Risks of Online Forums for Premedical and Medical Students : Academic Medicine

To the Editor:

Online forums for premedical and medical students have grown in popularity. The Student Doctor Network (www.studentdoctor.net) and other sites like it boast thousands of participants and provide students with an unfiltered medium to discuss concerning topics.

While such forums generate social capital and can help disseminate information, they can also promote misinformation and provoke anxiety amongst students. The anonymity offered by online pseudonyms permits candid discussion but limits accountability. Furthermore, individuals may test ethical boundaries when they mention proprietary information such as national board examination content. Though some sites rely on volunteers and members to moderate online content and mitigate some of these risks, others allow uncensored posting. We think it is crucial that students and medical educators be aware of the following key issues:

• Professionalism: Many forums censor the most incendiary of posts. Nevertheless, sexist comments, offensive pseudonyms, and inflammatory posts are often permitted. In addition, trainees may compromise themselves by providing information that can be used against them by others, including admissions departments and residency directors. Students must therefore be cognizant of the fact that they represent themselves and their schools when using these online resources.1
• Accuracy of online information: The authoritative tone taken in many posts may fuel rumors or provoke anxiety, especially when misinformation is introduced. Medical students who take the advice provided by their peers must do so with proper skepticism.
• Ethical implications: Writing and accessing information about examinations and specific test questions in an online forum are forms of cheating. Medical schools should adopt policies that address social networking and Internet posting and promote proper online conduct; such policies should also be a part of professionalism education.

Like social networking sites such as Facebook, online forums for medical students represent a logical evolution of our growing technical capabilities.2 Many of the risks inherent to this new medium existed before the Internet.3 Still, medical educators should adopt a deliberate approach to responding to the challenges and opportunities presented by the digital age.

Sachin H. Jain, MD, MBA

Special assistant, Office of the National Coordinator for Health Information Technology, Department of Health and Human Services, Washington, DC; [email protected].

Emily R. Maxson

Fourth-year medical student, Duke University School of Medicine, Durham, North Carolina.