Mohammad Al-Ubaydli’s blog

Professionalism when you have no privacy: advice for medical students

Posted in Society by Dr Mohammad Al-Ubaydli on February 4, 2009

This post is the result of a conversation I had with David Doherty (3G Doctor), Dawson Costello (Medical Student Blog) and Rob Navarro (Sapior) on my birthday. I know I should have been discussing more entertaining topics but when faced by three incredibly bright and interesting people I cannot help but try and learn from them. They certainly got me thinking and any errors below are due to my thinking.

The other day I saw a Facebook status update for a medical student saying that he was “Hating patients”. When someone tried to teach the student that this was a foolish sentence to write the student said he thought no one would find his writing interesting. This is a serious error of judgement.

I am not a fan of Facebook’s founder, and one of the things that trouble me the most about the site is that it encourages a mental model of privacy but has a business model of publicity. In other words, people are comfortable sharing information because they have the impression of private conversations with friends, but fundamentally Facebook benefits from spreading your messages as far and wide as possible. This is why they ban applications that reduce the number of “friends” you have.

The comfort you should feel in Facebook is the same you should feel about picking your nose while in your car: it feels private, but everyone can see you. And with video phones, if you are famous enough, someone will record you.

In the long run, this will not be a problem for most people. First, as everyone gets caught doing something stupid in a social network website, legislation will arise to minimize the fallout, just as politicians step in when everyone makes financial mistakes by borrowing too much or saving too little. Second, and more significantly, people will be more forigiving as they see that everyone is falliable. In 2005 there was a witch hunt over a South Korean woman caught on video phone failing to clean up after her dog in a railway carriage appeared on the internet. In 2015 there will be no such recriminations, in South Korea at least, as such an incident will no longer be news.

But there will never be such clemency for doctors. For example, the public reaction to an NHS manager getting in touch with her friends on Friends Reunited has been severe:

Eastern and Coastal Kent PCT assistant director of strategic partnerships Caroline Davis wrote on Friends Reunited: “I now live in Dover, where I work for the NHS, bullshitting for a living, no change there then.”

I found out recently about discplinary action the trust was compelled to take. The reaction towards doctors will be even more severe. Partly this is because there are so few of us, but mainly because we have a duty to society. We receive heavily subsidized training, the public trust us with their lives, and accords us the respect of professionals.

My advice to medical students is simple: assume everything you write today will be read in 20 years’s time. John Steinbeck has a good line on this:

It seems to me that if you or I must choose between two courses of thought or action, we should remember our dying and try so to live that our death brings no pleasure on the world

What you write will definitely be availabe in that time because Google, and its more powerful successors, index and archive everything. And because storing old data costs less than the revenue from putting advertisments around those data, no matter how trivial the data seems to be. And people will definitely read what you wrote because in 20 years you will be a doctor with status in your community. Members of your community – including patients, journalists and lawyers – will regularly study your older writings to look for patterns of behaviour. Do not give them a reason to think badly of you.

If that means not using Facebook, then stop using Facebook. The privilege of being a doctor is far more significant than anything a free website can offer you.

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  1. David Doherty said, on March 5, 2009 at 4:14 pm

    An interesting related story at Mobile Business News,

    Social networking ruining future of Britain’s brightest?

    With more than 360 British universities searching applicants online, a straight-A college student with impeccable school reports and a real dedication to their education may no longer be accepted by their chosen university because of their family’s background, some photos they had taken on a night out or their secret extra curricular activities.
    Figures released from people search website, yasni, reveals that more than 360 British universities are carrying out free background checks on applicants via online searches; checking their social networking sites, reading blogs they have commented on and looking at pictures they have uploaded onto the web.

    Social networking sites could be the future for university recruiting efforts and research from yasni has found that Oxford and Cambridge University, Britain’s most elite places to study, are using yasni more actively than any other university, with several thousand searches coming from both universities in the last four months.

    The top five British universities using yasni are, in order: Oxford University; Cambridge University; The University of Nottingham; Sheffield Hallam University; University of Manchester.

    The Top 10 UK and US universities using yasni as people search source are, in order: Oxford University; Cambridge University; Harvard University; Stanford University; University of New York; Yale University; University of Nottingham; University of California Los Angeles; Sheffield Hallam University; Princeton University.

    Steffen Ruehl, CEO and cofounder of, commented on the findings: “These statistics highlight how important it is for people to monitor their online reputation and be aware of what image they are portraying on the net. It is no longer enough for a student to have straight A’s and strong reports; if they party every night of the week and write inappropriate comments on a blog, they could be hindering their future opportunities.

    “Once again I stress that these social pages are just that; social. Just because an applicant has a wild night out once a month doesn’t make them unsuitable. Universities must be sure to use the information intelligently and not disregard a very suitable applicant,” he continued.

  2. oldmdgirl said, on September 11, 2009 at 10:41 pm

    So, did you stop blogging then?

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