• Christopher J Barlow, Stewart Morrison, Hugh On Stephens, Emily Jenkins, Michael J Bailey, and David Pilcher.
• The Alfred Hospital, Melbourne, VIC cjdbarlow@gmail.com.
• Med. J. Aust. 2015 Dec 14;203(11):439.

ObjectivesTo describe the social media usage patterns of medical students and to identify factors associated with their posting of unprofessional content on social media.DesignVoluntary survey, delivered online.SettingAll students in all 20 Australian medical schools were eligible to participate (16 993 individuals).ParticipantsOf 1027 initial respondents during the study period (29 March - 12 August 2013), 880 completed the survey.Main Outcome MeasuresPrevalence of unprofessional online behaviour on social media by medical students, as reported by students about their own and others' accounts.ResultsPosting of unprofessional content was self-reported by 306 students (34.7%), mainly depictions of intoxication (301 students, 34.2%) or illegal drug use (14 students, 1.6%), or posting of patient information (14 students, 1.6%). Posting of unprofessional content was associated with posting evidence of alcohol use and racist content online, MySpace use, and planning to change one's profile name after graduation. Factors associated with reduced unprofessional content included believing that videos depicting medical events with heavy alcohol use were inappropriate, and being happy with one's own social media portrayal. Exposure to guidelines on professional online conduct had no effect on posting behaviour.ConclusionsSocial media use was nearly universal in the surveyed cohort. Posting of unprofessional content was highly prevalent despite understanding that this might be considered inappropriate, and despite awareness of professionalism guidelines. Medical educators should consider approaches to this problem that involve more than simply providing guidelines or policies, and students should be regularly prompted to evaluate and moderate their own online behaviour.

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