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Twitter is increasingly used by educators to establish professional learning communities. This study investigates social interactions and knowledge construction in synchronous online discussions using the Twitter hashtag #MedEdChat. Three synchronous Twitter discussions on #MedEdChat during the early part of the COVID-19 pandemic were analyzed using social network analysis and content analysis. The results showed that a small number of individuals dominated the discussion, while also serving as hubs for connections with others in more peripheral positions. Our content analysis suggested that social-related (e.g., responding to others’ messages, continuing threads, expressing emotions) and cognitive-related posts (e.g., information exchange, sharing, asking questions) could promote social interaction and knowledge construction.