Cheating at medical school

British Medical Journal, Feb 3, 2001

Anonymous letter should have been consigned to the bin

EDITOR--I was disappointed to read Smith's editorial on cheating at medical school.[1] Trial by media has become a sign of the times, but I had hoped that the professional journal of the medical profession would rise above such sensationalism. It is easy for us all to be filled with righteous indignation about the cheating of a student, but we do not know all the circumstances, and I hope that adherence to confidentiality means that we never will.

The appropriate authority dealt with the issue, and I believe that it is nobody else's business. What right has the media to question a judgment based on facts when they do not have all the facts at their disposal? In any event, I wonder about the motives of the student who exposed this lapse by one of his or her colleagues anonymously.

Of course doctors must have integrity, but it is wrong to assume that a person lacks integrity on the basis of one incident. After all, who can affirm that they have never once been dishonest in their entire career? Hopefully, we learn from our mistakes and aim to do better in the future.

Smith says that justice is not a private matter and calls for exposure. I think that exposure has little to do with justice and much more to do with selling newspapers. Public opinion is more influenced by the media slant or spin than the facts of the case. How olden do tabloid newspapers treat us to full exposure of the life of person who has been accused of a crime well before any trial has taken place? Where is the justice in that? We are in serious danger of engendering a situation in which the fear of publicity is such that decisions made by responsible people will be expedient rather than just.

I think that the BMJ should have consigned this anonymous letter to the waste paper basket and not taken the opportunity to call into question the integrity of a future member of the medical profession. This editorial does little to support a beleaguered profession and could cause much more serious damage.

S A Spencer senior lecturer in paediatrics, Keele University North Staffordshire Hospital, Stoke on Trent ST4 6QG andy_spencer@hotmail.com

[1] Smith R. Cheating at medical school. BMJ 2000;321:398. (12 August.)

Incident was dealt with appropriately

EDITOR--I was disturbed by Smith's editorial on cheating at medical school.[1] In the current climate of doctor bashing by the media and the recent vigilante attacks on supposed paedophiles and mob violence in the name of justice, I was disappointed that Smith thought that doctors should respond to this student's cheating in a way that would show other students and the public that justice had been done. Rather than undermine faith in our system of justice I think that we should be highlighting that this matter was dealt with appropriately.

Smith's editorial was based on information in an anonymous letter, whose writer must have led a protected life if this is the most ugly scene that he or she had witnessed. If this was such a significant event surely he or she could have signed the letter? I note that Smith confirmed the facts with the medical school concerned, but owing to confidentiality I am sure that he was not given all the details.

We all know how stressful medical final examinations can be, the culmination of five or six years of striving to be a doctor. Depression, anxiety, and stress often unhinge previously stable minds. The student in this case had been exemplary before this event. I agree that cheating destroys trust and the incident must be dealt with professionally and fairly, but must we respond to a lynch mob mentality in order that justice is seen to be done? I think that the medical school probably responded in a measured way. Rather than lose a valuably trained doctor we have gained a professional who has learnt a painful lesson.

Belinda Brewer general practitioner registrar Wittering's Health Centre, East Wittering, West Sussex PO20 8BH binksbrewer@hotmail.com

[1] Smith R. Cheating at medical school. BMJ 2000;321:398. (12 August.)

Public horsewhipping is not the answer

EDITOR--I read with dismay the aspersions cast at one of my colleagues and my medical school by Smith in his editorial on cheating.[1]

This matter was indeed public knowledge within a very short time. The fact that it was not deliberately publicised does not, I believe, signify an intention to cover it up. Such disciplinary matters must be commonplace in any school and are dealt with in private with all the facts present--as they should be. Who ever heard of a disciplinary board that worked like "America's Funniest Home Videos," inviting the public to "press a button now" to decide the outcome? Which medical school can say that it has never had to deal with cheating before?

University College London Medical School has an excellent reputation in the United Kingdom and abroad, and its exams are rigorous. Such a matter should not call into question the validity of its degrees or the integrity of its tutors. Surely name calling is not necessary? As to the call for debate? By all means, but please keep everything in perspective.