Medical students are posting unprofessional content online, including violations of patient confidentiality, and few schools have policies to address the problems, according to a study published in the Journal of the American Medical Association.

Medical students are no different from other adults their age -- they're used to living life online, according to an Associated Press report on the JAMA article. And they're coming to realize that online antics can hurt them now, when seen by medical school deans and other people in authority, and it can hurt them later, when they're 50 and trying to establish a place at the top of their profession, Susan Barnes, of the Lab for Social Computing at the Rochester Institute of Technology, told the AP.

"A quick search of YouTube finds numerous videos posted by medical students, from harmless musical numbers to a prank with what appears to be a dead body. There's no way to tell whether the cadaver prank is real and it wasn't part of the study, but real or staged, it doesn't reflect well on the medical profession," Katherine Chretien, of the Washington, D.C., VA Medical Center, the study's lead author] told the AP.

"I watched it and I definitely cringed," she told the AP.

Students making inappropriate use of social media sites can reflect poorly on themselves, their institutions, and the medical profession, according to a statement from the JAMA this week.

Researchers found that, of the schools that responded to the survey, 60% reported having had incidents involving students posting unprofessional content online. Some 13% reported incidents involving violations of patient confidentiality in the past year. Students posted profanity, discriminatory language, depictions of intoxication, and sexually suggestive material, according to the JAMA.

But there's good news: "Issues of conflict of interest were rare," according to the article.

How did schools discipline infringers? Of the schools that reported incidents and responded to a question about disciplinary action, 67% gave a formal warning, and 7%, or three schools, reported student dismissals. Some 38% of schools have policies to cover student-posted online content. Of schools without such policies, 11% are developing them.

"The formal professionalism 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," according to the article.

Even experienced doctors struggle with social media. On the one hand, tools such as Twitter and YouTube can help get information out to patients and the general public about swine flu and other subjects. On the other hand, healthcare professionals struggle with the same privacy issue that all professionals face on the Internet, with the added complication that healthcare professionals often feel required to keep an extra distance from their patients. Even a simple question like whether to friend a patient on Facebook is complicated.

For example, Sachin Jain, an intern, became Facebook friends with a woman whose baby he'd helped deliver three years earlier, Jain told NPR. "I was curious to hear about the progress of her baby girl, but I wondered about the appropriateness of this interaction," he wrote in the New England Journal of Medicine last month, according to NPR.

The woman told Jain she was bored with her job and wanted advice on applying to med school. Jain gave her a few suggestions, and, "Among other things, I recommended that she carefully consider her online identity," NPR reported.

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