Residency and the social media dilemma: Advice from the trenches

First-year resident Amanda Ly, DO, is also a blogger who has over 50,000 followers on Instagram. But in the fall of 2017 when she was interviewing for residency spots, the social media influencer put all her accounts on hiatus or made them private.

Though Dr. Ly is careful to keep her social media posts positive and professional, she—like so many medical students going through the rigors of securing a residency—practiced extreme caution with her social media presence because she didn’t want to take the risk of something being misconstrued.

“I was really nervous going into interviews in a competitive specialty and wanted to do everything I could to increase my chances,” says Dr. Ly, who is a general surgery intern in a community hospital in the Detroit area.

Navigating social media can be challenging for those applying for residency. Once you’re a resident, different challenges emerge. Below, program directors and a resident share their social media advice.

Are program directors checking candidates’ social media accounts?

The family medicine program at Mercy Hospital in St. Louis does not check candidates’ social media accounts, says Sarah Cole, DO, its program director.

“I know the candidates are more sophisticated users of social media than I am,” Dr. Cole says. “They can hide more than I know to look for. I’m not going to go hunting for that. I really do not get the sense when speaking with other program directors at other institutions that anyone is making a social media review a part of their interview process.”

Mercy Hospital has a long and nuanced social media policy for all its employees. “Essentially it asks co-workers to adhere to HIPAA rules at all times and to be very mindful of anything a co-worker is posting in terms of professionalism,” Dr. Cole says. “I review that policy with incoming residents and the hospital goes over it with them as well. So they hear it twice and they’re expected to adhere to it.”

The program has not had to address any major professionalism infractions in regards to their social media policy with residents.

“A lot of the students I mentor have told me they use aliases on social media or that they’ve created privacy blocks because they’re concerned that programs will look at their accounts and find something questionable,” says Tyree Winters, DO, the associate program director of the pediatric residency program at Goryeb Children’s Hospital in Morristown, New Jersey. Dr. Winters also does not check residency candidates’ social media accounts.

Beyond social media

Dr. Winters thinks there needs to be more guidance starting in medical school about social media usage. The AOA’s social media guidelines are available here. Students and DOs also need to be mindful of their internet footprint at large, Dr. Winters says.

He advises his residents to conduct an Internet search of themselves. “You’d be surprised what comes up. Make sure that your public view on an Internet search doesn’t include things you don’t want your mother to see,” advises Dr. Winters. “Definitely avoid nudity, profanity and hate speech.”

Dr. Winters follows the social media policies of the hospital’s parent health system, which emphasize avoiding HIPAA violations.

He recalls a case at a hospital he worked where a bad accident had occurred on the freeway and one of the ER nurses on duty posted a picture of the bloody triage bay with no descriptors of the patients. “But there was a huge story about the accident in the news, and so people could put two and two together,” says Dr. Winters. “I tell my residents to practice extreme caution.”

Dr. Ly keeps the details of her work very separate from her Instagram. She takes measures to not disclose her location nor the hours she’s working, and she never posts anything even remotely related to a patient.

Dr. Ly advises others that if they’re questioning whether to post something, they shouldn’t post it.

“Your career is No. 1,” she says. “At the end of the day, you should be willing to quit your social media ASAP if it threatens your career.”

‘Pretty extreme scenario’

The recent case of the Cleveland Clinic resident who lost her position over anti-Semitic remarks she made on social media is a pretty extreme scenario, says Dr. Cole. “If a professional infraction by a resident occurs on social media, it’s typically minor enough that it simply calls for some coaching,” Dr. Cole says. “Most of the time, it’s not going to result in action.”

Dr. Ly admits to making some social media snafus along the way. “I did have some instances where I felt like I might have said too much. I started my Instagram the second year of medical school and at the time, there wasn’t a lot of guidance,” she says. “So there was some trial and error, but I learned.”

The positive side of social media

Despite all the precautions, there are obvious opportunities to be gained from social media.

“It’s a great tool for networking and self-expression,” Dr. Winters says. ”I have a social media account for my Hip Hop with a Doc dance program.”

Dr. Ly says her blog, Coffee and Scrubs, has enhanced her journey in medicine in immeasurable ways.

“My blog has been an awesome way to connect with people and exchange ideas, and it gave me an additional support system that I didn’t think I would get going into it,” says Dr. Ly.

Dr. Cole finds social media a useful tool in connecting with her residents.

“I have intentionally maintained a social media presence because if I don’t, I wouldn’t know half of what is going on in my residents’ lives,” she says. “If they post that they had a busy night last night, for example, I know I probably need to reach out to that resident from a wellness perspective. It helps me keep my finger on the pulse to see how my residents are doing.”

Related reading

To post or not to post? That is the question for DOs on social media

Should physicians be friends with their patients on social media?