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On 5/22/2020 at 8:31 PM, AdamMD said:

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None of us are the kids that we used to be.  I think the first question would be how likely is it that these messages surface again?  Is there any chance that you're being a bit overly paranoid about them? Even if they do surface, an honest and sincere explanation that you used to share beliefs about this that you no longer do; or that you said things to be part of the crowd and now regret it can go a long way.  Next, keep in mind that actions speak louder than either words or old facebook messages.  How can you advocate for equity and equality among diverse populations now? Putting effort into this will not only provide some protection from the past, but also make you a better physician and a better person.

 

Your professional responsibility largely starts when you become a medical student, and it definitely firms up when you become a resident and are now under the authority of the college.  You don't need to be an angle before medical school as long as your behaviours were within reason (criminal records are hard to talk you way out of).

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I would suggest you download and use the Chrome extension "Social Book Post Manager". It's a program you can run in the background which will systematically go through your facebook history and unlike any posts you've liked, and delete any comments or posts (this is customizable). It can't do anything for messages unfortunately since the data is saved on the side of the recipient as well. The only way around that is to permanently delete your facebook account.

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21 minutes ago, zxcccxz said:

I would suggest you download and use the Chrome extension "Social Book Post Manager". It's a program you can run in the background which will systematically go through your facebook history and unlike any posts you've liked, and delete any comments or posts (this is customizable). It can't do anything for messages unfortunately since the data is saved on the side of the recipient as well. The only way around that is to permanently delete your facebook account.

and it may seem harsh but honest if that actually destroyed things I would go that route. I not sure it does actually but worth exploring. 

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6 minutes ago, rmorelan said:

and it may seem harsh but honest if that actually destroyed things I would go that route. I not sure it does actually but worth exploring. 

So on facebook there's the activity log in your setting which is basically just a chronological list of all of your activity, mostly just everything you've liked, commented, or posted. The program goes into there and then manually unlikes posts (you can set it to, for example "unlike all comments from May 2020, and delete all posts from the year 2018, but don't touch anything else"). It takes a while especially if you're clearing out years worth of activity (can take a day or longer). 

I suppose in a sense, data on the internet (especially on a website like facebook that sells your data to third-party marketing firms) may never truly be deleted. However, unless you're running for president, no one will bother parsing petabytes of archived data in massive data banks to look for dirt on you. IMO in the context of medicine, deleting all overtly available activity like that on Social media (whether public or private), should be sufficient.

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1 minute ago, zxcccxz said:

So on facebook there's the activity log in your setting which is basically just a chronological list of all of your activity, mostly just everything you've liked, commented, or posted. The program goes into there and then manually unlikes posts (you can set it to, for example "unlike all comments from May 2020, and delete all posts from the year 2018, but don't touch anything else"). It takes a while especially if you're clearing out years worth of activity (can take a day or longer). 

I suppose in a sense, data on the internet (especially on a website like facebook that sells your data to third-party marketing firms) may never truly be deleted. However, unless you're running for president, no one will bother parsing petabytes of archived data in massive data banks to look for dirt on you. IMO in the context of medicine, deleting all overtly available activity like that on Social media (whether public or private), should be sufficient.

sure that is a comfort level thing - I am on the paranoid side :) side effect of being a computer programmer involved in security consulting probably. 

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22 minutes ago, supadupafly said:

Whereas if you've already entered and haven't really misbehaved since, it doesn't seem to make much sense to me to take disciplinary action

I do agree that the context, age, and what exactly you said does matter, however I think this last bit is a slippery slope. If you only stop using racial and homophobic slurs when you get into medicine/professional school bc it can now backfire on you, and not because you see and really understand why what you said was wrong, then you lack a lot of emotional maturity/understanding about why this language is harmful. (I'm not saying you don't have it supadupafly, just people in this situation.) 

And I really disagree with the direction this conversation kinda went with trying to delete the evidence here. The point should be about what this would look like to a dean of medicine, and what this says about you as a future physician. Do you truly understand the impact of using those words? Do you still reach for them when you're mad or upset or drunk? Have you truly done the reflection needed to realize why you said them, and the impact ingrained or subconscious racism and homophobia can have on your future patients? We all mature and we're not the people we were in high school, and if these are public posts you should delete them so they can't cause further harm, but there's more to this conversation than burning the evidence and moving on.

To go back to Adam's question, it will obviously be on a case by case basis on what could hypothetically get leaked to a dean of medicine. If you have conversation after conversation from 2 years ago where you're throwing around slurs like it's no tomorrow, it wouldn't be surprising if they did use it as a reflection on your character. Then it would be on you to show how that isn't you anymore and the actions you've taken since then to demonstrate that you understand why what you said was wrong.

 

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very true, and I agree. I think the primary need for addressing these issues is the potential loss of trust of patients based on the person's words. in this case, it's all about demonstrating that this instance doesn't reflect who you truly are, currently. and that would vary on a case-by-case basis like you said. 

part of me just thinks that maybe addressing this shouldn't be the school's responsibility, since the conduct occurred before their enrollment. things like suspension, etc might be unjust if the student hadn't displayed this conduct while being a student of the school. perhaps encouraging the student to reflect and grow, and them having to explain their actions at further stages of their career (matching, etc...) would be the better path.

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Thanks for the responses. They were really idiotic times in my life. Times when I used slurs without thinking of what they meant, rather just because they helped me sound cool. It's definitely something that I've been contemplating, especially with the tragic thing that happened to George Floyd. I've worked extensively with minorities and individuals that would be offended by the slurs I used, and I think I matured through the process and learned the weight these words carry. 

I am just a little bit ashamed and paranoid. If one of my friends that I used to joke about this decides to try screwing me over and sending these messages to my dean (VERY VERY neurotic thinking) I don't want to be forced into giving up medicine and being kicked out. 

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2 minutes ago, AdamMD said:

Thanks for the responses. They were really idiotic times in my life. Times when I used slurs without thinking of what they meant, rather just because they helped me sound cool. It's definitely something that I've been contemplating, especially with the tragic thing that happened to George Floyd. I've worked extensively with minorities and individuals that would be offended by the slurs I used, and I think I matured through the process and learned the weight these words carry. 

I am just a little bit ashamed and paranoid. If one of my friends that I used to joke about this decides to try screwing me over and sending these messages to my dean (VERY VERY neurotic thinking) I don't want to be forced into giving up medicine and being kicked out. 

This was nice to read, I think you've learned from your mistakes. I don't speak for all minorities except myself but I can say I personally would accept this as an apology, and I am pretty sure others would too. 

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In situations like these, it's often hard to tell whether someone is truly apologetic because they've changed, or whether they're apologetic mainly because they suddenly realize the grave consequences it could have on their career. I'm also not certain what "years back" in this context means, because if you're a student who's in their mid-20s, then you're likely referring to things which happened within the last 7 years, which isn't exactly a remote history of ill-conceived actions.

If you were not in medical school, would you still feel as compelled to address this? Clearly this is all hypothetical, and your motivations will have to be taken at face value, but good on you for at least trying to remedy it.

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This is true, but I would argue that the value of “a few years” is less clear when someone is developing mentally (ie your teenage years). It may only be 8 years, but most people I know are radically different leaving undergrad than they were in freshman year of high school. I wouldn’t judge them for something they did or said that far back, because of the major events that often happen in people's lives during those few years

 

but you’re right that it’s important to assess if you’re genuinely saddened by your own actions or just regretful that you weren’t as discreet

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I actually a couple years ago found the published manuscript for a qualitative research study I participated in when I was early in medical school (like MS1), which included some quotes that made me feel very bad about myself and some of the viewpoints I had at that time.  I didn't quite grasp the idea of privilege and systemic injustice, and I saw discrimination and bias as something that happened on an individual level, rather than a broader societal system that needs to be dismantled on a systemic level.  My understanding of these things now (while not complete by any means) is greatly informed by a lot of reading, learning, lived experience, and working with a really diverse population including people I would never have met if not in medicine.

I think our society is such that most of us at some point have benefited from or in/advertently engaged in behaviours or words that were racist, sexist, homophobic, transphobic, or any number of other things.  Even those of us who are marginalized in some ways/based on some identities likely benefit from privilege in other aspects of our lives.  I wish that I had had more education about these topics growing up, not just about overt behaviours but also about stigma, implicit biases, and other ways that most of us participate in systems of oppression on a regular basis, but I didn't.

I think this is work that all of us have to do in one way or another, no matter what we have or haven't written online.  There are very few people who can't learn more/do more in these areas.  I have tried to focus on reading about different people's experiences in their own words, and trying to educate myself as best as I can.  I'm trying to do the uncomfortable work of noticing the ways in which I benefit from some of these systems of oppression, and I am trying to think of ways that I can help to dismantle them.  I think I have a lot more work to do there.

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8 hours ago, Intrepid86 said:

In situations like these, it's often hard to tell whether someone is truly apologetic because they've changed, or whether they're apologetic mainly because they suddenly realize the grave consequences it could have on their career. I'm also not certain what "years back" in this context means, because if you're a student who's in their mid-20s, then you're likely referring to things which happened within the last 7 years, which isn't exactly a remote history of ill-conceived actions.

If you were not in medical school, would you still feel as compelled to address this? Clearly this is all hypothetical, and your motivations will have to be taken at face value, but good on you for at least trying to remedy it.

I agree that one should be regretful because they realize those comments are wrong and not because those comments can have consequences. However, I don't agree with calling it "ill-conceived actions." Respect for other cultures and people is learned over time, through exposure to different kinds of people, by reading articles and books, etc. No one is born with a perfect set of ethics. Also, a person's environment has a huge impact on their attitudes and behaviour, especially when they are in high school or university. If someone says something racist because all their friends (and even their parents) have that attitude, then is it really that person's fault? As an analogy, if a kid who grows up in a low-SES neighbourhood steals during high school because they see their friends and parents doing it, is that an "ill-conceived action" or is that just the consequence of having a bad environment?
I think making mistakes, reflecting on them, feeling regretful about them, and changing your attitudes and behaviours is the most important thing. Obviously, the best case is if you can be surrounded by highly ethical people your whole life (parents and friends), but not everyone has that privilege.

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On 5/30/2020 at 8:37 PM, 58753 said:

I agree that one should be regretful because they realize those comments are wrong and not because those comments can have consequences. However, I don't agree with calling it "ill-conceived actions." Respect for other cultures and people is learned over time, through exposure to different kinds of people, by reading articles and books, etc. No one is born with a perfect set of ethics. Also, a person's environment has a huge impact on their attitudes and behaviour, especially when they are in high school or university. If someone says something racist because all their friends (and even their parents) have that attitude, then is it really that person's fault? As an analogy, if a kid who grows up in a low-SES neighbourhood steals during high school because they see their friends and parents doing it, is that an "ill-conceived action" or is that just the consequence of having a bad environment?
I think making mistakes, reflecting on them, feeling regretful about them, and changing your attitudes and behaviours is the most important thing. Obviously, the best case is if you can be surrounded by highly ethical people your whole life (parents and friends), but not everyone has that privilege.

 

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