Dr. Scott Segal and Dr. Brian Gelfand have seen a lot of residency applications. After 10 years of reading personal essays medical school graduates write to earn a spot in prestigious training programs at Brigham and Women’s Hospital, the doctors came across two personal essays that not only sounded familiar but contained an identical paragraph.
The example confirmed their growing suspicion of plagiarism among residency application statements, spurring them to launch a systematic study of the essays that are supposed to distinguish applicants from one another. In a study published today in the Annals of Internal Medicine, Segal, Gelfand, and their co-authors report that 1 in 20 residency application essays submitted to the Harvard teaching hospital contained evidence of plagiarism.
“I was dismayed by the extent we found,” Segal said in an interview. “A professional lapse as great as this is unacceptable.”
To reach their conclusion, the authors examined almost 5,000 personal statements submitted as part of applications to the five largest residency programs -- internal medicine, anesthesiology, general surgery, obstetrics and gynecology, and emergency medicine -- at the hospital between September 2005 and March 2007. Depending on the specialty, between 28 and 45 percent of applicants nationwide sent their applications to the Brigham, so the authors believe their results mirror what may be happening across the country.
All identifying information was removed and essays were analyzed by software called Turnitin for Admission Essays. The tool looked for similarity of wording by comparing the application essays to Internet pages, printed work, and other essays. If more than 10 percent of an essay appeared to be the same as another source, it was considered plagiarism.
Three-quarters of the essays had no content that was suspect, but 5 percent met the definition for plagiarism. Applications from outside the United States and Canada were more likely to include plagiarism. Among US citizens, the prevalence was almost 2 percent. Among non-US citizens, it was almost 14 percent. Students with lower test scores were more likely to have plagiarized passages in their essays, but even the highest achievers were also flagged.
Examples of plagiarism included stories about patients, family members, or fellow students with only a few words changed.
“I think that is the part that bothered me the most,” Segal said. “You read this heartfelt anecdote about a person’s illness or a family member’s illness or a particular patient and it turns out not to be their experience at all.”
In an editorial that appears with the article, Dr. Maxine Papadakis and Dr. David Wofsy of the University of California, San Francisco, School of Medicine, ask whether the personal statement has outlived its usefulness. Both cut-and-paste plagiarism and assistance from hired writers or college counselors amount to misrepresentation, they say. They also worry that applicants who are not US citizens will be stigmatized by the actions of others.
“If the integrity of the personal statement is increasingly polluted by Internet samples or hired consultants, perhaps the personal statement is ill-suited to this era and best left to history,” they write. “Of course, eliminating the personal statement would not solve the problem of ensuring integrity in our ranks, an issue that deserves the continued attention of those in our profession.”
Segal suggests that the profession consider a national system for vetting residency applications, as already occurs in higher education in the United Kingdom, for example. He finds the personal statement valuable as he decides which candidates to invite for interviews.
“It gives insights into their character, beyond the numbers. I’d hate to lose that,” he said.
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