According to Weill Cornell Medical College's Standards of Conduct, students (and faculty) are expected to act as responsible medical professionals, maintaining the highest integrity and ethical standards that are representative of our school. Students are entrusted to assume responsibility for their own behavior and attitudes — to monitor themselves. For example, faculty or staff are present during exams to distribute the exams and answer any questions that may arise — not to monitor students' "behavior."
As the Student Handbook suggests, students are responsible "for the integrity of the content of the academic work performed and submitted, including papers, examinations and reports." One example of unsuitable conduct (in fact, the first mentioned in the examples provided in the Handbook) is "knowingly or carelessly representing the work of others as one's own" — in other words, plagiarism.
Plagiarism is representing someone else's words or ideas as one's own. It may be intentional (e.g., copying or buying another's paper online) or unintentional (not giving credit for an author's ideas that you have summarized in your own words).
Plagiarism is a type of "intellectual theft." In fact, the word plagiarism is derived from the Latin roots plagiarus, a plunderer or kidnapper, and plagiare, to steal.
Typical Ways Students Plagiarize
- Using another writer's original words without properly using quotation marks around the author's original words and without citing the source;
- Putting another writer's ideas in your own words (paraphrasing) but not properly citing the source;
- Paraphrasing the original source by simply changing the original word order or using replacing a few words without proper citation;
- Paraphrasing the original but retaining the original source's identical sentence structure without proper citation;
- Organizing your paper identical to that used by another author;
- Having someone write your paper (e.g., a friend; a writing service).
Consequences of Plagiarism
Plagiarism is academic dishonesty and thus is a violation of Weill Cornell Medical College—s Standards of Conduct. As such, it could ultimately result in your being unable to continue your studies here. Plagiarism is not giving credit where credit is due and thus is a form of cheating, i.e., fraud, and, depending on intent and circumstances, is punishable to varying degrees, ranging from not receiving credit for the course to dismissal from the medical college. For an outline of how such suspected violations are handled at WCMC, please refer to the Student Handbook.
Sanctions for plagiarism can occur long after the actual commission of the action. For instance, some faculty from various institutions who have been found to have plagiarized have had their degrees revoked or their books or articles withdrawn from publication (Hacker, 2009). Plagiarism is a serious offense, and claiming you "didn—t know" isn—t a sufficient "excuse." Thus, it is very important to be familiar with when and how to properly acknowledge sources.
How Plagiarism Can Be Avoided
Citing Your Sources
- Acknowledge the source of any direct quote.
- Acknowledge the source of any idea or opinion you have paraphrased or summarized.
- Facts — common knowledge that can be found in a number of places and probably known by many people — do not need to be cited. However, you must be careful to distinguish a generally known fact from a study statistic or result, for example. Note the difference in these two examples:
- Type I diabetes is usually diagnosed in children and young adults. This is a generally known fact that is supported throughout the literature; thus, no acknowledgement is needed.
- 23.6 million children and adults in the US have diabetes — 7.8% of the population. These statistics are specific to a particular source or study — in this case, the 2007 National Diabetes Fact Sheet — and would thus have to be cited.
- Oftentimes the author(s) of the written work you are reading (the "primary source") will cite other sources (for you, the "secondary source").
- If you want to use something your primary source directly quoted or paraphrased from another source, you must make that clear for your reader.
- Failure to do this is a common — but dangerous — mistake that can get you into trouble. You are given your readers the false impression that you have directly read that secondary source.
- Remember that any type of source used needs to be cited — including those found on the Internet, presented in class or on a course web site, or in personal communication such as email or phone conversation. This also includes photographs, graphs, tables, and other statistical information taken from another source.
- If in doubt, cite! (Again, if in doubt, cite!) Better to be safe than sorry!
Establishing Good Writing Habits
- Practice writing using your own words
- Make your own outline to organize your own ideas and use your own words to convey those ideas.
- If you are having difficulty summarizing the author—s ideas, try not to look at the original; instead, rely on your own notes and memory.
- Do not make "cosmetic changes" to the source material by simply reversing word order, using a synonym here or there.
- Avoid cutting and pasting text from the Internet. This is almost certain to get you into trouble.
- Do not submit the same or similar paper for credit in more than one course unless your course/clerkship director has given you authorization to do so.
How a Style Guide Is Useful
A style guide provides a set of standards for writing your documents, including usage, grammar, punctuation, capitalization, and formatting style for citations and bibliographies. A style guide is useful in that it provides uniformity and consistency in the style and formatting of your document.
When citing your sources, use a specific style guide — perhaps one proposed by your instructor or one frequently used in your field, such as
- American Medical Association Manual of Style: A Guide for Authors and Editors (AMA)
- Publication Manual of the American Psychological Association (APA)
- Chicago Manual of Style
If you are submitting a paper to a journal, refer to the journal's author guidelines, which may be specific to that publication. Numerous biomedical journals follow the Uniform Requirements for Manuscripts (URM), developed by the International Committee of Medical Journal Editors (ICMJE), among whose members include the Annals of Internal Medicine, British Medical Journal, New England Journal of Medicine, and The Lancet.
Each of these guides is referenced under "Sources" at the end of this document. These individual guides provide details, with examples, on how to reference specific sources (e.g., books [authored, edited, editions, etc.], chapters, articles, abstracts, media, presentations, electronic, dissertations, unpublished documents, government documents).
These guides will also provide preferences as to whether you should cite references in parentheses in the text or use footnotes or endnotes. One method is to cite the source in the text, putting the author's last name and publication year in parenthesis and giving the page number if this is a direct quotation (Johnson, 2008, p. 421). At the end of the paper, the full reference will be given linked with the author's name in an alphabetical listing: (e.g., Johnson, H. (2008). Doctor-patient communication. JAMA 15:420—428). Another method is to use footnotes (at bottom of the page) or endnotes (at the end of the paper) that use raised numbers at the end of an idea or quoted words to link the reader to the source.
If you use footnotes, your reference page will be organized numerically, beginning with the first reference noted in your paper and ending with the last reference cited in your paper. If you are using the parenthetical option (e.g., Robbins & Carlyle, 1954), your reference page will be organized alphabetically by author.
Typical Examples of Plagiarism and How to "Correct" Them
Note: In these examples, bold italic = from original source; italic = student writing. These examples follow the Publications Manual of the AMA (2009).
Original Source Material: Ibrahim, S. A. (2009). Health inequities: A global concern. American Journal of Public Health 99 (7): p. 7.
Furthermore, in reacting to the global economic downturn, many nations, including the wealthy ones, are downsizing their commitments to health and social expenditures. History teaches us that in times like these, we often balance the books on the backs of the poor, the disenfranchised, and the minorities. But we need a new vision. It is imperative that we use the current crisis as an opportunity to reshape the global community. Everywhere in the world, the engine of economic prosperity runs on human capital and innovation, and nothing impacts human capital and innovation more than health. A father lost to AIDS in South Africa represent a lost opportunity to provide for the future of a family. A son or daughter lost to tuberculosis in India or China represents a lost opportunity to raise the next computer genius whose creativity we may need to achieve better world connectivity. An African—American child in inner city Chicago lost to crime or imprisonment represents a lost opportunity to develop the next visionary leader.
Student Version A: Plagiarism — Near Verbatim Text with No Attribution
Many nations are downsizing their commitments to health and social expenditures. A new vision is needed. We must employ the current crisis to reshape the global community. Across the world, economic prosperity runs on human capital and innovation, and nothing affects human capital and innovation more than health. A child lost to tuberculosis in India or China is a lost opportunity to raise the next mathematical genius whose creativity we may need to reach improved world connectivity. An African—American child in inner city Los Angeles lost to crime or imprisonment is a lost opportunity to develop the next visionary leader.
Comment: This student is clearly plagiarizing. It is just about a verbatim copy of the original source. Although the writer has condensed this by eliminating some sentences and phrases and using a few synonyms, the writer is relying too heavily on the original source and passing it off as his/her own. He also does not give any credit to the original source.
Student Version B: Plagiarism — Mere Cosmetic Changes
In responding to the global economic recession, many countries, including the rich ones, are less committed to spending money on health and social concerns. As the history books teach us, we frequently balance the books on the backs of the minorities and the impoverished. A new vision is necessary. It is imperative that we use the current crisis as an opportunity to restructure the international community. Health has the strongest impact than anything else upon innovation and human capital. For example, a father in Africa who dies from AIDS translates into losing a chance for providing for his future family; a child who dies from starvation in India or Viet Nam translates into losing a chance for the next genius scientist (Ibrahim, 2009).
Comment: Despite the citation at the end and despite the replacement (and sequence) of many of the more academic (original) language and phrases into that more likely to be used by students, he/she still has borrowed some of the original source's language some of the basic sentence structure, general organization, and examples of the original source.
Student Version C: Acceptable
As Ibrahim (2009) notes, although countries may spend less on health and social concerns, given the current economic climate, we must "use the current crisis as an opportunity to reshape the global community" (p. 7). Deaths due to such health and social issues as HIV, tuberculosis, or starvation, may deprive countries — developed or undeveloped — from future family providers, political or social leaders, or scientific geniuses (Ibrahim, 2009).
Comment: The student no longer claims the ideas or wording or sentence structure as his/her own. Rather, quotation marks surround the language of the original source, along with the appropriate page number and reference to the source in the text itself ("As Ibrahim (2009) notes . . . "). In addition, the student paraphrases in his/her own words Ibrahim's ideas and gives proper attribution.
Original Source Material: Steinbrook, R. (2008). Medical student debt — Is there a limit? The New England Journal of Medicine, 359, 2629—2632.
There are no easy solutions to the problem of medical student debt. Until the economy improves, schools, states, and the federal government are unlikely to be able to provide the substantial additional resources that are required to make a measurable difference in the upward spiral of indebtedness. Among the changes that could help are keeping tuition increases at or below the rate of increase in the CPI; providing a majority of financial assistance in the form of scholarships or grants; expanding loan—repayment programs to assist a wider variety of graduates, such as those who become primary care physicians; and revitalizing and expanding the National Health Service Corps. At a minimum, students need counseling about financial aid and debt management that will help them to make wise decisions and minimize the long—term impact of their medical school loans.
Student Version: Plagiarism — Failure to Attribute Source
Until schools and government provide more resources to our medical students, the following might be some solutions for the problem of extensive medical student debt: (1) tuition should stay at or below those of the CPI; (2 scholarships or grants need to be expanded; (3) more types of graduates should have access to loan—repayment programs (e.g., hose who enter family medicine. In any event, students should be advised on how to manage their financial aid and debts so they can make good decisions regarding the future impact that loans may have for them.
Comment: Although this student uses few direct borrowings from the original source, he/she has taken its ideas without acknowledging the source. All the student has to do is acknowledge the source either in the text itself (e.g., "As Steinbrook (2008) suggests…") or in a footnote or parenthetical citation at the end.
Primary Source Material (what you read yourself):
Gillick, M. R. (2009). Medicine as ecoculture. Annals of Internal Medicine, 151, 577—580.
Secondary Sources (what are cited in the primary source):
Kouri, B.E., Parsons, R. G., & Alpert, H.R. (2002). Physician self-referral for diagnostic imaging: review of the empiric literature. American Journal of Roentgenology 179, 843—50.
Mitchell, J.M. (2007). The prevalence of physician self-referral arrangements after Stark II: Evidence from advanced diagnostic imaging. Health Affairs 26, 415—424.
Levin, D.C., & Rao, V.M. (2008). Turf wars in radiology: Updated evidence on the relationship between self-referral and the overutilization of imaging. Journal of the American College of Radiology 5, 806—810.
Imaging centers have a long history of lucrative self—referral arrangements with private physicians, a practice that led to federal laws restricting self—referral for patients enrolled in Medicare and Medicaid (Kouri, Parsons, & Alpert, 2002). Many physician groups have surmounted the legal constraints by creative leasing arrangements. In California, as many as 33% of magnetic resonance imaging scans, 22% of CT scans, and 17% of PET scans involve self-referral by nonradiologists, typically through lease or time-share arrangements (Mitchell, 2007)—a process associated with overuse of tests (Levin & Rao, 2008).
Student Version A: Plagiarism — Incorrect Attribution
As Gillick (2009) points out, physicians' profitable practice of referring patients to imaging centers led to the federal government to keeping a tight reign on this practice for Medicare and Medicaid patients. However, to get around legal barriers, some physician groups have various leasing practices. For instance, up to one—third of magnetic resonance imaging scans, over one—fifth of CT scans, and 17% of PET scans are self—referrals through lease or time—shares. This procedure typically involves test overuse.
Comment: This student only read the Gillick article, and although he/she does acknowledge Gillick, the acknowledgement is incorrect. Gillick, in fact, obtained this information from three other sources.
Student Verion B: Plagiarism — Implication that Student Read Secondary Source
As Kouri, Parsons, and Alpert (2002) point out, physicians' profitable practice of referring patients to imaging centers led to the federal government to keeping a tight reign on this practice for Medicare and Medicaid patients. However, to get around legal barriers, some physician groups have various leasing practices. For instance, up to one—third of magnetic resonance imaging scans, over one—fifth of CT scans, and 17% of PET scans are self—referrals through lease or time—shares (Mitchell, 2007. This procedure typically involves test overuse (Levin & Rao, 2008).
Comment: This student seems to acknowledge what are used as secondary sources in the original source; however, the student only consulted Gillick, but the implication is that he/she had actually consulted all three of those secondary sources.
Student Version: Acceptable — But Not Ideal
As Kouri, Parsons, and Alpert (as cited in Gillick, 2009) point out, physicians' profitable practice of referring patients to imaging centers led to the federal government to keeping a tight reign on this practice for Medicare and Medicaid patients. However, to get around legal barriers, some physician groups have various leasing practices. For instance, up to one-third of magnetic resonance imaging scans, over one-fifth of CT scans, and 17% of PET scans are self-referrals through lease or time—shares (Mitchell, as cited in Gillick, 2009). This procedure typically involves test overuse (Levin & Rao, as cited in Gillick, 2009).
Comment: This student makes clear that he/she did not actually consult the secondary sources. Ideally, the student should have consulted the original sources, rather than having to refer to the secondary source. This example, with three secondary sources, particularly illustrates the awkward structure of such repetitious lengthy parenthetical citations of secondary sources.Are Some Sources More Preferable Than Others?
Be discerning about the content's quality and be careful not to include embedded references that you have not actually read. We strongly advise that you use peer-reviewed resources that are recognized in your field and such search engines as Pub Med or Ovid MedLine. Wikipedia is not an evidence-based resource, nor are Google book previews or Amazon material such as "Inside This Book." One of the pitfalls of using the Internet is that the information is not permanent; web pages can be taken down at any time and, thus, even when you cite the complete web page(s) in your references, that web page may no longer be available when our reader tries to access it.References
American Medical Association (AMA). (2009). AMA Manual of Style : A Guide for Authors and Editors (10th ed.). Chicago: JAMA/Archives Journals; Oxford University Press. Retrieved Nov. 13, 2009, from http://www.amamanualofstyle.com//oso/public/index.html [Note: WCMC is an online subscriber]
American Psychological Association. A. (2009). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.
Gillick, M. R. (2009). Medicine as ecoculture. Annals of Internal Medicine, 151, 577-580.
Hacker, D. (2009). A writer's reference (6th ed.). New York: Bedford/St. Martin's Press.
Ibrahim, S. A. (2009). Health inequities: A global concern. American Journal of Public Health 99 (7): p. 7.
Indiana University, Bloomington: Writing Tutorial Services. Plagiarism: What it is and how to recognize and avoid it. Retrieved November 1, 2009, from http://www.indiana.edu/~wts/pamphlets/plagiarism.shtml
International Committee of Medical Journal Editors. (2009). Uniform requirements for manuscripts submitted to biomedical journals. Retrieved Nov. 13, 2009, from http://www.icmje.org/urm_main.html
Kouri, B. E., Parsons, R. G., & Alpert, H. R. (2002). Physician self-referral for diagnostic imaging: review of the empiric literature. American Journal of Roentgenology 179, 843-50.
Levin, D. C., & Rao, V. M. (2008). Turf wars in radiology: Updated evidence on the relationship between self-referral and the overutilization of imaging. Journal of the American College of Radiology 5, 806-810.
Mitchell, J. M. (2007). The prevalence of physician self-referral arrangements after Stark II: Evidence from advanced diagnostic imaging. Health Affairs 26, 415-424.
Northwestern University Academic Conduct Committee. Academic integrity at Northwestern: How to avoid plagiarism. Retrieved Nov, 1, 2009, from http://www.northwestern.edu/uacc/plagiar.html
Steinbrook, R. (2008). Medical student debt - Is there a limit? The New England Journal of Medicine, 359, 2629-2632.
University of California, Davis, Division of Student Affairs, Office of Student Judicial Affairs. (September 2006). Avoiding plagiarism: Mastering the art of scholarship. Retrieved November 1, 2009, from http://cai.ucdavis.edu/plagiarism.html
University of Chicago Press. (2006, 2007). Chicago manual of style online (15th ed.). Retrieved Nov. 13, 2009, from http://www.chicagomanualofstyle.org/home.html
Weill Cornell Medical College. (2009-2010). Student handbook. New York: Weill Cornell Medical College.