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Twitter has been widely used to create a professional learning platform where participants engage in social interaction and negotiation of meaning. This study will focus on examining the use of #MedEdChat for topic-centered synchronous online discussions. Using survey analysis, this study found that most participants are lurkers who read others’ tweets, followed by other activities including liking, retweeting, responding and posting original tweets. Participants were overall satisfied with their experience on #MedEdChat. Among the three key elements of online community, participants’ cognitive presence significantly predicted their satisfaction, which suggested that the topics should be carefully selected to generate curiosity and interest, and allow participants to share different perspectives, construct explanations, and apply the knowledge into their own work.