that defines appropriate and inappropriate social networking site content, but of course, without censoring students.

The researchers put forward a few recommendations for addressing concerns identified in the study, such as: ‘The formal professional curriculum should include a digital media component, which could include instruction on managing the digital footprint, such as electing privacy settings on social networking sites and performing periodic Web searches of oneself. This is important given that residency program directors, future employers, and patients may access this information.’

The study has been published in the September issue of the Journal of the American Medical Association, a theme issue on medical education.