Sheahan: On professionals and professionalism

Malachi Sheahan III

On March 19, 2019, I sat in the audience of the scientific sessions at the Annual Meeting of the Society for Clinical Vascular Surgery (SCVS). I was there with two of my trainees who were eagerly waiting to present their research. As we watched the abstract presentation, “Prevalence of unprofessional social media content among young vascular surgeons,” I thought “Ah ha! A teachable moment.” This proved to be prophetic, although I was the one about to be schooled.

After the session, I begrudgingly acknowledged the excellent job my trainees had done with their presentations (tough love is the only love to us Irish Catholics). Then I casually mentioned the “interesting” abstract on social media. Be careful, I warned, what you do online reflects not only on you, but also the program. I was allowed about 90 seconds of satisfaction for delivering this sage advice before my residents confronted me with an Instagram post of my wife (a vascular surgeon) pretending to drink out of a bottle of champagne during Mardi Gras, just two weeks earlier. Further digging easily uncovered other potentially unprofessional behavior such as bathing attire, cocktail parties, and my own unfortunate (although not very provocative) Halloween costumes. If Sun Tzu were alive today, he would be forced to add a new chapter to “The Art of War”: “Never stage a battle over the internet with millennials.”

Confronted with my hypocrisy, I reviewed my thought process. It would never occur to me that my wife’s postings were unprofessional, so why the need to judge the trainees so harshly? We can easily rationalize these impulses. In our minds they are young and vulnerable. But what we’re really saying is these silly kids just don’t understand. Through our best intentions we are infantilizing our trainees, all of whom are adults by any other measure.

There are also much larger issues at play than the maturity of our trainees. Modern society has a troubling history of using the term “professional” to marginalize women, minorities, and the LGBTQ community. A Black woman with natural hair, two men holding hands, a Muslim woman wearing a hijab, how many times have these actions or appearances been labeled unprofessional?

“Provocative” is another dangerous term and one that is almost always directed at women. What does it mean when a woman dresses or poses provocatively? Literally, it means they are invoking a strong reaction, with the implication it is deliberate. The further insinuation is that the bearers of this strong response, usually men, are powerless and therefore blameless in their actions.

Professionalism and what constitutes appropriate social media conduct require serious conversation

Categorizing movements and ideas as “political” is another weapon commonly employed to suppress women and minorities. Labeling today’s advocates of same sex marriage as “unprofessional” is the same tactic used against past proponents of women’s suffrage and the civil rights movement. Even during this global pandemic, common sense precautions are often labeled political, usually to discredit experts.

As scientists, we must protect our role as educators and shine the light of evidence and truth into these conversations which have been co-opted from us. Rather than classify this behavior as unprofessional, we should view activism for science and human rights as our obligation. Indeed, the ACGME Core Competency of Professionalism calls for residents to exhibit an attitude of altruism and advocacy and to understand that they are accountable to not only the patient, but also to society as a whole.

A conversation on what constitutes appropriate professional conduct on social media is worth having. First, however, we must ensure that any guidelines could not be applied disproportionally to anyone based on their gender, sexual orientation, or ethnicity. Let’s make the most of this teachable moment.

Malachi Sheahan III, MD, is the Claude C. Craighead Jr. professor and chair in the division of vascular and endovascular surgery at Louisiana State University Health Sciences Center in New Orleans. He is the medical editor of Vascular Specialist.


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