Since I joined twitter in in 2009, I’ve become increasingly active in the medical community online. As a rising medical student I have enjoyed exploring the intersection between medicine and media with other colleagues active in both fields. I felt as though I was an equal player in the game. That is, until it hit me...I may not be an equal player just yet.


Recently I've seen a few physicians "call each other out" in a manner that I believe is akin to Theresa Brown's physician bullying in the New York Times. In these instances passive aggressive strategies were used to expose an individual's mistakes, rather than personally contacting the offending party and offering constructive criticism or suggestions for improvement. While it is important to educate medical professionals that use social media about best practices, I am disappointed by  the use of social media to amplify physician faux pas and embarrass or attack offenders. 

Other than writing this vague blog post,  I can’t really do or say much about the many instances of bullying I've seen. I’m just beginning my career, so I’m not in any position to confront any  physician on twitter, publicly or privately, especially those at academic institutions where I may one day need a job. In a school setting, it would be unwise for a medical student to directly confront an attending. It would be even more unwise for the medical student to make this confrontation public. So why would it be okay for a medical student to confront a physician online ? 

Twitter is not a democratic forum free of consequences, even for those who wish to engage in a productive and respectful dialogue with “superiors”. Even though I believe we should use social media to teach our colleagues, the extent to which I can teach other medical professionals is limited. The hierarchies that exist in medical education may exist in the digital space. I can't say I've specifically "confronted" a higher ranking physician, but I'm certainly not foolish enough to find out!

My guest post on KevinMD.com

I’ve read a number of recent articles on social media and medical professionalism. The latest post in the New York Times about physicians and Facebook prompted me to think about my own presence online. Dr. Ryan Greysen, a Robert Wood Johnson Foundation clinical scholar at Yale School of Medicine, says he is concerned about the professionalism of “the new generation of physicians and students who enter the medical world after years of saturation in social media.” As a member of the new generation, I’m wondering if I should be more worried about my digital footprint standing in the way of my future career?

The recommendations reported in the Times are suitable for more experienced physicians or for those who are new to social media. These recommendations however,  fail to take into account the realities of living and growing up in a digital world. Despite the fact that I never use my camera, I find myself tagged in new Facebook pictures every week-- some photos are candid, and others are not. I can untag the ones I don’t like, but whether or not those photos are visible on my profile, they still exist somewhere online. Because I don't post pictures myself, my untagged photos may still be accessible to people who can view my friends’ albums, and as  Dr. Danielle Ofori explains, you never know what “a friend’s friend’s friend might do with a photo.” Over the past six years I've accumulated exactly 1,602 tagged photographs, but I have no idea how many photos I have untagged...Is there an app for that?

Despite your best efforts to maintain a professional profile online, you cannot control every aspect of your digital footprint. Therefore, should you fear the possibility that a photo you didn't post could “cast a poor light” on your medical career? As a member of the next generation of physicians, I’m wondering what we can do to protect ourselves against this possibility in the future.

Maybe new physicians should give up the “fun and casual side of social media,” but what difference will it make if no one else makes the same sacrifice? Perhaps it won’t matter as much by the time I’m an intern because my residents and attendings will probably have untagged and unwanted Facebook pictures out there too.

My guest post on KevinMD.com

When applying to medical school, the American Medical College Application Service (AMCAS) asks aspiring physicians if they would like to be considered “disadvantaged” applicants or not. Many premedical students find themselves troubled by this question and wonder, what does it mean to be disadvantaged? How does being a disadvantaged applicant affect my medical school application? According to the information American Association of Medical Colleges, the organization that provides the AMCAS application, “disadvantaged status is self-determined.”  ...Okay...so how is an applicant to know?

AMCAS suggests that it may be appropriate for those from medically underserved areas or those of low socioeconomic backgrounds to apply as disadvantaged applicants. AMCAS however, fails to advise those who fall into neither category. For example, a medical school applicant may have faced long-term adversity that has nothing to do with living below the poverty line. Learning disabilities, or discrimination due to sexual orientation or gender identity may diminish an applicant’s educational opportunities. Being an immigrant or learning English as a second language may also be a significant obstacle to academic enrichment.

Each medical school has its own policies for how it views disadvantaged applicants. Students that seek this status are asked to provide an additional essay on the AMCAS explaining why they consider themselves to be disadvantaged. This information may be useful in helping an admissions committee understand the broader context of an applicant’s background. If the goal of identifying disadvantaged applicants is to provide admissions committees with a more holistic picture, then extraordinary circumstances of adversity are equally as valid as financial disadvantages.

As you can see, the vague nature of self-determined disadvantage creates unnecessary confusion for medical school applicants. Search “disadvantaged status” and “ AMCAS” and you will find yourself on a wild-Google chase for the answer. Unfortunately, many students end up consulting websites like the Student Doctor Network, where premeds with questionable motives may discourage those who feel disadvantaged from claiming this status for a “leg up.” The discussions that take place on these sorts of websites can be quite unproductive and demeaning towards others’ personal struggles.

If, for example, the AMCAS is only aiming to identify educationally disadvantaged (e.g. being the first/only person in a family to graduate college) and financially disadvantaged (e.g. being raised in poverty) applicants, then questions on the application should be more explicit, and one’s status should be easily determined without any confusion. Medical school applications are costly and time-consuming. Applicants should not have to consult third-party resources to interpret what AMCAS may or may not mean by being “disadvantaged.”