One or more medical students set to graduate this year allegedly cheated during last year's exams, according the head of Melbourne University's medical school. The claims, which are being investigated, have distressed and angered students and staff.
By TINA THORBURN
Melbourne University has launched an investigation into claims that cheating occurred during a medical student exam late last year.
A third-year Doctorate of Medicine student, or group of students, is alleged to have cheated during an Objective Structured Clinical Examination (OSCE) on Tuesday, December 17, 2013.
Several days after the incident, the head of Melbourne Medical School, Prof Jim Best, sent an email to all third-year medical students that alleged: “During the lock down period for the morning group, a student or students accessed mobile phones to inform students scheduled for the afternoon session of the content of the OSCE cases.”
The email said there would be an investigation and, if the allegations were correct, the student or group of students involved could face expulsion. “The Melbourne Medical School takes this allegation of cheating very seriously,” it said.
When contacted about the incident, Prof Best said he was unable to provide details because he only knew the “general principles involved”.
At the time of the incident, one student, who wished not to be named, remembered an infuriated Prof Steve Trumble, chair of Clinical Education and Training and Development at Melbourne Medical School, telling students that cheating disadvantaged their peers and was disappointing.
When contacted about the incident, Prof Trumble said the university’s MD course was designed to “help students develop their inherent traits of honesty, integrity and respect for their peers”.
“We’d have zero tolerance of anybody who sought to gain an advantage over their peers through misconduct. That’s not what you want in your future doctor,” he said.
The allegations sparked outrage in a closed Facebook page shared by the 2014 class of Melbourne medical students.
One post used derogatory language to describe the “cheaters”, and blamed international students desperate for a job, or failing students desperate to pass.
The university is yet to take action or advise students about the outcome of the inquiry.
Another student who wished to remain anonymous admitted that in the past they had received a text message from a fellow medical student who was waiting to sit the exam, and asked for the OSCE topics in an attempt to gain an advantage.
“I said 'hell no', but it’s totally possible that someone did it this time, and got caught,” the student said.
Another student, who also wished to remain unnamed, was appalled by the allegations and thought the university needed to take action.
“They should be kicked out. It’s breeding the wrong kind of doctor.”
The alleged cheating student or students is among the group that will graduate as doctors at the end of this year and enter the workforce next year as medical interns in hospitals around Victoria.
This comes after 24 University of Adelaide medical students were caught cheating in a reproductive health exam at the end of last year.
By TINA THORBURN
One in five medical students has thought of suicide in the past 12 months. The alarming statistics come from a report released by depression support group beyondblue in October, last year.
“We’ve known for a long time that doctors [and medical students] are not faring too well from a mental health perspective compared to the general population,” says Nick Arvanitis, beyondblue’s workplace and workforce project manager.
Alarmingly, when compared to the general public, substantially more medical students were diagnosed with depression or anxiety.
“We know that if their health is not great, this is going to impact on the quality of the treatment and support that they can provide to people within the community,” Mr Arvanitis says.
“Mental health is everyone’s business, it is not just an individual or a profession or a workplace.”
Former president of the Australian Medical Student Association and final year University of Sydney medical student Ben Veness disagrees.
He sees little merit in the public awareness of mental health in any particular group.
“I think if [mental health and illness] is managed well by the profession, I don’t see why the public really have to know,” Mr Veness says.
“If the medical profession does a good job of managing this, the patient shouldn’t even notice.”
But sometimes, not even colleagues and acquaintances seem to notice. At the end of last year, nine months into her medical internship at Bendigo Hospital, 24-year-old Dr Vyshnavi Janakan took her life.
The tragedy came as a shock to hospital staff, fellow medical students and her family.
One of Dr Janakan’s former acquaintances is Dr Sophie Butcher. Both Sydney-raised, Dr Butcher met Dr Janakan on a maths camp in year 10 and their aspirations to become doctors brought them both to the University of Melbourne, first Dr Janakan and then Butcher a year later.
Since then the pair have crossed paths numerous times, both on the netball court and at Ballarat Hospital. Although Dr Butcher doesn’t describe their friendship as close, she recalls that Dr Janakan always had a smile on her face.
“Everyone viewed her as a chirpy, happy, and always up for a joke,” Dr Butcher says. “That’s why everyone was so shocked and confused about it all.”
The director of medical education at the University of Melbourne, Prof Geoff McColl, was also saddened by Dr Janakan’s death, and says internships are a particularly stressful time. Programs, like Mental Health First Aid, are being put in place to ensure the right help is available.
“Mental Health First Aid is an evidence-based mental health, two-day, small-group program which is around identifying mental health disorders in others, without stigma, and then trying to direct them as much as possible to the appropriate resources,” says Prof McColl.
“This year we have used this program for our second year MD students, and it was incredibly enthusiastically supported.”
A couple of years ago, in an effort to turn this sentiment into policy, the Australian Health Practitioner Regulation Agency brought in mandatory reporting. T
his national law requires all health practitioners, in all states except Western Australia, which has its own legislation, to report another treating practitioner whose behaviour “may place the public at substantial risk of harm”.
Beyondblue's Mr Arvanitis believes this policy was implemented to encourage doctors to seek help before mental health or other issues become unmanageable.
However, according to the practitioner regulation agency website, mandatory reporting is only for health practitioners that “place the public at risk”, with no mention of risk for the individuals themselves.
Suicidal thoughts and poor mental health are a concern for everyone, from medical student to practitioner to patient. Equally alarming are the allegations of academic misconduct at Melbourne Medical School.
A month after beyondblue released its report, 24 University of Adelaide medical students were caught cheating. The fifth-year students took screen shots of the reproductive health exams on university iPads and left them for the next students due to take the exam.
After an investigation, the students involved had a 10 per cent reduction in their assessment, and have been added to an internal dishonesty register.
At the end of this year, most of these 24 final-year medical students will move into South Australian hospitals as interns. Only students with Commonwealth Supported Places are guaranteed an internship placement in South Australia.
The University of Adelaide Dean of Medicine, Prof Alastair Burt, did not comment when asked if the 24 students caught cheating were local or international.
Only a month after the incident in Adelaide, the University of Melbourne Medical School was informed of a potential incident of academic misconduct. It was alleged a third-year MD student, or group of students, accessed their phones to inform other students of a clinical exam’s content.
The medical school responded by announcing its disapproval to the class of students during their exams, followed by an email on 20 December that states: “The Melbourne Medical School takes this allegation of cheating very seriously and will investigate … If after a thorough investigation a committee upholds an allegation of academic misconduct against a student or group of students it may recommend to the Vice-Chancellor that their enrolment be terminated.”
Despite the school’s disapproval and inquiry, students have heard nothing. When asked about the investigation, the University of Melbourne Dean of Medicine, Prof James Best, said he was unable to provide details, stating he only knew the “general principles involved”.
Professor of Psychiatry at the Alfred Hospital and Monash University Jayashri Kulkarni has been working with medical students for years, as a medical educator and clinician psychiatrist. Prof Kulkarni refers to cheating as a “non-pathological” way of handling stress.
“There are healthy ways of dealing with stress, like talking about it. That’s the most healthy way,” she says . “But as stress levels increase, we will see people do things that are not on, like cheating.”
Prof Kulkarni has noted the increasing rates of mental health issues and depression among medical students, and attributes this worrying increase to long training, intense pressure while studying and competition for jobs.
“Positions in hospitals have not kept up with graduates,” Prof Kulkarni says. “Pressure and workload can lead to social isolation, in particular from families. Losing touch with friends and family are significant factors adding to depression and mental health problems.”
This was true for medical student Rishi Narenthiran. At the age of 18, Mr Narenthiran left Sri Lanka for the first time in his life and came to Melbourne to study. Seven years later he is a third-year MD student at the University of Melbourne, and admits that at first being away from his family and support networks affected his mental health.
“In my first three years, I couldn’t bring myself to do anything,” says Mr Narenthiran. “I just didn’t have the energy and I just felt down. I definitely had issues with depression.”
Although he never sought professional help or counselling, he strongly recommends struggling students to seek help. His hindsight and better self-awareness allows him to better manage his mental health now that he’s a medical student.
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