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"Now they're waking up to the reality of older people and people with authority over them, like deans, seeing their Facebook pages," Goodstein said.
And many young adults don't appreciate that an Internet prank can bounce back years later, said Susan Barnes of the Lab for Social Computing at the Rochester Institute of Technology in Rochester, N.Y.
"Are they going to be able to live it down when they're 50 and a well-known surgeon? Or is it going to come back to haunt them?" Barnes said.
Medical schools should address professionalism online in classes and develop policies for the digital age, Chretien said.
Bawdiness among medical students far precedes the Internet, Chretien acknowledged. The now-defunct Pithotomy Club of Johns Hopkins Medical School, for example, made a tradition of racy skits and songs skewering professors for nearly 100 years.
"In the past, these weren't broadcast on the Internet. Now it's up for public consumption," Chretien said.
The Association of American Medical Colleges helped distribute the survey in the spring. The researchers invited deans of 130 schools to take it, and 78 responded.
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