BACKGROUND : Although there have been a number of studies of cheating in universities , surprisingly little has appeared recently in the literature regarding academic dishonesty among medical students . METHOD : To assess the prevalence of cheating in medical schools across the country , class officers at 31 of 40 schools contacted distributed a survey in the spring of 1991 to their second-year classmates . The survey consisted of questions about the students ' attitudes toward cheating , their observations of cheating among their classmates , and whether they had themselves cheated . The results were analyzed using contingency tables , t-tests , Pearson correlations , and one-way analysis of variance . RESULTS : Of the 3 , 975 students attending the 31 schools , 2 , 459 ( 62 %) responded . Thirty-nine percent of the respondents reported witnessing some type of cheating among classmates during the first two years of medical education , while 66 . 5 % reported having heard about such cheating . When reporting about themselves , 31 . 4 % admitted cheating in junior high school , 40 . 5 % in high school , 16 . 5 % in college , and only 4 . 7 % in medical school . Reports of cheating varied across medical schools , but no relationship was found between rates of cheating and medical school characteristics . Men were more likely to report having cheated than were women . The best predictor of whether someone was likely to cheat in medical school was whether they had cheated before , although the data strongly support the role of environmental factors . Medical school honor codes exercised some effect on cheating behavior , but the effect was not large . CONCLUSION : About 5 % of the medical students surveyed reported cheating during the first two years of medical school . The students appeared resigned to the fact that cheating is impossible to eliminate , but they lacked any clear consensus about how to proceed when they became aware of cheating by others . The guidance students appear to need concerns not so much their own ethical behaviors as how and when to intervene to address the ethical conduct of their peers .