CORRECTED: On residency applications, some fudge the details

A study of medical school graduates applying for ophthalmology residencies is the latest to show that some students may be tempted to doctor parts of their application to get ahead of the competition.

"Ophthalmology is a very competitive field," Dr. Michael Wiggins, the study's author and the associate residency program director at the Jones Eye Institute, part of the University of Arkansas for Medical Sciences in Little Rock, told Reuters Health. The Jones Eye Institute gets over 100 applicants for 3 spots every year.

"There is a lot of pressure," Wiggins said. "There aren't a lot of residency spots. I'm sure the temptation is there to make yourself look as good as possible."

In residency applications to the Jones Eye Institute, Wiggins found misrepresentation in about 1 in 13 applications that listed published studies - all "errors" that made the applicants look better.

Wiggins reviewed a total of 821 residency applications that the institute received over five years, excluding applications from the institute's current residents and faculty. When he looked at the 201 applicants that had listed "peer-reviewed" published studies on their resumes, he found 15 cases of misrepresentation.

"A lot of it you can say is due to perhaps a carelessness filling out the application," Wiggins said. "It could be due to a misunderstanding on the part of the applicant. But ... there are some cases that are pretty clear cut that it's hard to write off as those types of things."

The most common error in applications was that applicants' names had been bumped up on the list of study authors, making it seem like they had a bigger role in the research. In other cases, applicants had added their names to studies that the original didn't list them on at all, bumped other authors off the author list, or cited studies that Wiggins couldn't track down even though they were supposedly published in a major journal.

Foreign medical school graduates were more likely than graduates from U.S. schools to list a study that was cited wrong -- possibly because they are at a disadvantage and feel extra pressure to strengthen their applications, according to Wiggins, whose study appears in the Archives of Ophthalmology.

The rate of errors - about 2 percent of all applications - is on the low end of what recent studies have found in residency applications for other specialties. Those studies have shown errors of between about 1 and 16 percent of all applications to different programs.

Directors of residency programs now have plenty of evidence that errors - whether intentional or not - may show up on some of their applications. The question is how to prevent applicants from fudging their credentials, and how to catch those that do embellish when directors are looking at hundreds of applications at a time.

"That's going to take tremendous manpower to verify those," Dr. Gary Yang, who published a similar study on errors in applications for radiation oncology residencies, told Reuters Health. Yang is the director of Gastrointestinal Radiation Medicine at the Roswell Park Cancer Institute in Buffalo, New York. He is moving this week to the Loma Linda University Medical Center in California.

Yang thinks one thing residency program directors can do is educate medical students while they're still in school about their responsibility to be honest about publications. "We can try to emphasize, 'What is the ethical conduct in the scientific community about how you report your data?'" he said.

Wiggins also said that asking applicants who are invited for interviews to forward copies of their publications could discourage fudging. "If word got out to applicants that this was becoming the norm, I think you would see this incident going down further," he said.

"I would think that the carelessness errors would go down, and certainly the intentional errors would go down," said Wiggins.

SOURCE: http://link.reuters.com/kez37m, Archives of Ophthalmology, July 7, 2010.