Student doctors admit to forging medical records

More than one-third of senior medical students at Dundee have admitted they would falsify patient information and forge other doctor's signatures on documents.

The students made their confessions anonymously in a major study into growing research misconduct in vital medical trials, a conference called to confront the problem was told.

Britain's top doctors and medical research directors were told that many future doctors now appeared willing to invent information or documents concerning their patients in trials that test the effectiveness of drugs and other health procedures.

Dr Sarah Rennie of Dundee medical school and medical lecturer Joy Crosby asked medical students to reveal if they would cheat in exams, falsify patient information, plagiarise other people's work or forge signatures.

More than 36% of students in fourth and fifth year said they would commit or had committed such a forgery. Only four out of 10 students said they ought to report misbehaviour or fraud to the authorities if they saw it happen.

Worse, three-quarters of the students who thought that they should report misconduct would not in practice be willing to take the risk of "whistleblowing" on colleagues.

Dr Richard Horton, editor of the medical journal Lancet, has offered to publish Dr Rennie's work. He told the conference that his wife, a junior doctor, had been asked by her colleagues at an English hospital to join them in a plan to invent medical audit data about their patients. The reason for proposing the fraud was that, as hard- pressed junior doctors, they feared that they didn't have the time to do genuine work.

"This is high quality research," Dundee University Professor of Medicine Charles Forbes told the Sunday Herald. "It's the first time that such a large number of students have been directly polled on these issues. But I don't think anyone could be happy about the results."

Professor Forbes said the problem wasn't restricted to Dundee. "All the universities are looking at the same kind of problems. Dundee is just the first to try and quantify what they are."

Part of the problem is that new assessment methods being used in universities may be making cheating easier and safer. Students now use computers to write reports for assessment all through their courses, instead of sitting a single, final examination.

The conference called on the General Medical Council and other bodies to set up a national panel to set new standards and offer help to investigate complaints. It also called for appropriate support for whistleblowers, as well as for researchers who might be falsely accused.

Under procedures proposed by the Edinburgh conference, universities, industry, medical charities and NHS trusts will have to prove they have anti-fraud measures in place and an effective system for managing allegations of research misconduct. If not, funds for new research will be refused, and given instead to other organisations.

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