Fraud and Deceit in Research: a Junior Doctor's Perspective
Sir,
I write in response to the above article and the many letters written
following its publication. As an MSc student in an established research
institution, we are encouraged to undertake research and review journal
articles. Recently as part of the coursework, I wrote an essay on the
issue of fraud and misconduct in medical research and came across this
paper as well as Smith's(1) within the same edition.
It is distressing to discover how common fraud occurs and how
difficult it is to uncover it. From the articles that continue to be
published on this subject as well as the recent case of Hwang Woo-suk, it
is evident that it is an international problem that will not disappear.
Why is it committed? This question has been addressed by many but a
thorough understanding of the motivations behind it is still lacking.
As a junior doctor at the bottom rung of the career ladder, I can
understand the impetus for such misbehaviour. It certainly is not easy to
get a paper accepted for publication whether it be a case report or an
original research. In addition, the commitments of a full-time job can
put many junior doctors under even greater pressure if their worth is
heavily assessed by the number of publications they possess. The recent
change in specialist training can also compound matters for those who are
caught in a training limbo. The guidelines for Specialist Registrar
National Training Number short-listing issued by The London Deanery awards
accumulative points to research, publications and presentations(2). For a
junior trainee, this means non-willingly entering a race to collect as
many points as possible in order to “progress” within their career. The
means by which this end is achieved is left to each individual, often
without much guidance.
This “Publish-or-Perish” syndrome is well-recognised and will
continue to exist. I am hopeful that current foundation trainees will be
relatively spared from falling victim to this expectation with a true
change of attitude whereby individuals will be given heavier merit on
their clinical and interpersonal skills as well as other achievements that
make them all-rounded individuals(3).
Hanson suggested that the approach to dealing with research fraud
should begin with reinforcing internal structures namely education,
training in research ethics and practice, good documentation procedures
and “the implementation of a procedure for investigation of suspicions of
fraud….. characterised by efficiency, impartiality and competence”(4).
This is easier said than done. Sometimes these “internal structures” fail. In addition, once you are in the
challenging world of "work”, you do not receive specific training in these
matters. The subject of research and publication ethics is not formally
taught in most medical schools in the UK and definitely not once you have
graduated unless you actively seek such education.
Furthermore, what is the true definition of fraud? Would salami-
publishing count as an example or is it restricted only to the
manipulation of data? What about those who fake qualifications? And what
about gift authorship?
In summary, although the problem of fraud or misconduct is well-
recognised and has spanned across four decades of debate, there is still
no real solution to this problem or its prevention. I shall watch with
interest the outcome of the introduction of the Modernising Medical
Careers (MMC) scheme on the number of cases of fraud that will occur in
the future.
References
1.Smith R: Investigating the previous studies of a fraudulent author.
BMJ 2005; 331: 288-91
Rapid Response:
Fraud and Deceit in Research: a Junior Doctor's Perspective
Sir,
I write in response to the above article and the many letters written
following its publication. As an MSc student in an established research
institution, we are encouraged to undertake research and review journal
articles. Recently as part of the coursework, I wrote an essay on the
issue of fraud and misconduct in medical research and came across this
paper as well as Smith's(1) within the same edition.
It is distressing to discover how common fraud occurs and how
difficult it is to uncover it. From the articles that continue to be
published on this subject as well as the recent case of Hwang Woo-suk, it
is evident that it is an international problem that will not disappear.
Why is it committed? This question has been addressed by many but a
thorough understanding of the motivations behind it is still lacking.
As a junior doctor at the bottom rung of the career ladder, I can
understand the impetus for such misbehaviour. It certainly is not easy to
get a paper accepted for publication whether it be a case report or an
original research. In addition, the commitments of a full-time job can
put many junior doctors under even greater pressure if their worth is
heavily assessed by the number of publications they possess. The recent
change in specialist training can also compound matters for those who are
caught in a training limbo. The guidelines for Specialist Registrar
National Training Number short-listing issued by The London Deanery awards
accumulative points to research, publications and presentations(2). For a
junior trainee, this means non-willingly entering a race to collect as
many points as possible in order to “progress” within their career. The
means by which this end is achieved is left to each individual, often
without much guidance.
This “Publish-or-Perish” syndrome is well-recognised and will
continue to exist. I am hopeful that current foundation trainees will be
relatively spared from falling victim to this expectation with a true
change of attitude whereby individuals will be given heavier merit on
their clinical and interpersonal skills as well as other achievements that
make them all-rounded individuals(3).
Hanson suggested that the approach to dealing with research fraud
should begin with reinforcing internal structures namely education,
training in research ethics and practice, good documentation procedures
and “the implementation of a procedure for investigation of suspicions of
fraud….. characterised by efficiency, impartiality and competence”(4).
This is easier said than done. Sometimes these “internal structures” fail. In addition, once you are in the
challenging world of "work”, you do not receive specific training in these
matters. The subject of research and publication ethics is not formally
taught in most medical schools in the UK and definitely not once you have
graduated unless you actively seek such education.
Furthermore, what is the true definition of fraud? Would salami-
publishing count as an example or is it restricted only to the
manipulation of data? What about those who fake qualifications? And what
about gift authorship?
In summary, although the problem of fraud or misconduct is well-
recognised and has spanned across four decades of debate, there is still
no real solution to this problem or its prevention. I shall watch with
interest the outcome of the introduction of the Modernising Medical
Careers (MMC) scheme on the number of cases of fraud that will occur in
the future.
References
1.Smith R: Investigating the previous studies of a fraudulent author.
BMJ 2005; 331: 288-91
2.www.londondeanery.ac.uk
3.www.mmc.nhs.uk
4.Hansson MG: Protecting research integrity; Sci Eng Ethics. 2000;
6(1):79-90
Competing interests:
None declared
Competing interests: No competing interests