Secrets and lies

Medical students often share particular characteristics, such as perfectionism, determination, and conscientiousness. Such qualities are useful for those undergoing a demanding training, but they can also become problematic. Perfectionism may lead to “imposter syndrome,”1 in which you constantly feel inferior and anticipate being “found out,” or even cheating. Determination may elide into competitiveness and conscientiousness tip over into obsession. There is great pressure on medical students to achieve, and there are moral implications that may come out of stress provoking behaviour. Consider the experience of Mark and Sheetal.

Mark and Sheetal have been working as a pair on a clinical attachment. Both students were asked by the consultant to take a history and to conduct a full examination of Mr Holmes, a patient in the ward. Sheetal took a history and undertook an examination. However, Mark, who was busy doing last minute revision for an impending exam, took only a cursory history and did not examine Mr Holmes. When asked for the results of the examination by the consultant, Mark makes up incorrect but realistic sounding results, which the consultant records in the patient notes. What should Sheetal say or do?