Student conduct

In the clinical setting, you should briefly pay respects, daily, to the Clinical Nurse Consultant in charge of any ward in which you may be working.  Similarly, many private practices have Practice Managers who act as co-ordinators for busy interdisciplinary clinical administrative teams.  Part of your training and experience will be to see oneself in perspective and take the first steps towards correct personal inter-relationships with all other health professionals. Medicine is traditionally a conservative discipline. It is inappropriate to use first name terms unless and until the more senior members of your team ask you so to do. 

Most patients will enjoy having you as part of their extended health team.  Many of you will be going into practices which do not normally have medical students present. Be sensitive to the fact that occasionally your Preceptor may ask you to excuse yourself in certain situations where an individual patient (whether in the public health sector or in a private clinic) is under stress, or if such patients wish for a special one-to-one consultation. The privacy, modesty and dignity of patients are paramount, above all else.  Never, ever examine patients of the opposite sex alone.  Seek the presence of a nurse, a receptionist or another party, independent of the patient, when you are about to undertake such a clinical examination.  Wash your hands before and after examining every patient.

When undertaking the Doctor of Medicine program, you will come into possession of highly confidential clinical information about patients; and come into contact with unpublished scientific data which is the intellectual property of your Preceptors and their teams.  Never discuss the details of any patient, or even that you have seen an individual patient, by name, with anyone not entitled to such information.  Never discuss patient's details with other professional health colleagues, in places (such as lifts or corridors) where there are third parties present.  Clinic records, hospital records, and (in many cases) scientific records in scientific institutions are confidential documents and must not be copied or divulged in any way.  Access to these records is a privilege granted to you by your Preceptor.  Such is one of the great privileges of the medicine program.

The MD Program at The University of Queensland (UQ) is a professional degree program that prepares students for safe and effective clinical practice. Throughout the program you will undertake learning in a variety of clinical and non-clinical environments. It is important that you are mindful of the professional dress code expectations for your particular site.

The Medical Student Code of Professional Conduct stipulates that students are required to "Ensure my appearance and dress are appropriate to enable effective and respectful interaction with patients and families".

It is important to consider infection control, professional representation to patients and placement provider expectations when it comes to dress code.  Your appearance can reflect your professionalism.  Students are required to consider the environment that you are in, and dress accordingly. 

Guiding principles

• For teaching being delivered on a university campus, students can dress as per their personal preference.  Guidance may be given locally on suitable attire for certain practical teaching sessions (e.g. lab work, physical examination tutorials).
• For teaching being delivered on a hospital campus, where there is no expectation of interaction with patients:
  • students should dress in smart casual attire.  Full clinical dress is not required.
  • guidance may be given locally on suitable attire for certain practical teaching sessions (e.g. lab work, physical examination tutorials).
• For clinical immersion/placement or activities taking place in a clinical/patient setting, appropriate business style dress is expected as outlined below:
  • Clothing must be neat, tidy, clean, and allow for safe movement in clinical tasks (e.g., CPR)
    • Bottoms: Full-length or knee-length garments such as pants, skirts, or shorts that allow ease of movement and maintain professional coverage.
    • Tops: Professional-style shirts or blouses. Long sleeves must be able to be rolled or pushed above the elbow to meet ‘Bare Below the Elbow’ guidelines.
    • Footwear: Closed-toe, non-slip shoes impermeable to sharp objects and fluids and should be in good condition.
  • The following clothing does not meet the expectations of appropriate clinical attire:
    • Clothing that is casual, revealing, or ill-fitting, including items that compromise professional appearance or restrict safe movement.
    • Garments made from transparent or overly stretchy materials, or those designed for leisure, athletic, or social settings (e.g., beachwear, gym wear).
    • Items that appear sloppy, distressed, or excessively worn, such as ripped jeans, graphic tees, or hoodies.
  • Scrubs are permitted at certain hospitals/placement providers (see table below). You will be notified by your Learning Community (LC) if your placement provider has permitted the wearing of scrubs. Do not wear scrubs without permission. 
  • Clean white coats may be required
  • Medical Student ID card must be always worn
  • Medical Student name badges are strongly recommended
  • For infection control, long hair should be firmly secured when bending over to examine patients; jewellery should be discrete and unobtrusive
  • Facial hair must be clean and neatly trimmed.  Students should be aware of the requirement to be clean shaven for mask fit-testing/in clinical environments where masks are required, to meet OHS requirements.

Entry to the clinical environment may be denied to students who do not meet these requirements. 

These rules are there to acknowledge the rights of sick patients to feel secure in a professional environment where you have the privilege to learn from their experience.

Guidance around wearing UQ purple scrubs

Adapted from AHPRA guidance for practitioners. This is designed to guide students in relation to their responsibilities in interacting with social media.

As medical students you are a part of the medical profession subject to governance of the Medical Board and regulation through the Australian Health Practitioner Regulation Agency. As University of Queensland (UQ) medical students you are also representatives of UQ and are required to act in keeping with the Student Code of Conduct.

Lastly, during clinical placements, you are also undertaking work-integrated learning within the institution you are placed and are required to act in accordance with any conduct policies of the placement provider (such as Queensland Health).

Your social media use should align with the requirements of each of these organisations. These include:

• The Medical Board of Australia and Australian Health Practitioner Regulation Agency (ASPX, 228.9 KB)
• The University of Queensland Medical School (PDF, 9.1 MB)
• Placement providers: e.g. Queensland Health, General Practitioner Practices

Professional and legal obligations for medical students and medical professionals apply on social media platforms. You should always consider how your online activities may be interpreted regardless of the platform, purpose or intended audience. Social media posts may exist forever, so you must consider how this may reflect on you and the medical profession in future. Overall, if you are in doubt, don’t post.

Purpose

This guidance is to help UQ Medical Students to understand and meet their obligations when using social media.

Definitions

Social Media – as defined in the AHPRA guidance (ASPX, 228.9 KB):

Social media is a term that is constantly evolving but generally refers to internet-based tools that allow individuals and groups to communicate, to advertise or share opinions, information, ideas, messages, experiences, images, and video or audio clips. They may include blogs, social networks, video and photo-sharing sites, wikis, or a myriad of other media, used for:

• social networking (Facebook, Twitter, WEChat, Weibo, WhatsApp)
• professional networking (LinkedIn) 
• discussion forums (Reddit, Whirlpool) 
• media sharing (YouTube, Flickr, Instagram) 
• content production (blogs [Tumblr, Blogger] and microblogs [Twitter]) 
• knowledge/information aggregation (Wikipedia) 
• virtual reality and gaming environments (Second Life), and 
• booking sites and apps (HealthEngine, Whitecoat, Podium).

This is not an exhaustive list.

List adapted from:

• Social Media and Health Care Professionals: Benefits, Risks, and Best Practices
• Medical Board of Australia - Social media: How to meet your obligations under the National Law (ASPX, 228.9 KB)

Expectations

When using social media, you can meet your obligations by:

• complying with confidentiality and privacy obligations 
• complying with your professional obligations as defined in the Australian Medical Board’s Code of conduct
• maintaining professional boundaries 
• communicating professionally and respectfully, and 
• not presenting information that is false, misleading or deceptive, including advertising only claims that are supported by acceptable evidence.

AHPRA: Medical Board of Australia - Social media: How to meet your obligations under the National Law (ASPX, 228.9 KB).

In addition to the above you must also ensure that your social media use is consistent with the following:

• The UQ Medical Student Code of Professional Conduct, particularly noting the following extracts (Code of Professional Conduct (PDF, 9.1 MB):
  • As a medical student, I will:
    • not exploit any patient
    • not exploit my role as a student doctor for personal gain
    • not give advice or provide information to patients, family members or the public, which is beyond my level of knowledge and expertise.
    • hold all patient information in confidence, including after patients have ended treatment or died.
    • respect the right of all patients to determine who should be provided with their personal information.
    • ensure that my use of digital communications (e.g. email and text messages) and social media is consistent with my ethical and legal obligations to protect patient confidentiality and privacy and the University and Medical Board’s social media guidance.
• Placement provider policies:
  • These will usually prohibit photographs or videos of the workplace and clinical environment without specific permission
  • These will usually prohibit disclosure of confidential information about hospital/health service/placement provider to the public including use of new technologies, treatments and research

Breaches in professional expectations

In the event that there is a breach in professional expectations on social media the following actions should be taken.

If it is your own post:

• The post/message should immediately be removed.
• Please contact your learning community for further advice and support.

If it is a concern around another medical student’s post:

• Consider discussing with the student as they may not be aware of the potential breach in expectations.
• Please raise this concern with the learning community or submit a grievance via the Grievance resolution process on my.UQ.

The situation will then be investigated according to the Supporting Fitness to Study and Misconduct frameworks.

Examples for medical students

Scenario 1

Student A has a private social media account. They share a day in the life video which includes information about the patients they have seen that day. Patient names and demographics have been removed. However, one of the followers of the account makes a complaint to the medical school that they could tell that one of the patients was one of their relatives based off the clinical information present.

Explanation: Student A has breached confidentiality. Although patient names and demographic information has been removed, the information present was sufficient for someone who knew some details of the situation to re-identify the patient. Furthermore, there is concern that the student is potentially exploiting the patient and their role as a student doctor for personal gain such as a social media following.

Scenario 2

Student B has a public social media account listed as a medical student. They have a significant following and have now been able to obtain financial endorsements. The student recommends certain products for wellbeing despite limited evidence of proven benefits.

Explanation: Student B has breached social media guidelines as they are recommending products without acceptable evidence basis. It is important for the trust in the profession to be maintained by only presenting or recommending based off of acceptable evidence. Furthermore, there is a concern that the student is using their role as a student doctor for personal gain through financial incentives.

Scenario 3

Student C has a public social media account. They share a day in the life video which includes photos of the clinical environment. Within the photos in the background there is a patient XR identifiable.

Explanation: Student C has breached confidentiality. It is also likely that the student has breached the placement provider policies by taking photographs of the workplace without prior permission.

Scenario 4

Student D has a public social media account. The student talks broadly about their experiences and challenges as a medical student. They do not provide any identifying information of any institutions or individual patients

Explanation: Student D has not breached any of the professional expectations.

Scenario 5

Student E has a private social media account. Within several photos they have a UQ shirt on. In their post in a discussion forum they present a viewpoint that is derogatory.

Explanation: Student E has breached the UQ Code of Conduct and the AHPRA guidance. Although posting as a private account, they are identifiable as connected with UQ and therefore the conduct must be in keeping with the UQ expectations. AHPRA Registered practitioners will not be investigated purely for holding or expressing their views on social media. However, there is no place for discrimination, racism or intolerance in healthcare, including on social media.

Scenario 6

Student F has a public social media account. They share day in the life videos which include photos of the clinical environment.

Explanation: Student F has likely breached the placement provider policies which commonly prohibit photographs of the clinical environment without prior permission.

Scenario 7

Student G has a public social media account. A patient that the student saw as part of the medical team in a previous immersion, reaches out to connect via social media. The student accepts the invitation and follows the patient’s account in return.

Explanation: Student G has breached professional boundaries. Although the student hasn’t initiated the contact this is still a breach of professionalism. For this reason, many health professionals do not have easily accessible/searchable social media profiles.

Scenario 8

Student H posts a video on a social media platform. The student highlights that they are a UQ representative advocating for a particular cause. The student has not obtained approval to act as a University representative.

Explanation: Student H has breached the code of conduct as they have not acted in keeping with the University values. They are misleading the audience of the post that they are representing UQ’s views.

Scenario 9

Student I posts a video making fun of the “worst workplace ever” but the placement provider is not named. The student has in their profile information section that they are a medical student. The video is geotagged with the hospital location.

Explanation: Student I has breached the code of conduct by not acting in accordance with the values of the University. Additionally, they will have likely breached the policies of the placement provider and although not directly named this is re-identifiable through the additional information of the post and the profile.

Checklist for medical students

Adapted from the Queensland Government document Personal use of social media guideline.

Source: Queensland Government Customer and Digital Group