You are an FY2 in a medical ward

Personal Details:

Name: Dr Evans (your colleague)

Medical Record:

Notes:

You have received a phone call from a fellow FY2 doctor, Dr Evans. She is very concerned about another colleague, Dr Smith. She reports that Dr Smith has posted a selfie with a patient on his public social media profile, revealing the patient’s face. The caption reads, “Boring morning session.” Dr Evans is worried but does not want to confront Dr Smith herself and has asked you for advice.

Task:

Talk to your concerned colleague and formulate a safe and appropriate plan of action.

Opening Sentence: “Hi, it’s Sarah Evans. Have you got a minute? I need to talk to you about something I’ve seen, and I’m really worried.”

Open History (to give freely): “It’s about Tom Smith. I was just scrolling through Instagram, and he’s posted a picture of himself with one of the elderly patients from the ward. You can see her face clearly. The caption says, ‘Boring morning session’. I can’t believe he’s done it. It’s completely unprofessional.”

Cues to give: “I don’t want to get involved directly. Tom can be a bit defensive, and I don’t want to cause trouble. Can you talk to him?”

ICE (Ideas, Concerns, Expectations):

Ideas: “I think he needs to be told to take it down immediately.”

Concerns: “Can he get into serious trouble for this? Can the hospital get into trouble? It’s a massive breach of confidentiality.”

Expectation: “I want you to tell me what we should do. I feel like we can’t just ignore it.”

How to Act: You are a responsible, worried, and slightly panicked junior doctor. You know this is wrong, but you are scared of getting involved in a confrontation.

More History (only if asked): You have a screenshot of the post. It’s on his public Instagram profile. You know the patient in the photo; she is an elderly lady who can get confused.

Social History: N/A

Questions to ask:

“Should we just tell his educational supervisor?”

“What if he just deletes it? Is that enough?”

Opening & Creating a Safe Space:

Of course, you can talk to me. You look worried. What’s on your mind? Thank you for trusting me with this. It takes courage to raise a concern about a colleague.

Gathering the Facts: Tell me exactly what you saw on his social media profile. What was in the post about the patient? Did it contain any information that could identify them? Is his profile public or private?

Exploring Your Colleague’s Concerns: How did it make you feel when you saw those posts? “You said you don’t want to get him into trouble. What’s your relationship like with him?

ICE (Ideas, Concerns, Expectations): What are your thoughts on how serious this is? What were you hoping I could advise you to do?

Sarah, thank you for telling me about this. You have absolutely done the right thing by raising this concern. This is a very serious issue, and we do need to act on it.

Addressing and answering the patient’s ICE:

You are right to be concerned. This is a major breach of patient confidentiality and is completely unprofessional. Posting a recognisable image of a patient on social media without their explicit consent is a serious ethical violation. The derogatory comment about the session makes it even worse. Yes, he could get into very serious trouble for this.

Next Steps:

You’ve asked me to speak to him, which I am happy to do, and we can do it together if you want.

You mentioned he could be defensive, but I think it is our duty to explain to him that this is not appropriate and breaches the patient's right and can put him in serious trouble.

I think he needs to understand that if he is not aware, he will need to delete this post as soon as possible. We will encourage him to discuss that with his trainer and supervisor to learn from it.

Possible consequences

I don’t have the expertise to expect what could happen, but something like this may be escalated by the supervisor, and it might end up needing further investigation under the GMC.

Reassure and support your colleague

You’re worried about getting into trouble or being seen as a troublemaker. You will not get into trouble. The GMC guidance on ‘Raising and Acting on Concerns’ is very clear. We have a duty to act when we see unprofessional behaviour that puts patients' or the public's trust in the profession at risk. By coming to me, and by us going to speak to him and then involving a supervisor, you are fulfilling your professional duty. It’s the right and brave thing to do.

Addressing ideas, concerns, and expectations: Agree that the behaviour is unacceptable and a serious breach of professionalism. Reassure your colleague that she has done the right thing and will be supported.

Formulate a safe plan by speaking to your colleague and then involving a senior (the educational supervisor). Suggest doing it together to support your colleague. Frame the action in the context of professional duty (GMC guidance).

What is scenario testing? This is a professionalism and ethics station. It tests the candidate’s understanding of GMC guidelines on social media use, patient confidentiality, and raising concerns. The key is to demonstrate a safe and appropriate escalation pathway. It also tests the ability to support a worried colleague.