How To Avoid Allegations Of Plagiarism In Medical Coursework And Exams

Author: Dr Ellie Mein, medico-legal adviser, Medical Defence Union (MDU)

 

Plagiarism – presenting someone else's work or ideas as your own without crediting the source, or reusing your own work without acknowledging previous publication or submission for another piece of academic work – is not a new concern in medicine. 

Honesty and integrity are long-established qualities for a medical career, and medical defence organisations are often contacted by doctors and medical students for support because they’ve been accused of plagiarism by their royal medical college or university.

Now, with easy access to increasingly sophisticated artificial intelligence (AI) technology, such as ChatGPT, it has become more important than ever to be able to demonstrate that the work submitted as coursework and for exams is above suspicion.

In the US, ChatGPT has been reported to have generated answers capable of passing the United States Medical Licensing Exam and the Stanford Medical School final exam in clinical reasoning. The technology has also been used to create academic papers, including one discussing this very issue – Chatting and cheating: Ensuring academic integrity in the age of ChatGPT – and how higher education establishments should respond to prevent and detect academic dishonesty using such chatbot tools. 

 

Here we examine some of the common reasons allegations of plagiarism arise and advise on how to avoid the common pitfalls that doctors and medical students can encounter.

 

How widespread is plagiarism?

Over the last five years, the Medical Defence Union (MDU) has provided medicolegal support in around 40 cases where there were allegations of plagiarism. The cases were evenly split between qualified doctors and medical students.

Many cases arose out of inadvertent mistakes, rather than a deliberate attempt to copy, and were successfully defended by the MDU. But, nevertheless, the concerns raised often triggered a fitness-to-practise investigation, which was not only very stressful for those accused but affected their future careers. 

Doctors from a wide range of specialities completing postgraduate qualifications, such as the child health diploma or masters in medical education, faced plagiarism allegations. Other cases involved doctors writing up research for publications and carrying out clinical audits.

Allegations of plagiarism and collusion in cases involving medical students were mostly detected in their work by medical schools via the use of text-matching software such as SafeAssign and TurnItIn.

This software identifies words and phrases in the submitted work that match those in other works by comparing the text to global databases of other students' work, the organisation's own database of student work, and millions of other sources such as articles and books.

However, while the software flags potential issues, such as a high percentage similarity score, it does not necessarily indicate wrongdoing.

For example, this software will flag sections of text as being identical to other sources when correctly referenced. It was therefore possible to mount a robust defence of members' actions in a number of cases. 

 

Your career on the line

For qualified doctors, the ramifications can be serious. When academic establishments have suspected plagiarism in doctors’ studies, they have communicated this to either their workplace or directly to the General Medical Council (GMC). This led to local disciplinary proceedings for misconduct or a GMC investigation.

Some doctors were cleared by the GMC, but where a Medical Practitioner Tribunal Service (MPTS) panel found dishonesty was proven, the doctors received warnings or suspensions. In a small number of cases, where there were additional concerns about conduct, the doctor was erased from the register and could no longer practise.

For medical students, plagiarism concerns almost always resulted in a fitness-to-practise (FTP) investigation by their university. The sanctions ranged from having the mark for the piece of work capped or having to repeat the assignment, through to warnings or exclusion from the course.

In setting a sanction, fitness-to-practise committees considered issues like:

• the student's seniority

• the extent and nature of the plagiarism

• the committee’s view of the honesty of the student when giving evidence

• their willingness to engage with the investigation and reflect on their conduct

• mitigating factors such as mental ill health

• whether there were other concerns, probity or otherwise, as part of the investigation.

 

Impact on GMC registration 

Medical students who have been involved in a fitness-to-practise investigation need to disclose this to the GMC when applying for registration. When doing this, they must be open and honest and include a reflection on the importance of professionalism and probity, how these relate to the GMC's guidance, and show insight and remediation into the concerns raised.

You can ask your medical defence organisation for support and read the following guidance:

• Reflective practice for doctors and medical students

• The reflective practitioner - guidance for doctors and medical students.

The GMC has guidance on what to disclose when applying for registration, and if you're not sure whether to disclose something, it is important to check with your medical defence organisation.

The specific guidance on what to share about medical school concerns suggests that if you are still not clear on whether you need to declare an issue on your application, then you can seek input from one of their advisers.

If you fail to disclose a fitness-to-practise investigation when applying for full registration, the GMC are likely to request an explanation of why you didn’t disclose the information in your application. 

 

Tips on avoiding allegations of plagiarism

Plagiarism can come in various forms, so it's possible to breach academic conduct rules without realising it. Here are some tips to help avoid common pitfalls:

• Be familiar with your organisation's policy on academic misconduct and definition of plagiarism

• Be aware of the potential to self-plagiarise where you reuse your own work without referencing it

• Ensure you properly cite or reference published work used in a dissertation or project. Use quotation marks when reproducing exact text, and reference correctly as required by the university or the publication

• Don't paraphrase too closely, otherwise known as “para-plagiarise.” Paraphrasing too closely, such as by changing the odd word without adding your additional insight – could be considered a form of plagiarism

• If you're working with a study partner, be mindful of the potential for collusion and unauthorised collaboration when generating a written piece of work. This offence entails you copying part of another person’s work or allowing your own work to be copied. Bear in mind, it will not be clear who the original author was

• Add a reminder when making rough notes if a section of text is taken directly from another source. This avoids inadvertently using wording from another source that you think is your own

• While there are various free plagiarism checkers online, it's unlikely they will scrutinise your work to the same level as the software and staff reviewing the work. Relying on these could lead to a false sense of security. Universities can use more advanced technology as well as checking IP addresses for online exams

• Don't be tempted to cut corners to meet deadlines. If you're struggling to cope with your studies or under time pressure, speak to your supervisor for extra support or to get an extension

• Do not use AI to generate ideas or content for your own coursework or publications because it could expose you to allegations of plagiarism.

To demonstrate the dangers of using AI to help with coursework and publications, the MDU used AI to generate answers to some common medico-legal questions. See if you can spot the genuine answers from those provided by an AI system in this quiz.