Consider this forum a form of harsh reality training.
Fact is (and I've talked about this before), there is a lot of ego in medicine. I'm no exception to that.
There are a lot of people who are also control freaks. There's a lot of knee-jerk "this person must be stupid because he/she didn't immediately 'get it' when prompted" stuff too. This field, medicine, is pretty tough, and for most residents just starting out, it's a crash course in feeling like a stupid prick most of the time. This crash course is given by nurses, respiratory techs, anesthesia techs, other residents, and attendings on a regular basis.
Why would anyone expect this forum to be any different?
Now, I'm not exactly happy with the situation, in general, that dictates the day-to-day interactions in the hospital. As I've gotten on my soapbox about it before, our internal cross-team bickering and fighting prevents us from forming a solidarity that could protect us from attacks from outside parties who prey on that weakness (trial lawyers, JCAHO, advocacy groups, etc.).
However, fact is, it's a reality. As such, it becomes easy to forget how you do something is as important as what you do. But, people learn that occassionally being intimidating gets results. We have to make critical life and death decisions all the time, and there is often more than one way to get there. Patience goes out the window. When we feel we're right in the face of opposition, we get frustrated. Frustration leads to anger. Anger leads to loose tongues, and saying stuff we normally wouldn't say to people we otherwise like and want to like us. After a while, though, your skin gets so thick that you just learn that the quickest way to make your point and not have to entertain opposing opinion, especially when you've already considered that opposing opinion, is to immediately smash it. Squashing opinion in a heavy-handed manner has its own certain economy to it. Right? Wrong? I don't know. But, medicine is not for the weak.
This is the way it is. Everyone's time is precious. We are continually expected to do more and more with less and less resources. People often don't want to spend the time (or feel the need) to explain themselves when they believe they are right. They see anyone getting in their way to what they know is the truth as an obstructionist, and often nothing more.
And, why should this forum be any different? It is a reflection of how things really work out there. Attempting to censor creates an unnecessary artificiality. It'd be like JCAHO stepping in and not really understanding the day-to-day grind, and still expecting you change. That's the key: not really understanding.
Forums aren't reality. They reflect reality, though. And, it's generally a "safe" place for people to say normally what they wouldn't say. Yes, the whole "alpha male" thing exists here. But, you know what? It exists in the real world too. And, if you recognize who those alpha males are, you have a golden opportunity to learn (without much recourse or personal neck-on-the-line) how to effectively deal with them here.
So, I guess I'd say leave things as they are. There are dominant personalities out there. And, guess what? Many of those dominant personalities are smarter than you. They're not always going to tolerate what they perceive to be stupidity. To that, I'd say the following:
1) Think before you post (you'll be expected to do this on the wards, too).
2) Learn how to "manage" your own language and presentation to minimize harsh reactions (you'll be expected to do this on the wards, too).
3) Recognize the difficult personalities as an opportunity to learn, and you'll have a much smoother time.
4) No one can argue against facts.
5) Anyone can argue against opinion.
6) If you're funny and well-spoken and present a logical argument in going up against the "big dogs", you're going to get noticed.
7) You have a unique opportunity to practice here without any real fear of reprisal. Use that opportunity. Censor the forum and you lose that.
You heavily moderate this forum, and you ruin the chance to get some real-life experience in a relatively safe environment. Don't divulge too much personal information (even in PM's) unless you really trust someone here, and even then be careful. And, you can pretty much speak your mind. This forum is a great outlet full of a ton of useful information. If you censor it, you lose that. And, that would be truly unfortunate.
-copro
