Plagiarism and Academic Integrity: Annals of Internal Medicine Caves

We have a classroom in our home. It’s called the dinner table. This is the locale where over the years, my wife and I have tried to teach 5 kids right from wrong. As we parents ourselves still struggle with these issues, it is clear that integrity remains an indefinite element of life’s curriculum.

There was a time when this table was an actual classroom, when my wife and I home schooled 2 of our youngsters for about 3 years. I could devote an entire blog to this adventure.

Many of our family dinners were seasoned with discussions about integrity. We have discussed and debated the lapse in integrity that has seeped into our educational culture, as well as into society at large. We have reviewed dozens of news accounts detailing ever more resourceful methods of cheating and stealing ideas without attribution. This phenomenon has no boundary and has permeated the medical profession. Euphemisms like ghostwriting cannot camouflage the practice for what it often is – cheating.

Yes, I know that times have changed, and many of yesterday’s values have been retired. But, I don’t regard personal integrity to be an elastic virtue that is subject to modification based on popular culture and demand. Honesty and personal probity are absolute, not relative values that can be shifted or sanded down.

Indeed, it is my view that diluting the definition of integrity has damaged every level of our society. Once this occurs in one sphere, such as education, it is impossible to contain the practice there. It seeps out and spreads. We must forcefully identify it when we see it and strive to reverse its propagation. This endeavor is often a tough slog upstream, but the objective merits the effort. I think that it is a fight than we can win.

The July 20th issue of the Annals of Internal Medicine reported that 5% of applicants to residency programs plagiarized portions of their personal statements. Presumably, all of these individuals will become physicians, and some will become academic researchers. Isn’t personal integrity an absolute requirement for these professions? One could argue that plagiarism should be a disqualifying offense. An editorial on the journal article in the same issue states that:

If the integrity of the personal statement is increasingly polluted by Internet samples of hired consultants, perhaps the personal statement is ill-suited to this era and best left to history. In 1 stroke, this action would solve the problem of plagiarism on personal statements substantially more effectively that a nationwide campaign.

I vigorously reject the editorialists’ view. The proper response to unethical behavior is to denounce it, not to escape from it. If our profession is stained by plagiarists who are cheating on their applications to medical residency programs, we should hold these individuals accountable and strive to raise the ethical bar of all applicants. To ‘reassess’ the need for the personal statement as a response to plagiarism is itself cheating. Every year, high school kids are caught cheating on standardized tests. Is the cure for this to abandon the test or to work harder to teach our kids about raising their IQs, or integrity quotients? Ethical goalposts should be firmly rooted.

In a prior post, I have lambasted the legal profession for dumbing down academic standards in an effort to burnish the credentials of law students.  Our profession should not emulate this approach.

I am dismayed that one of our most prestigious medical journals has gone soft, when a firm hand is required.  I'd like to invite the editors to my dinner table so my kids can teach them right from wrong.