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Doctors have notoriously poor penmanship. But it seems their typing also leaves a lot to be desired.

Several studies have found that a small but non-trivial percentage of medical school graduates seeking placement in residency programs plagiarize their applications. And at least some of those copy-and-pasters may be training in the nation’s operating rooms as you read this column.

The latest addition to this infelicitous literature is a recent report in the journal Anesthesia & Analgesia Case Reports. Anesthesiologists at West Virginia University in Morgantown looked at the personal statements of 467 medical school grads applying for a residency in anesthesiology in 2013. After downloading the documents through the National Residency Match Program’s Electronic Residency Application Service (ERAS), they ran them through the plagiarism detection program “Viper,” which scans more than 10 billion text sources, identifying passages with at least eight consecutive copied words.


Of course, computers are great at recognizing patterns, but not necessarily context. As a result, such systems don’t automatically differentiate plagiarism from a legitimate reason for copying words, such as a direct quotation. So the West Virginia group analyzed each suspicious phrase by hand. They found that 4 percent of applications from students in the United States, and 13.6 percent of those from foreign-trained students, had at least one plagiarized passage, even after eliminating quotations and coincidental overlap. In one case, nearly 60 percent of an applicant’s essay was lifted from other sources.

Although the lifted text came from a variety of sources, the most common was an outfit called Medfools, which touts itself as an online resource for would-be doctors. One of the services Medfools provides is a bank of personal statements, presumably for applicants wondering what residency programs want to read.


To be fair, Medfools makes the following disclaimer clearly visible on their site: “Please do not copy or plagiarize residency personal statements in the Medfools Personal Statement Library. This practice is unethical and foolish. We are embarrased [sic] to even have to state the obvious, but lately we have seen many portions of personal statements copied and claimed as original work. Please treat these personal statements only as a source of example and inspiration for your own original personal statements. Consider these personal statements publications in a medical journal which should not be copied and used in a manner that is not suitable for the medical profession. If you get caught, it’s game over for you, so please respect the writers, and save yourself the potential embarrassment and hardship.”

It’s tempting here to say, “So what?” After all, 4 percent isn’t exactly in the realm of the law of large numbers. But the figure is remarkably consistent over time. A study published in 2010 found plagiarized text in about 5 percent of nearly 5,000 personal statements submitted to the five largest residency programs run by Brigham and Women’s Hospital. Again, the percentage was substantially higher among foreign-trained graduates than for US citizens.

But for the group at West Virginia University — and, we’ll add, we agree with them — the findings are indeed cause for concern. They call for institutions to ban residency seekers “who demonstrate a willingness to bend the rules of proper conduct.”

Misappropriation of other people’s words, they write, is “a failure of personal integrity” that may well indicate a predilection for other, perhaps more serious, misconduct down the line, including fabrication of data. And research does suggest that what goes for lovers also goes for academic miscreants: “once a cheater, always a cheater.” There’s a mini-epidemic of cut-and-pasted progress notes in medical charts, for example, which can introduce errors and propagate them throughout various records. Studies also indicate that people who cut corners in school tend to do so in the workplace. Thus, catching plagiarism early could well help to halt what one group of authors called an “escalating spiral of misconduct.”

Dr. Robert Johnstone, an anesthesiologist who helped conduct the latest study, said he and his colleagues couldn’t do anything with what they learned because the applicants were de-identified. “Many were accepted into residency programs, including ours,” he told STAT. “After our study was published, no one has stepped forward to admit plagiarism, a reason we, and others, need to be proactive.”

The West Virginia anesthesiology department says it will now screen the personal statements of every applicant to its medical residency programs — and reject those applications found to contain plagiarism. “If neither ERAS nor residency programs take action to detect and thwart plagiarism, its rate will likely remain high,” they wrote. We can only hope not.