Worked Examples: Social Media Scenarios

Social media scenarios are increasingly common in the UCAT SJT. They test your understanding of confidentiality, professional image, boundaries, and the courage to act when a colleague makes a mistake online. This lesson works through detailed scenarios covering posts about placements, patient photographs, and colleague behaviour.

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Principles to Apply

Before working through the scenarios, review these principles:

1. The same professional standards apply online as offline — The GMC does not distinguish between the two
2. Social media posts are permanent and public — Even deleted posts may have been captured
3. Patient confidentiality applies in all contexts — Including social media, WhatsApp groups, and private messages
4. You have a duty to act when you see a colleague breach professional standards online
5. Proportionality still applies — Not every social media misjudgement requires formal reporting

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Scenario 1: A Colleague Posts a Photograph from a Clinical Setting

The Situation

A fellow medical student posts an Instagram story showing themselves in scrubs, standing in a hospital corridor. In the background, a patient is visible on a trolley. The student's caption reads: "Night shift vibes 🏥 — love this placement!" The patient's face is partially visible.

Analysis

• The patient is identifiable (or potentially identifiable) in the photograph
• The patient has not consented to appearing on social media
• The post breaches confidentiality — even though the student did not intend to share any clinical information
• The hospital location may also be identifiable, which could help identify the patient
• Instagram stories last 24 hours but can be screenshotted and shared

Worked Response (Appropriateness Format)

Action A: Contact your colleague immediately and ask them to delete the post. Explain that the patient is visible in the background.

Rating: Very appropriate The most urgent priority is to remove the post. Contacting the colleague directly is the fastest way to achieve this. You should explain the problem clearly and ask for immediate deletion.

Action B: Ignore it — the patient is only in the background and probably cannot be identified.

Rating: Very inappropriate "Probably" is not good enough when it comes to patient confidentiality. Even partial visibility may allow identification, especially by people who know the patient. Ignoring a potential breach is a failure of your duty to act.

Action C: Report the post to Instagram so that the platform removes it.

Rating: Inappropriate, but not awful Reporting to the platform may eventually lead to removal, but it is slow and unreliable. Meanwhile, the post continues to be visible. Direct contact with the colleague is more effective and faster.

Action D: After ensuring the post is removed, inform your clinical supervisor or placement lead about the breach.

Rating: Very appropriate Even after the post is removed, the breach occurred and should be documented. Your supervisor may need to check whether the patient has been affected and ensure the colleague understands the seriousness of the issue.

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Scenario 2: A Colleague Vents About a Patient on Social Media

The Situation

A fellow medical student posts on Twitter/X: "Had the most annoying patient today — spent an hour explaining their diagnosis and they STILL didn't get it. Some people are just thick. #MedStudentLife"

Analysis

• The post does not name the patient, but it:
  • Is disrespectful and unprofessional
  • Could potentially identify the patient if someone connects the student, the date, and the clinical setting
  • Undermines public trust in the medical profession
  • Is a Fitness to Practise concern — medical schools have investigated students for far less
• The use of "#MedStudentLife" explicitly identifies the poster as a medical student, linking the unprofessional behaviour to the profession

Worked Response (Most/Least Appropriate Format)

Which is the MOST appropriate action?

A. Like the tweet to show solidarity with your overworked colleague B. Reply publicly: "You shouldn't be posting this — take it down" C. Send the colleague a private message explaining that the post is unprofessional and could identify the patient; ask them to delete it D. Screenshot the post and report it to the medical school without talking to the colleague

Answer: C is the MOST appropriate. A private message is respectful, proportionate, and focused on getting the post removed quickly. You are giving your colleague the opportunity to correct their mistake.

Which is the LEAST appropriate action?

Answer: A is the LEAST appropriate. Liking the post associates you with the unprofessional content and actively endorses disrespectful language about a patient.

Why B and D Are Not Ideal

• B (public reply): While the intention is good, a public reply draws more attention to the unprofessional post and could embarrass your colleague publicly. A private approach is more proportionate.
• D (screenshot and report without talking first): For a first offence of this nature, speaking to the colleague first is more proportionate. However, if they refuse to remove the post or this is a pattern of behaviour, reporting would become appropriate.

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Scenario 3: Someone Posts a Photo of Clinical Notes

The Situation

You are added to a WhatsApp group for your clinical placement year group. A student posts a photo of a set of handwritten clinical notes, asking: "Can anyone help me read this consultant's handwriting? Lol 😂." Patient name, date of birth, and hospital number are visible in the image.

Analysis

This is a serious confidentiality breach:

• The patient is clearly identifiable — name, DOB, and hospital number are all visible
• The image has been shared with a group of people who may have no clinical role in the patient's care
• WhatsApp messages can be forwarded, screenshotted, and shared beyond the group
• The student may not have realised the severity, but intent is irrelevant — the breach has occurred

Worked Response (Appropriateness Format)

Action A: Reply in the group asking the student to delete the image immediately, as it contains patient-identifiable information.

Rating: Very appropriate Speed is critical — every second the image is in the group, more people may see it or screenshot it. A clear, direct message in the group is the fastest way to alert the poster and others.

Action B: Send the student a private message asking them to delete it, without mentioning it in the group.

Rating: Appropriate, but not ideal A private message is polite and gives the student the chance to correct the mistake quietly. However, it is less ideal than a group message because (1) it is slower — the student may not see the private message immediately, and (2) other group members may screenshot the image in the meantime.