Use of social media by doctors and medical students is common and growing. Although professional standards and codes of ethics that govern the behaviour of medical practitioners in Australia and New Zealand do not currently encompass social media, these codes need to evolve, because professional standards continue to apply in this setting. Inappropriate use of social media can result in harm to patients and the profession, including breaches of confidentiality, defamation of colleagues or employers, and violation of doctor–patient boundaries. The professional integrity of doctors and medical students can also be damaged through problematic interprofessional online relationships, and unintended exposure of personal information to the public, employers or universities. Doctors need to exercise extreme care in their use of social media to ensure they maintain professional standards.

The working hours of junior doctors have been a focus of discussion in Australia since the mid-1990s. Several national organizations, including the Australian Medical Association (AMA), have been prominent in advancing this agenda and have collected data (most of which is self-reported) on the working hours of junior doctors over the last 15 years. Overall, the available data indicate that working hours have fallen in a step-wise fashion, and AMA data suggest that the proportion of doctors at high risk of fatigue may be declining. It is likely that these changes reflect significant growth in the number of medical graduates, more detailed specifications regarding working hours in industrial agreements, and a greater focus on achieving a healthy work–life balance. It is notable that reductions in junior doctors’ working hours have occurred despite the absence of a national regulatory framework for working hours. Informed by a growing international literature on working hours and their relation to patient and practitioner safety, accreditation bodies such as the Australian Commission on Safety and Quality in Health Care (ACSQHC) and the Australian Medical Council (AMC) are adjusting their standards to encourage improved work and training practices.

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underestimating prevalence by up to 100%.PHE used a small study from 2010 in northern Sweden with a population of 76 000 to estimate the rates in an ethnically diverse population of 50 million people in England. Twenty per cent to 50% of people in some urban CCGs are from BAME groups with lower AF prevalence than white populations. Bradford AF prevalence was reduced by 70% in South Asians in comparison with the white population. 2 The Swedish study was conducted over 7 years and included all cases of AF, including all transient hospital inpatient cases that occurred in one in three cardiac operations. When the authors analysed cases identified in a single year rather than over 7 years, numbers were reduced by half. A Scottish study based on GP diagnoses showed that the annual prevalence was less than half that in Sweden. AF in people over 85 was 22% in Sweden and 7.1% in Scotland. 3 Comparing PHE estimates based on Sweden with the QOF 2018/2019 data from general practice in London boroughs shows overestimates of between 28% and 100% (Table 1), the higher figures being most pronounced in boroughs with large black or South Asian populations.These data from Sweden are not reliable for the estimation of annual AF prevalence as determined by GPs and substantially overestimate annual reports of prevalence in these populations. Commissioners and GPs should beware of the gap between flawed estimates and the reality of their local community prevalence.

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