I'm a graduate medical student, currently in my third year at a UK university. Before going back to study I used to work in a junior role for a med coms agency, so have some idea of both sides of the fence; a poacher turned pheasant as it were.
The main social media I use are facebook, which as I get older increasingly becomes a forum for school friend's marriage photos, and twitter, which is much more interesting from a "professional" perspective. I might also sometimes look at forums, such as the BMJs doc2doc, but I don’t have an account and would use them much more rarely. Likewise, I know next to nothing about patient forums and online support groups - I suppose that you might become more aware of such things after specialising in a particular area.
There was a small amount of social media advice from the medical school, which I think entailed posting a well meaning but probably universally unread guidance document from the BMA onto the school intranet. Despite this, I (hope!) I have the common sense to stay within the boundaries of professionalism of social media. I'd never say anything potentially identifying or directly critical of a patient or colleague, and generally try and avoid mentioning my personal experiences online.
I don't "self define" as a med student on twitter; my account is very much "dual use", tweeting about and following people on a mix of medicine and general science, with politics, current affairs, and jokes thrown in too. I think many others use it in this way too, as I follow people who mix topics as diverse as neuroscience and militant feminism, or architecture, comedy and middle east politics.
I've never been asked for medical advice over social media, which probably says more about the good sense of the people I interact with than anything else. I might jump in to correct what I think is a misapprehension about something medical that someone else has posted - I remember one about DNRs - but I think in general I'd steer clear of getting stuck into people's personal health problems via social media, even if I think they're misguided. It is a matter of how well you know someone, etiquette and judging the situation. I know that some people, notably Embarrasing Bodies' Dr Christian, who I follow on twitter, does give out lots of advice, but I think his celebrity status means people come to him for advice, and makes him something of a special case.
One facebook based medical page I follow is "The Medical Registrar" and other similar eponymous pages, where anonymous doctors share their gripes and jokes about their day jobs. I know some people in the profession have criticised anonymous doctors on social media, and many of the discussions degenerate into unedifying (but funny) slanging matches and comedy oneupmanship, but I think this is a legitimate outlet for black humour and self expression. What once might have been kept in the doctors’ mess now has as broader viewing, but as long as people keep within the bounds of professionalism I don’t think that genie can be put back in the bottle.
Whilst I think some level of regulation for directly consultative use of social media will become necessary, if only for medicolegal reasons, in general social media are something to be welcomed. Patients' and doctors' use of social media isn't something that can be rolled back; the profession shouldn't be afraid of a bit more of the "Dr Google" assertiveness from patients, and the public will need to come to terms with the fact that we may not always conduct ourselves online like "Doctor in the House". But overall, more communication and openness about health can only be a good thing.
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