Plagiarism: What will doctors who faked their pasts lie about in the future?

By now you've probably all heard about the plagiarism study that came out of Brigham and Women's Hospital this week. Like so many others, I was shocked and dismayed to hear the results of the research: one in 20 applicants for a residency at the Harvard teaching hospital faked parts of the personal essay they submitted with their applications.

The researchers, led by Dr. Scott Segal, vice chairman for education at Brigham and Women's Hospital and an associate professor with Harvard Medical School, found that applicants to all specialties had cribbed material, according to the study, which was published this week in Annals of Internal Medicine. No demographic within the applicant pool went untainted.

The findings came from research that involved analyzing some 5,000 essays for evidence of possible plagiarism. Researchers used iParadigms' Turnitin for Admissions software to compare essays in applications submitted from Sept. 1, 2005 to March 22, 2007, with a database of Internet pages, published works, and previously submitted essays to calculate the percentage of a submission that matched another source. A match of more than 10 percent to an existing work was defined as evidence of plagiarism.

Here are some examples of matches the software spotted. I've bolded the words that are not an exact match.

[Excerpt from a personal essay with a total 9 percent match]
I have excellent communicating skills and feel comfortable interacting and working with individuals from a wide range of social and cultural backgrounds.

[Excerpt from the database]
I have excellent listening skills and feel comfortable working and interacting with individuals from a wide range of social and cultural backgrounds.

In some cases, the copied material would involve a supposedly heartfelt anecdote about patients--a form of fakery that strikes me as even more egregious, because it seems to pass someone else's experience off as one's own.

One applicant described witnessing a high maternal mortality rate first hand in a busy OB/GYN unit. The matched text was about a person who visited a young man with Hodgkin's disease.

[Excerpt from the personal essay that was part of a 30 percent match]
At times I felt their fear was my fear. However as a member of their health care team, there was comfort in helping to orchestrate a diagnosis and treatment. The joy of helping these patients reinforced my confidence that OBGYN was the right field for me.

[Excerpt from the database]
At times I thought his face was my face, his fear my fear. However as a member of his health care team, there was comfort in helping to orchestrate the diagnosis and treatment of his Hodgkin's Disease. The joy of helping this patient and others reinforced my confidence that internal medicine was the right field for me.

This cut-and-paste approach to concocting a past and a hoped-for future suggests to me that some applicants don't have enough confidence in their achievements to just put themselves out there on the page. Instead, they've gone and appropriated someone else's story with the help of online editors who may charge as much as $325 an hour to polish an essay.

My dictionary defines plagiarism as the act of taking the ideas or writings from another and passing them off as one's own. The word comes from plagiarius, which means kidnapper in Latin. Seems apt, yes? Those resident wannabes had stolen some other person's life.

The researchers note that plagiarism covers a multitude of sins, from poor documentation and proofreading to outright, premeditated fraud. It's even possible the applicants had cryptomnesia, or hidden memory, and weren't aware that they were copying "remembered content" from another source.

Fast forward a few years. What happens when a doctor blanks out while writing a prescription or speculating on possible diagnoses or coming up with a treatment plan? Are these applicants future fraudsters in the making?

Even before entering residency programs, they're passing themselves off as someone else. If they're doing that now, could Medicare fraud be far behind? - Sandra