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Using Anonymous Social Media in Modern Medical Education

In the modern era, image is everything. Our evaluations from both preceptors and peers can drastically change our life trajectory and this is far more true in the realm of medicine. We are continually prodded to make connections in every clinic in which we rotate, at every conference we attend and with every professor with whom we contact. We tidy-up our LinkedIns, Instagrams and public Twitter accounts to project our abilities and thriving successes for all to see. But behind the rose-tinted glass screens, students and residents have a particularly strong fear of being perceived as weak, unintelligent or incompetent by those who surround them. This insecurity fuels the incredible power that exists in social media anonymity and the ability to be vulnerable while seeking out knowledge and support from others.

No matter where you may be on your path in medicine, you’ve probably heard of Student Doctor Network, #MedTwitter and Reddit’s r/Residency or r/MedicalSchool. While these websites are all centered around medicine and medical education, each contains its own unique reputation, features and ecosystem of users.

Student Doctor Network (SDN) is one of the first of its kind — a free and moderated online space to help everyone from high school students to retiring physicians navigate the ever-complex world of medicine. Forums are broken up based on your stage of learning and other niches within medicine, such as Military Medicine for example. My journey into SDN started on their “Interview Feedback” database, where users could share their medical school interview experiences and their impressions of each school. A particularly critical version of this feature, the “Medical School Interview Question Bank,” a compilation of most-potential interview questions, left me feeling ready and confident for my interview day. The “Confidential Consult” sub-forum has also helped when an official advisor was unreachable or my question was particularly embarrassing. These resources become invaluable to non-traditional applicants or students without a designated advisor at their home institution to support them. Similarly, students without physician parents or close friends who are also in the medical field can use the experts here as a surrogate for casual advice about life in medicine. This forum and all the information therein is recorded permanently and can be revisited at any time, which has tremendous utility for future information seekers.

Contrasting to the focused, professional nature of SDN, Twitter is a much more turbulent environment with vast amounts of continually updating content. Nonetheless, this platform still has its uses. Anonymity is completely optional on Twitter, as many users affiliate their accounts with their real identities. Many residency programs and program directors are available to reach out to, to make connections with and to ask questions to. Internet advocacy is far more prevalent on #MedTwitter, and it’s easy to follow social movements such as #WhiteCoatsForBlackLives or #WomenInMedicine, which both aim to remedy disparities in medical care and representation. It’s also the internet stalker’s paradise — using their powers for good, we hope. If you’re looking to access the newest information about a program and their research in real time, this is the place to be, as programs continually push out content about their activities. The mix of anonymous and public profiles, paired with limited content moderation, gives Twitter one of the most interesting dynamics in the medical social media space. Public profiles linked to students are open to public scrutiny, while anonymous users retain an unfettered ability to bully and harass others. This dynamic collides explosively when public users make inappropriate comments or like and retweet controversial content. As situations like this are not terribly uncommon on Twitter, we can gain an appreciation for the use of anonymity in our social media use. As Twitter has recently changed their language moderation policies, we also gain an appreciation for moderation in these spaces.

Reddit combines the moderated, medical focus on SDN and the turbulent large user base of Twitter, with a healthy side of memes and pop-culture. r/Premed, r/MedicalSchool and r/Residency are the largest, but far from the only forums for trainees and physicians alike. Other subforums — or subreddits — dedicated to the MCAT, USMLE, Anki cards, international graduates and other topics with large communities grant near immediate access to almost any relevant question you have. Reddit provides a significant platform for social support and answering the questions that students may be too embarrassed to ask or have difficulty finding. The most efficient study tips and resources are also archived and available at a moment’s notice, which can be empowering for students who lack reliable academic advising at their college or access to high-end tutoring services, which often costs thousands of dollars. r/MedicalSchool carries the torch on from Student Doctor Network’s premed Interview Question Database and provides resources for residency and fellowship applicants via a moderated Google Sheets form, with knowledge “crowdfunded” from users. This same crowdfunding is used in the prominent “Name and Shame” and “Name and Fame” threads used to disparage or commend residency programs following the interview season, respectively. Whether this crowdfunded knowledge is reliable, though, remains in question.

That is not to say these platforms do not have their pitfalls. With great anonymity comes great misinformation and bullying. The lack of personal information attached to a profile can lead users to be significantly more willing to attack their peers and leave disparaging remarks. Furthermore, there is no accountability system or way to check credentials in many cases, one must simply take others’ word on information being displayed. Who’s to say @SuperDuperRealMD is actually a real physician? A lay-person with enough training from the TV shows “Scrubs” or “Grey’s Anatomy” could merely be pretending to be a physician. Raise your suspicions against any lupus-denying diagnosticians you find out there. An additional threat may be “doxxing” of users. The shield of anonymity is not impermeable and if enough information slips through, one’s online presence can be found out. This is all the more reason to use anonymity as a resource for growth, rather than hate.

As medical school and residency become more competitive, students must keep up with their peers to gather vast amounts of information, study practices and resources to thrive in our ever evolving field. Sometimes, it’s just not enough to study hard and some students would like every edge they can find. For others, it is worth having a place to share their insecurities. Though not without its drawbacks, free and anonymous social media levels the playing field for disadvantaged students and creates opportunities for peer support that may otherwise be viewed as shameful in the real world by peers and preceptors alike.

John Waters John Waters (1 Posts)

Contributing Writer

Thomas Jefferson University Sidney Kimmel Medical College

John is a third year medical student at Thomas Jefferson University (Sidney Kimmel Medical College) in Philadelphia, PA. Prior to attending medical school, he completed a Bachelor of Science in microbiology at University of Idaho and worked in Boise's rapidly-developing tele-health sector. He has long-standing interests in medical education, disability advocacy, and technology-in-medicine, with extended interest in artificial intelligence. In his free time, he enjoys running, yoga, and traveling with his wife.