Case study of candidate misconduct at the PLAB exam

The case:

Following the PLAB 1 exam held on 1 November 2018 the GMC received information about a candidate sharing content of the exam in a public forum.

An investigating manager for the GMC wrote to the candidate explaining they would be considering the matter in line with the GMC’s Candidate Misconduct policy and, if appropriate, would refer the matter for consideration by an Assistant Director. The investigating manager directed the candidate to the GMC’s Candidate Misconduct procedure and invited them to provide comments. 

The candidate responded by saying they did not know it was against the rules to discuss the exam questions. They went on to explain that the reason they shared the question was to prompt discussion and that they did not act with malice.

Given that the candidate had signed the terms and conditions of the exam, which includes abiding to the rules laid out by the GMC, the investigating manager felt it was appropriate to escalate the matter for further consideration.

The decision

The Assistant Director was presented with the investigation manager’s case which included the candidate’s comments. They considered each of the point in turn and their conclusions were:

1. The candidate had booked this exam on the basis that they agreed to follow the procedures and so they should have made themselves familiar with them
2. Sharing the information for the purpose of discussion with other candidates, in an open online forum, is sharing exam material and could potentially be seen to advantage a future candidate in advance of their exam date
3. There is no consideration of malice in these procedures

The Assistant Director accepted that social media can provide a great support network for many types of groups, including those taking professional exams. And social media is a convenient, fast and targeted way to share material like this. However, that does not make it appropriate and/or correct. This was considered in the Student BMJ publication in a paper titled ‘Is sharing past exam questions a form of cheating?’ published by Marika Davies; London Vol. 24, (Dec 2016). 

This concluded that “Working together to revise for exams, learning from past students, and passing knowledge on to those coming after you is part of being a medical student. Sharing old exam papers is a natural part of this, but can become a problem if that information has been obtained illicitly. In a case described in The BMJ students at an Australian medical school took screenshots of a multiple-choice question exam and passed them on to students who had not yet sat the exam.  Anne Tonkin, emeritus professor at the University of Adelaide School of Medicine, describes the rote learning of illicitly obtained exam questions as a form of cheating, and says that developments in technology—such as screenshots, file sharing, and mass email—have resulted in a highly efficient system for students to recall entire exams with great accuracy.”

Taking account of all the circumstances of the referral, the evidence from the candidate and wider research on this subject, the Assistant Director concluded that sharing these questions in this format, in a public forum did mirror the actions outlined as misconduct in the PLAB Misconduct Procedures.

The penalty applied to this case was that the candidate’s results were annulled. The sitting counted towards the candidate’s attempts. 

Information about this case is available for the GMC’s Registrar. They may take this information into account as a matter of good character when considering a future application for registration with a licence to practise.

Legislative provisions 

Under section 21B(1) of the Medical Act we require, amongst other things, to be assured that an applicant for full registration with an overseas qualification possess the knowledge, skills and experience necessary for practicing as a fully registered medical practitioner in the United Kingdom and that their fitness to practise is not impaired.

If a candidate is guilty of misconduct in the PLAB test, we cannot be certain that they possess the necessary knowledge and skills, nor that their fitness to practise is unimpaired.

The GMC’s publication Good medical practice explains the importance of probity for all registered doctors. Paragraph 81 of the publication states that “You must make sure that your conduct justifies your patients’ trust in you and the public’s trust in the profession”.