Cheating at medical school

British Medical Journal, Feb 3, 2001

EDITOR--Smith in his editorial asks whether the BMJ was right to publicise the episode of cheating during a final examination at the Royal Free and University College London Medical School.[1] I am surprised that he felt the need to ask--of course it was right.

The editorial raises two issues. The first is whether the student had attained the required standard without resorting to cheating. The examining committee obviously considered that she had but without proof (how often had she cheated in the past?). Surely the public needs to have confidence that all doctors have shown beyond doubt that they have the knowledge and ability to practise safe medicine? This has not happened in this case. I wonder what would have happened had this been an A level examination.

The second issue is the naivety of the committee in thinking that the medical profession wishes to adhere to old fashioned paternalism and allow a student to pass because she is known to be a good student. It is for just this reason that the General Medical Council has lost the confidence of the public. What happens now that the standards of academic achievement of the entire medical profession are to be questioned?

Smith is correct in saying that justice not only has to be done but also must be seen to be done. I am deeply upset that the student was not asked to resit the entire examination at the next sitting. I am grateful that some members of the profession are prepared to state publicly that the judgments made in this case are simply not good enough for a modern profession.

Neil Fergusson consultant anaesthetist Countess of Chester Hospital, Chester CH2 1BL Neil.Fergusson@btinternet.com

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

Keeping quiet about cheating will not increase public confidence

EDITOR--Smith's editorial on cheating makes me more positive about the medical profession's future.[1] We as doctors are not practising a secret craft any longer, and more openness and public discussion, although causing its own problems, is far to be preferred to mutterings about the secrets of our craft. Alter the Bristol affair, the Shipman case, and many others--particularly after evidence that responsible bodies ignored warnings and advice--keeping too quiet will not increase public confidence. The public will begin to ask what other skeletons are hidden in our cupboard.

Rod MacQueen staff specialist Liverpool Hospital, Liverpool, New South Wales 2170, Australia randjmac@ix.net.au

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

Public declaration of an appropriate punishment is important

EDITOR--I support the BMJ's publication of the details of a student's cheating in her final examinations.[1]

Although professional knowledge and skills, which can be tested, are an important component of a doctor's work, I believe that the most important qualities in a doctor are honesty and integrity. Patients must be able to trust their doctors. In my experience, most patients will accept and understand when mistakes are honestly and openly explained.