​​To Tweet or Not to Tweet:
Should the GMC Police Doctors’ Social Media?

Where is the line of professionalism in the age of digital outrage

Doctors have always had opinions. Once, they were solely discussed in hospital corridors. Now, they’re broadcasted to the world in 280-character rants.

In January 2024, the General Medical Council (GMC) implemented new guidance titled "Using social media as a medical professional," emphasising the importance of maintaining professionalism and boundaries online. A key directive from this guidance states: "You must not use social media to abuse, discriminate against, bully, harass or deliberately target any individual or group.”

But who decides what crosses the line? Is a doctor calling out poor working conditions "harassment" of NHS leadership? Is criticising physician associates (PAs) a legitimate concern or targeted abuse? The GMC offers no definitions, leaving doctors walking an ethical tightrope.

Social media has become a war zone for medics. X is flooded with doctors taking swipes at colleagues, hospital management, and, lately, the GMC itself. The PA debate, in particular, has ignited a firestorm with accusations of misinformation, professional gatekeeping, and outright bullying. The GMC acknowledges the toxic discourse but has done little beyond expressing “disappointment.” Will it act—or is it afraid of the inevitable backlash?

And here’s the biggest question: Should the GMC be policing doctors’ online behaviour? Some argue that professionalism doesn’t switch off after work—if you wouldn’t say it on a ward round, don’t post it. Others insist that regulating doctors’ speech outside of clinical settings is a dangerous overreach.

The GMC is in a precarious position. If it enforces its rules too harshly, it risks accusations of censorship and suppressing free speech. But if it remains passive, it undermines its own authority—because what good are professional guidelines that no one fears breaching? In reality, the GMC’s power is not just limited to the legal, but also reputational. A doctor placed before a tribunal for an offensive tweet doesn’t just face formal punishment; they face trial by public opinion.

But here’s the real question: can a regulatory body truly police discourse in an era where opinions travel faster than a resident doctor running for free food? If anonymous accounts post defamatory content, how does the GMC enforce accountability? And if social media fuels hyperbole and outrage by design through its algorithms, can professionalism even be meaningfully maintained in such a space?

The Vanishing Art of Ward-Based Teaching

The days of frequent ward-based teaching are over. Our consultant colleagues know this. Our resident doctors know this. Even the hospital vending machine, which somehow only takes exact change, seems to know this.

A recent study from the Yorkshire and Humber Foundation school revealed that 56% of newly graduated FY1 doctors had never received instruction on conducting ward rounds, yet 62% found themselves leading these rounds at least twice a week. Our desire for consultant-led teaching on ward rounds is almost laughable at this point.

In an attempt to bridge this educational chasm, we've seen a surge in countless sessions on resilience and leadership. The pendulum has swung so far towards generic training that we're at risk of diluting essential, knowledge-based learning.

MRCP(UK) Exam Chaos: Shattering Trust in Medical Assessments

Will we now forever be looking over our shoulders at past exam results?

This week, doctors who sat the MRCP(UK) Part 1 exam in 2023 found out—18 months later—that due to a data processing issue, 222 candidates who were told they had passed have, in fact, failed. Meanwhile, 61 candidates who were told they had failed have now passed, after likely paying for resits and sacrificing countless hours to study.

When major errors occur in other high-stakes industries—aviation, finance, even politics—heads roll. Ministers resign over data breaches and public sector failings. Why should the RCP be any different?

This is not just an administrative hiccup. Doctors have built their careers on these exams. A single result can dictate whether someone progresses in their training, whether they get their next job, or whether they uproot their life to another country. A delayed correction 18 months later is a breach of trust on an institutional level.

The vague explanation of a "data processing issue" is frankly insulting. What does that actually mean? Was this an algorithmic error? A spreadsheet malfunction? Human incompetence? A system error on this scale raises countless downstream questions. Trust in assessment is paramount, and trust is what the RCP have lost today.

Some have suggested waiving the exam for affected candidates, but this risks undermining the rigorous standards medicine demands. Handing out a pass serves to undermine the credibility of the qualification itself, which acts as a vital competency check. However, financial compensation must be considered—for the unnecessary resit fees, the lost time, and the immense stress caused.

This isn’t just about 222 doctors. The downstream effects impact us all… It’s now about trust in every medical exam. If these results were wrong, how many others might be? Do we now need to always look behind our shoulders at previous exam results?

Here’s to hoping we don’t receive emails asking us to sit our medical school finals again.

“I remember being asked to chase blood cultures that were sent earlier that day as a night FY1 - asked the day FY1 what they wanted me to do to make the bacteria grow faster”

“The patient was under-filled, and the parent team had just given 250ml fluid bolus and then 20mg of furosemide… I guess you can call it ‘balance’?”

“Fibrodysplasia ossificans progressiva (FOP) is a rare musculoskeletal condition where, after birth and progressively through life, muscles and tendons are gradually transformed into bone. For those wondering: Surgical removal of the extra bone growth has been shown to cause the body to "repair" the affected area with additional bone.“

“You know how gently tapping the back of the hand makes the vein all nice and visible? One of the F1s thought that could also be applied to intramuscular injections. On the glute.”

“This is a good thing- you’re an F2, you should be more risk averse than your more experienced supervisor. You are in the right place on the Dunning Kruger curve.”

What’s on your mind? Email us!

Some things to review when you’re off the ward…

Since 2011, England has had the biggest slowdown in life expectancy among the 20 European countries studied (BMJ)

The NHS is in crisis. Just seven months ago, Channel 4 hosted a debate with doctors and patients—but politicians refused to show up.

Calls for doctors caught up in the MRCP exam chaos to receive compensation (Sky News)

Weekly Poll

Last week’s poll:

How do you feel about specialty entrance exams (e.g. MSRA) having a decreased focus on factual knowledge?

…whilst you’re here, can we take a quick history from you?

Something you’d like to know in our next poll? Let us know!

We are rotational, and we know of all the downsides to this. How about another - never worthy of a permanent office desk? While managers settle into ergonomic chairs and nurses often get workstations, resident doctors roam hospital corridors, laptop-less and longing for a quiet space.

And it turns out, that lack of personal space might actually be making us sick. Studies show open-plan office noise increases negative mood by 25% and sweat response by 34%. Workers in open-plan offices also take 62% more sick days than those in individual cubicles.

How much more productive would you be if your attention wasn’t being diverted by a colleague every 5 seconds? How many more discharge letters would you be able to get through in a cubicle-like space?