Digital age poses new trouble spot for med schools

The case of a resident physician at Stony Brook University Medical Center who published an online picture of a fellow medical student with thumbs up next to a cadaver isn't unique in an Internet age.

Across the nation and elsewhere, doctors, nurses and others in the medical field have been disciplined and in some cases fired for posting inappropriate photos online, including a Staten Island paramedic who took a picture of a 26-year-old woman strangled with a cord then put it on his Facebook page.

In a survey conducted last year, 47 out of 78 medical schools nationwide that responded, reported incidents of students' posting unprofessional content online, including pictures and videos of themselves drunk or using illicit drugs.

"There is just no distinction between a personal identity and a professional identity online," said one of the study's authors, Katherine Chretien, director of student education at the Veterans Affairs Medical Center in Washington.

Medical students appearing in pictures beside cadavers dates back more than a century, said John Warner, a professor in the school of medicine and the history department at Yale University.

At the turn of the 20th century, medical students often posed for group shots around a cadaver, sometimes seriously, and sometimes mockingly, Warner said. The photos would even turn up as postcards or holiday cards, he said.

These types of photographs began to phase out in the 1920s and '30s, said Warner, who, along with James Edmonson, wrote a book titled "Dissection: Photographs of a Rite of Passage in American Medicine, 1880-1930." By the 1950s, the dissection photo virtually vanished.

In the first study to assess online posting of unprofessional content by medical students, deans of all 130 medical schools in the United States were invited to participate, including the dean of student affairs of Stony Brook's School of Medicine.

It's unknown whether Stony Brook - where Erica Katz of Port Jefferson, took the picture of Aaron Hartman of St. James, standing next to a male cadaver in 2005 while they were students there - took part in the survey.

"School of Medicine faculty and students receive requests to participate in literally hundreds of surveys every year - we are unable to confirm participation in any one study," said Lauren Sheprow, a spokeswoman for the university.

The survey, published in the Sept. 23-30 issue of The Journal of the American Medical Association, found that the most common problems include profanity, discriminatory language, and depictions of intoxication and sexually suggestive material. Most resulted in informal warnings. In three instances, the egregious behaviors were deemed serious enough that the students were expelled, according to the survey. Only six schools reported that students' behavior had violated patient confidentiality.

"We expected that it was out there," said Chretien, referring to online postings. "We didn't know how much of it has come to the attention of the deans. That part was unexpected."

Many medical schools do not have written guidelines in place to address student-posted online content, the study found. Only 28 deans who responded to a question about policies said their schools' professionalism policies deal with the issue. And, only five schools reported that their policies specifically addresses Internet use such as blogs and social networking sites.

"Medical students may not be aware of how online posting can reflect negatively on medical professionalism or jeopardize their careers," according to the study. "Educating students about these concerns may change Internet behavior."

With Jennifer Barrios

According to newspaper reports, several people in the medical profession have gotten in trouble by posting inappropriate pictures online. In one case, a patient’s problem was discussed on Facebook.

Staten Island: A paramedic who responded to a crime scene used his camera phone to snap a picture of a Staten Island woman who had been strangled with a hair dryer cord in March 2009. The paramedic was fired after it was discovered that the picture of the slain woman was posted on his Facebook page.

Syracuse: Dr. Donald Blaskiewicz, a neurosurgeon who completed his training at SUNY Upstate Medical University in Syracuse last summer, posted a picture of a patient’s head cut open with the brain fully exposed. Blaskiewicz told the university he did not take the photo but lifted it off the Internet.

Wisconsin: Two nurses at a Lake Geneva hospital reportedly took photos of a patient’s X-ray showing a device lodged in his body. One of the nurses told authorities that she talked about the photo, which did not include the patient’s name, on her Facebook page. The hospital fired one of the nurses.

PHOTOS: Click here to see photos of medical students and cadavers in earlier times