IMHO what's interesting is that the platforms benefit from it because their metric is engagement.

Consequently this scammer, med student or not, is generating traffic and transactions through the platforms he used. Those platforms grow and keep their user base, can sell more ads, etc. Some platforms might ban this kind of practice but barely enforce their own rules, others might precisely exist because they don't have such rules.

So what's fundamental here is the dynamic, how engaging content, fake or not, controversial or not, dangerous or not, does keep on being promoted to more people because it does make sense for the platforms.