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BMJ 2009; 339 doi: (Published 29 September 2009) Cite this as: BMJ 2009;339:b3945

Medical students’ professionalism lapses online

Many US medical schools need to tighten up their policies on internet use, say researchers, after a survey found evidence of unprofessional content posted by medical students online. Forty seven of the 78 medical schools who responded reported incidents ranging from profanities about the course and its staff to frank breaches of patient confidentiality on social networking sites and blogs. Other examples included sexually suggestive material, photographs of students drunk or using illegal substances, and requests for inappropriate friendships with patients on facebook.

Most of the guilty students were given an informal warning but three medical schools reported dismissing students after they had posted unprofessional material online.

The authors also asked deans or their representatives whether current professionalism policies covered online content. Only a third of respondents (28/73, 38%,) said their policies broadly covered online postings and even fewer policies (5/28) specifically mentioned the internet, social networking sites, or blogs.

Medical students behaving unprofessionally in public is nothing new, say the authors. But the impact is likely to be amplified when those behaviours are broadcast widely on media such as YouTube. Medical students may not be aware of the implications for their patients or their careers, and medical schools should make sure the curriculum includes the right guidance. Sixty per cent of US medical schools in the Association of American Medical Colleges responded to the survey.

Inactivated influenza vaccine works best for young adults

Vaccines against regular seasonal influenza can contain live attenuated viruses or inactivated viruses. A team from Michigan in the United States began comparing the two types in 2004 and have now concluded that for young adults at least, the inactivated vaccine works better. The 2007-8 influenza season was more severe than in previous years, so their fourth seasonal randomised trial accumulated enough cases of laboratory confirmed influenza for a conclusive result: the inactivated vaccine …

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