Unprofessional content on Facebook accounts of US urology residency graduates

Abstract

ObjectiveTo characterize unprofessional content on public Facebook accounts of contemporary US urology residency graduates. MethodsFacebook was queried with the names of all urologists who graduated from US urology residency programmes in 2015 to identify publicly accessible profiles. Profiles were assessed for unprofessional or potentially objectionable content using a prospectively designed rubric, based on professionalism guidelines by the American Urological Association, the American Medical Association, and the Accreditation Council for Graduate Medical Education. Content authorship (self vs other) was determined, and profiles were reviewed for selfidentification as a urologist. ResultsOf 281 graduates, 223 (79%) were men and 267 (95%) held MD degrees. A total of 201 graduates (72%) had publicly identifiable Facebook profiles. Of these, 80 profiles (40%) included unprofessional or potentially objectionable content, including 27 profiles (13%) reflecting explicitly unprofessional behaviour, such as depictions of intoxication, uncensored profanity, unlawful behaviour, and confidential patient information. When unprofessional content was found, the content was self-authored in 82% of categories. Among 85 graduates (42%) who self-identified as a urologist on social media, nearly half contained concerning content. No differences in content were found between men and women, MD and DO degree-holders, or those who did or did not identify as a urologist (all P > 0.05). ConclusionThe majority of recent residency graduates had publicly accessible Facebook profiles, and a substantial proportion contained self-authored unprofessional content. Of those identifying as urologists on Facebook, approximately half violated published professionalism guidelines. Greater awareness of trainees' online identities is needed.Keywords social media, professionalism, unprofessional behaviour, residency, graduate medical education IntroductionSocial media encompasses a diverse group of Internet platforms that facilitate the creation and dissemination of original and shared content. The personal and professional use of social media among urologists continues to rise. A 2013 survey of American Urological Association (AUA) members estimated that 74% of respondents had a social media account [1]. Of these, Facebook was the most popular among attending urologists (89%) and urology trainees (98%). Most urologists characterized their social media use as being for personal reasons, rather than professional or business purposes [2].The AUA has encouraged social media engagement and has published Social Media Best Practices [3]. These Best Practices support courteous, professional behaviour online by urologists and specifically indicate that members' online activities 'should be consistent with the AUA's professional Code of Ethics'. AUA members are reminded in the statements that the content urologists generate and share on social media may influence perceptions of the specialty. Non-US societies have also disseminated similar guidelines on urol...

A new wave of urologists? Graduating urology residents’ practices of and attitudes toward social media

“…While graduating residents' and consultants' 21 limited awareness of guidelines and legislations are concerning, as posting unprofessional content online has resulted in disciplinary action, [23][24][25] these finding highlight an opportunity to help urologists. Post-graduate medical educators can encourage residents to become more aware of SoMe policies, as there are roles for practicing safe and responsible SoMe use under several CanMEDS (Canada's framework for physician training) competencies.…”

“…22 These concerns are valid, as some physicians and medical trainees have experienced disciplinary action for posting inappropriate content. [23][24][25] Several medical organizations have developed professional SoMe use guidelines in response to these concerns. [26][27][28][29][30][31][32] Specific to urologists, BJU International (BJUI) and the European Association of Urology (EAU) have published guidelines for effective and responsible SoMe use.…”

Anesthesiologists, it’s time to get social!

“…A review of social media accounts from newly graduated urology residents found 40% had authored unprofessional or potentially objectionable content. 17 Given the pervasive use of social media among students, professional standards for social media interaction should be incorporated into the medical education curriculum to help physicians establish an appropriate and impactful social media presence. …”

Chipping away at the body politic one study at a time: the case for more ‘unprofessional’ online content

“…The recent paper by Koo et al on ‘unprofessional’ online content amongst American urology residency graduates has received attention in the lay press and social media outlets. The paper has an Altmetric Attention score of 341 – good for the fifth most online‐cited paper the BJUI has ever published.…”

“…This study is, to borrow a new hackneyed American aphorism, fake news. BJUI promotes intellectual discourse through responsible use of social media, yet this study muzzles free speech by stigmatising expression.…”