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Social media use in modern medicine is fraught with ethical dilemmas and risks of unprofessional behavior. This essay surveys the existing literature on the possibilities and pitfalls of social media use by health-care professionals and concludes that non-engagement with social media is not an option. A mindful approach, not vague guidelines or long checklists, will foster a generation of physicians comfortable using online platforms for education and reflection. The use of social media during global health experiences abroad has been largely ignored in the literature and presents special challenges. With a view to starting a reflective dialogue on this subject, this essay identifies some ethically nebulous aspects of global health blogging. The discussion focuses on physician and student blogging, but these principles should apply to other online platforms as well and should prove valuable for health-care professionals who are engaged in developing guidelines, educating medical students and resident physicians, or in sharing their experiences and insights on the internet.