title: An assessment of unprofessional behavior among surgical residents on Facebook: a warning of the dangers of social media.
abstract: OBJECTIVE
  Dismissal from residency is most commonly because of unprofessional conduct rather than cognitive failure. Disciplinary action by medical boards has also been associated with prior unprofessional behavior during medical school. Facebook is a social media network that has become ubiquitous in recent years and has the potential to offer an unvarnished view into the lives of residents using a public forum that is open to the public and program directors alike. The aim of this study was to evaluate the publically available Facebook profiles of surgical residents to determine the incidence and degree of unprofessional conduct.
  
  
  METHODS
  The American College of Surgeons Web site was used to identify general surgery residencies located in the Midwest. Resident rosters were then obtained using departmental Web sites. Facebook was then searched to determine which residents had profiles available for viewing by the public. The Accreditation Council for Graduate Medical Education's components of professionalism and the American Medical Association's report on professionalism in the use of social media were used to develop the following 3 categories: professional, potentially unprofessional, or clearly unprofessional.
  
  
  METHODS
  The chi-square test was used to determine significance.
  
  
  RESULTS
  A total of 57 residency programs were identified on the American College of Surgeons Web site, of which 40 (70.2%) provided an institutional Web site with a current resident roster. A total of 996 surgical residents were identified, of which 319 (32%) had identifiable Facebook profiles. Overall, 235 residents (73.7%) had no unprofessional content, 45 (14.1%) had potentially unprofessional content, and 39 (12.2%) had clearly unprofessional content. Binge drinking, sexually suggestive photos, and Health Insurance Portability and Accountability Act violations were the most commonly found variables in the clearly unprofessional group. There were no statistical differences in professionalism based on sex (p = 0.93) or postgraduate year status (p = 0.88).
  
  
  CONCLUSIONS
  Unprofessional behavior is prevalent among surgical residents who use Facebook, and this behavior does not appear to decrease as residents progress through training. This represents a risk to the reputations of hospitals and residency programs, and residents should be educated on the dangers of social media. Although it may be perceived as an invasion of privacy, this information is publically available, and program directors may benefit from monitoring these sites to identify gaps in professionalism that require correction.
authors: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska. Electronic address: sean.langenfeld@unmc.edu.
authors: Sean J
authors: SJ
authors: Langenfeld
authors: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
authors: Gates
authors: G
authors: Cook
authors: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
authors: Craig
authors: C
authors: Sudbeck
authors: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
authors: Thomas
authors: T
authors: Luers
authors: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
authors: Paul J
authors: PJ
authors: Schenarts
mesh_terms: D000328:Adult; D001519:Behavior; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007400:Interprofessional Relations; D008297:Male; D018907:Privacy; D011361:Professional Competence; D028743:Professional Misconduct; D061108:Social Media
keywords: Interpersonal and Communication Skills; Practice-Based Learning and Improvement; Professionalism; alcohol abuse; facebook; privacy; professionalism; social media