Society of University Surgeons Self-reported attitudes and behaviors of general surgery residents about ethical academic practices in test taking Valerie P. Grignol, MD, a Alyssa Gans, MD, a Branyan A. Booth, MD, a Ronald Markert, PhD, b and Paula M. Termuhlen, MD, FACS, a Dayton, OH Background. A correlation exists between people who engage in academic dishonesty as students and unethical behaviors later as professionals. Academic dishonesty has been assessed among medical students, but not among general surgery residents. We sought to describe the attitudes of general surgery residents with regard to ethical practices in test taking. Methods. A survey with 4 scenarios describing activities related to examination taking that may or may not be considered unethical was administered. Participants were asked about participation in the activities---either personally or any knowledge of others---and whether the activities were unethical. Results. Fifty-seven of 62 residents (92%) participated. For each scenario, >70% indicated that neither they nor anyone else they knew had participated in the activities. Behaviors deemed unethical included memorizing or using memorized questions to prepare for future tests (52%), selling questions for financial gain (90%), and purchasing previously used questions (57%). No difference in attitudes was seen among incoming interns, junior-level (postgraduate year [PGY]1--3), or senior-level (PGY4--6) residents. Conclusion. Overall, general surgery residents indicated that they had not participated in activities they felt to be unethical. Defining what is unethical was less clear. This represents an area for further education. (Surgery 2010;148:178-80.) From the Department of Surgery a and the Department of Internal Medicine, b Wright State University Boonshoft School of Medicine, Dayton, OH THERE HAS BEEN MUCH PUBLISHED on the importance of maintaining professionalism in medicine and the lit- erature is robust with evidence showing the need for professionalism training. 1-4 Of concern, studies have shown there is a positive correlation between people who engage in academic dishonesty as students and later as professionals. Among engineering, business, and nursing students, there is a positive correlation between academic dishonesty and unethical behav- iors in the workplace. 5-9 Although there are no spe- cific data showing a correlation between academic dishonesty and later unethical behavior among medical students, there are studies that show unpro- fessional behavior in medical school correlates with disciplinary action by state medical boards. 10 This is revealing in that unethical practices in school may correlate with unethical behavior in practice. Academic dishonesty is prevalent in medical school. 11-17 The prevalence of cheating among med- ical students has been reported to be between 4.7% and 58%. 12,18 Studies show that medical students of- ten disagree as to what constitutes cheating. To the investigators’ knowledge, the prevalence of and atti- tudes toward cheating have not been assessed among general surgery residents. In this study, we surveyed resident’s attitudes toward ethical situations concerning the American Board of Surgery In-Training Examination (ABSITE). The ABSITE is an annual, in-training examination for general surgery residents used to assess resident’s basic science knowledge and clinical decision skills. Attitudes toward this nationally administered exami- nation provide a common ground for assessment. Accepted for publication April 16, 2010. Reprint requests: Paula M. Termuhlen, MD, FACS, General Surgery Residency Program Director, Chief, Division of Surgical Oncology, Wright State University Boonshoft School of Medicine, Miami Valley Hospital, One Wyoming Street, WCHE 7000, Dayton, OH 45409. E-mail: paula.termuhlen@wright.edu. 0039-6060/$ - see front matter Ó 2010 Mosby, Inc. All rights reserved. doi:10.1016/j.surg.2010.04.016 178 SURGERY