It Is Time for Medical Educators to Update Guidance About Medical Students’ Use of Social Media

To the Editor:

We were intrigued by Dugdale and Braswell’s article 1 about medical students leveraging their medical student status on social media. As medical students at King’s College London, we provide below a United Kingdom perspective on this issue. Unlike the usual (but not universal) situation in the United States, medical students here can be as young as 17 years old. This highlights the increased need for medical students to act ethically toward their audience on social media.

At King’s, we note the lack of guidance about social media use, with only 1 lecture referencing the guidelines of the United Kingdom’s General Medical Council 2 on social media use. These guidelines provide basic advice

(such as not sharing patient details and not using one’s real name online) but have not been updated since 2013. Yet since then, as the use of social media has continued to rapidly proliferate, a new niche has emerged, filled by persons called “medical student influencers.” These influencers typically present an online insight into life as a medical student and provide aspirational content for prospective medical school applicants. Influencers extol the virtues of sacrificing sleep and marathon sessions of studying for examinations. They share 5 am theater selfies and post 10-plus hour “study with me videos” peppered by tech and coffee endorsements.

We remain unconvinced of the legitimacy of these depictions of the medical school experience. While this content may be motivational for some, we fear the consequence of valorizing unhealthy and unrealistic study habits to teenagers, who increasingly spend their formative years online. We worry that this cements the idea of medicine as inaccessible to students from underprivileged backgrounds, who may have other responsibilities. Coupled with influencers’ morally questionable endorsements of expensive technology, this pressures students to emulate unrealistic strategies to succeed. We feel it is necessary to rework current guidelines about social media to reflect the contemporary situation.

However, we recognize that medical students sharing their experiences online and offering advice for interview preparation or entrance exams can help inspire younger students, particularly those from deprived backgrounds, who are significantly less likely to have medical students in their social networks. As the reality of life at medical school can be aspirational, underprivileged students themselves can make use of their social media platforms once arriving at medical school, sharing useful tips, and building up a following to enhance their earning opportunities.

Medical student influencers typically promote a glamorous (and often unattainable) lifestyle and sponsor products, creating the moral ambiguity of leveraging medical student status for profit. As the reach of medical students on social media continues to grow, we support Dugdale and Braswell’s recommendations for clearer discussions and updated guidance throughout medical education about social media use.

References 1. Dugdale LS, Braswell H. Instacash: The ethics of leveraging medical student status on social media. Acad Med. 2021;96:507–511. 2. General Medical Council. Doctors’ use of social media. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/doctors-use-of-social-media. Published March 25, 2013. Accessed November 30, 2021.

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