SJT Textbook: Social Media & Digital Professionalism
Social Media Professionalism MSRA
This guide covers the essential rules of Social Media Professionalism MSRA scenarios. In the SJT, the line between your private life and public professional persona is often blurred, and the exam tests your ability to maintain GMC standards even when “off the clock.”
🎥 Video Lesson (YouTube)
🎧 Podcast Lesson (Spotify / Apple / Amazon)
FREQUENCY: High
PRIORITY: Must-Know
🎯 THE CORE PRINCIPLE
Social media and digital professionalism means applying GMC standards to everything you do online – posts, comments, videos, livestreams, direct messages – and to digital communication with patients (email, messaging apps, portals). You must protect confidentiality, maintain professional boundaries, be honest and accurate, declare relevant interests, and avoid misleading claims or endorsements.
For clinical care, patient information should only be shared via approved, secure systems, with the outcome documented in the clinical record. Personal accounts are not a substitute for proper clinical pathways, and giving individual advice in comments or DMs is usually unsafe and unprofessional.
In the MSRA SJT, high-scoring answers remove or reduce harm, move any necessary clinical communication onto approved secure channels, ensure information is accurate and transparent about conflicts of interest, and leave a brief, contemporaneous record if patient care has been influenced.
In Social Media Professionalism MSRA questions, you should apply the “Billboard Test”: would you be happy for your post or comment to be displayed on a billboard outside your hospital? If the answer is no, do not post it.
⚡ HIGH-YIELD ACTIONS (What Scores Points)
1. Pause and check posts or replies for confidentiality risks, tone, and accuracy before sending.
2. Direct any patient-specific queries from social media to official, secure clinical routes.
3. Avoid sharing identifiable details or images; minimise data and use approved tools for clinical images and messaging.
4. Declare any relevant financial or commercial interests when advising on products or services.
5. Correct significant inaccuracies or misleading content promptly, including your own posts.
6. Keep a brief note in the clinical record when digital communication affects patient care (what, why, when, and through which channel).
7. Challenge and help remove unsafe or unprofessional online content by colleagues in a proportionate, supportive way and escalate if needed.
To score highly in Social Media Professionalism MSRA ranking questions, you must demonstrate restraint. The correct answer is often to “take the conversation offline” or “not engage.”
• Posting “anonymised” cases where the patient could still be recognised by context, timing or details.
• Giving individual clinical advice, diagnosis or prescriptions via DMs or comments on personal accounts.
• Using unapproved personal apps or devices as the main record for clinical images or messages.
• Promotional content or endorsements without declaring financial or other interests.
• Online harassment, bullying or unprofessional arguments that could undermine public trust in the profession.
These traps prioritise convenience, attention or personal branding over confidentiality, secure systems and honesty. In the exam, look for options that reduce harm, move communication into official pathways, and maintain clear, recorded reasoning.
Be alert for these Social Media Professionalism MSRA red flags. Specifically, patient identifiers hidden in the background of photos (like whiteboard names) are a frequent exam topic.
💬 MODEL PHRASES (Use These in SJT Logic)
* “That image could identify a patient – please delete it and, if needed, use the approved clinical system with appropriate consent; I’ll document what we do.”
* “For transparency, I have a relationship with this organisation, so I’ll explain my role and the limitations of this advice.”
* “If clinical information is being shared, we should transfer the key details into the patient’s record so there is a clear audit trail.”
Protect identity • On-policy (secure) • Stick to facts • Transparency (declare interests) • Set boundaries • Act to remove or mitigate • Flag/escalate • Enter a brief record
Pause and ask: does this risk confidentiality, trust, or boundaries?
Route any patient-specific issues to approved clinical channels (not personal accounts).
Protect identity and minimise data; avoid posting recognisable details or images.
Check accuracy and declare any conflicts or affiliations.
If care is affected, document the key communication and decision in the clinical record.
📋 QUICK FAQ
Can I use WhatsApp for clinical images or messages?
You should prefer your organisation’s approved secure platforms. Where local policy pragmatically allows mobile messaging, you must minimise identifiers, avoid storing data on personal devices long term, transfer relevant information into the formal record promptly, and follow information-governance guidance.
Can I post anonymised cases on my public account?
Only if the patient cannot reasonably be identified directly or indirectly (for example by timing, location, or rare details). When in doubt, do not post, or obtain explicit, informed consent that clearly covers the use.
Can I give individual clinical advice in DMs or comments?
No. Provide general health education only. Direct individual queries to proper clinical routes (practice phone, online consultations, NHS services) so that assessment and documentation happen safely.
Do I need to declare affiliations or sponsorships?
Yes. You should be open about financial or other interests, avoid misleading advertising, and ensure any recommendations are evidence-based and transparent about limitations.
Should online communications that influence care be documented?
Yes. If a digital interaction changes assessment, advice or management, add a brief, contemporaneous entry in the clinical record describing what was discussed, the decisions made and through which channel.
📚 GMC ANCHOR POINTS
• Public professional communication must be accurate, not misleading, and should declare relevant interests (GMC Good medical practice 2024, public communication section).
• Social media use must maintain trust, respect confidentiality, and uphold professional standards (GMC guidance on using social media as a medical professional).
• Patient information should be shared on a need-to-know basis through secure routes, with appropriate records kept (GMC Confidentiality and IG principles).
• Records must be clear, accurate and contemporaneous, including when digital communication influences care (GMC Good medical practice 2024 – records).
💡 MINI PRACTICE SCENARIO
A patient sends a direct message to your personal social media account containing a photo of a rash and asks: “Can you prescribe something for this tonight?” Your organisation has an approved secure patient-messaging portal and a process for uploading photos into the electronic record.
Best action: Reply explaining that you cannot give personal medical advice through your private social media, signpost them to the official clinical route (for example the practice online consult or urgent service if appropriate), adjust your settings to prevent patient DMs in future, and document the interaction briefly if it contains clinical information.
Why: This maintains boundaries, directs care into secure, auditable systems, and protects confidentiality while still promoting safe access to help.
🎯 KEY TAKEAWAYS
✓ Confidentiality and patient safety take priority over convenience or online engagement.
✓ Use approved secure systems for clinical images and messages, not personal accounts.
✓ Be honest, accurate, and transparent about any commercial or other interests.
✓ Do not give individual clinical advice in DMs or comments; signpost to proper pathways.
✓ Briefly document online interactions that influence assessment, advice or management.
🔗 RELATED TOPICS
* → Confidentiality and Information Governance
* → Sharing Information with Consent
* → Maintaining Professional Boundaries
* → Professional Appearance and Behaviour
📖 FULL PRACTICE QUESTIONS
Example SJT — Best of 3 (8 options; choose three)
A medical registrar posts a selfie from the ward on a public social media account. No patient faces are visible, but a whiteboard in the background clearly shows bed numbers and patient surnames. Several colleagues have already liked the post. You see it during a break.
Options:
A. Ignore it – no one is directly looking at the camera, so it is not a problem.
B. Publicly quote-tweet or share the post criticising the registrar in detail for being unprofessional.
C. Ask the registrar privately to delete the post immediately, explaining the confidentiality risk and how patients could be identified.
D. Raise the issue with a senior or information-governance lead if the registrar refuses or if you are unsure about the seriousness, and seek advice on next steps.
E. Download the image and re-post it with the names blurred, joking about “what not to do”.
F. Remind the registrar to check the GMC social media guidance and local policy, and offer support in learning from the mistake.
G. Take a screenshot and circulate it widely in staff WhatsApp groups to “raise awareness”.
H. Comment publicly under the post: “This breaches confidentiality – what were you thinking?” and tag the Trust account.
Correct three: C, D, F
• C: Directly addresses the immediate risk by asking for deletion and explaining why the content is unsafe, prioritising patient confidentiality.
• D: Involves appropriate senior or IG support if needed, ensuring the issue is managed proportionately and in line with policy.
• F: Encourages learning and reflection, reinforces guidance, and supports professionalism without unnecessary public shaming.
Why others are weaker/wrong:
• A: Minimises a clear confidentiality risk and fails to act to protect patients.
• B: Publicly shaming a colleague in detail can undermine trust and teamworking; it is disproportionate.
• E: Reposting the image, even edited, risks further circulation and normalises unsafe behaviour.
• G: Spreading the image further in informal groups increases the breach and is unnecessary.
• H: Publicly calling out the colleague may escalate and embarrass them rather than resolving the issue through appropriate internal channels.
Example SJT — Rank 5 (best → worst)
A patient sends a message to your personal Instagram account: “Here’s a photo of my rash, can you advise and prescribe something? I can’t get through to the surgery.” Your Trust has an approved secure messaging route and an online consultation system; you are not on call, but you do see the message.
Options:
A. Reply: “I can’t give personal medical advice via this account. Please contact us using the official route [give details] or seek urgent care if you are very unwell,” then adjust your settings to prevent further patient DMs and document the interaction if clinically relevant.
B. Give brief advice in the DM about likely causes and suggest they contact their GP if it does not improve.
C. Screenshot the DM and share it in your team WhatsApp group asking for opinions on what to advise.
D. Ignore the message completely; social media is separate from work.
E. Ask the patient to post the photo publicly and tag you so that others can “learn from the case.”
Ideal order: A (1) > D (2) > B (3) > C (4) > E (5)
• A: Maintains boundaries, routes care into official systems, provides clear signposting for urgent issues, and closes down inappropriate access; documenting if needed maintains an audit trail.
• D: Avoids giving unsafe advice via social media but is weaker than A because it ignores a potential clinical need and gives no guidance.
• B: Attempts to help but still provides patient-specific advice via an insecure, unofficial channel with no formal record.
• C: Shares patient information in an unapproved group, increasing the breach and showing poor information governance.
• E: Encourages public sharing of identifiable clinical information, which is a serious breach of confidentiality and professionalism.
Why others are weaker/wrong:
• Any option that uses informal personal channels for detailed clinical advice or encourages wider sharing of identifiable information is unsafe and unprofessional.
• Doing nothing is better than breaching confidentiality, but still weaker than signposting to safe, official routes.
• Secure pathways, boundaries and proper documentation are central to high-scoring responses.
Pause before posting or replying
Route patient queries to official channels
Protect identity; minimise identifiable details
Use approved secure tools for clinical data
Document online interactions that affect care
Identifiable photos or “funny cases” from clinical areas
Direct messages asking for personal clinical advice
Unapproved apps as the main place clinical data is stored
Misleading or promotional posts without declared interests
- GMC — Good medical practice (2024): public professional communication (including social media)
https://www.gmc-uk.org/professional-standards/the-professional-standards/good-medical-practice - GMC — Using social media as a medical professional
https://www.gmc-uk.org/professional-standards - NHS England — Using mobile messaging applications in health and social care
https://transform.england.nhs.uk/information-governance/guidance/using-mobile-messaging-applications-in-health-and-social-care - NHS England — Email and text communications with patients: good practice overview
https://transform.england.nhs.uk/information-governance