Sharing cases and risking places, be careful with whom you discuss your white spaces.

As registration for the UK foundation programme opens this week, final year medical students across the world wait, fingers poised above keyboards, gearing up to answer the five life changing white space questions. White space questions are compulsory short answer questions based around common clinical scenarios that must be answered in 200 words or less. With five gruelling years at medical school, stand out national achievements, publications, and presentations all combined into a score out of fifty, these five questions are the final hurdle that stands between candidates and their first choice foundation schools.

Worth a total of fifty points, which combine with your academic score to give you a total out of 100, the questions provide a canvas for students to demonstrate they possess the qualities set out in the UKFPO person specification. Past questions have required students to reflect on clinical scenarios they have witnessed, or describe how they would deal with a common issue encountered by junior doctors. With the answers influencing the student’s fate for the next two years, the pressure is on, leading to bad practice such as collusion and plagiarism.

With five 200 word answers being all that stands between you and moving to the other side of the country, it’s easy to see why people are tempted to copy other people’s cases – changing a few details, working together with friends, or downloading supposed “model answers” from the web. Cheating comes in many guises, whether it is plagiarism, collusion, or unfair practice. With the penalty of removal from the application process altogether, even if just accused of unfair practice, vigilance is required to make sure you aren’t left without a job after graduation.

So what constitutes cheating? The submission of answers containing words or ideas that aren’t your own is blatant plagiarism; however seemingly innocent situations, such as discussing cases amongst friends require caution. Whilst it may be helpful to get another opinion, others may dissuade you from a good case, or ask if they could also use yours with a few details changed, as it sounds better than theirs. On this, the UKFPO is clear, plagiarism includes “both work that is copied from another source and work that has been slightly changed or paraphrased to make it look like it is different from the original.” Students may also work together, pooling ideas and sharing phrases; this counts as collusion.

Another common scenario is students leaving questions until the last minute, copying answers in light of the looming deadline (which is absolute, miss it and miss out). However, whether the deadline is a day, or an hour away, it is not worth succumbing to copying answers and jeopardising your friends’ careers along with your own.

All applications are rigorously checked by anti-plagiarism software, with plagiarised phrases pulled up and suspicious answers highlighted and thoroughly investigated. Additionally, students may be asked at random to verify their answers by providing supporting evidence.

Another area causing controversy under the cheating umbrella is medical students being coached or fed answers. Unfair practice is “any act whereby a person might obtain for him/herself or another, an unpermitted advantage leading to a higher mark or grade than his/her abilities would otherwise secure.” Worryingly profiteering companies have emerged, charging for one day courses coaching students. Courses can cost as much as £59, with one boldly advertising “sample answers for FPAS 2012 which reflect a high scoring application, step-by-step guidance on answering the white-space questions, and detailed written handouts.”

Such courses have raised numerous concerns regarding the exploitation of vulnerable students, particularly those coming from overseas. This has prompted Professor Derek Gallen, national director of the UK Foundation Programme Office to make the following statement: “These companies have no knowledge of the scoring criteria used to score applications. Many of these services use the same phrases and the FPAS plagiarism software will pick this up. We take plagiarism and collusion very seriously. Where evidence of this is found you will be withdrawn from the national application process and will be reported to the GMC.”

Kim Walker, special adviser to the UK Foundation Programme Office, explains that these issues have led to the introduction of the situational judgement test, a clinical scenario test done under exam conditions which will replace the white space questions next year. “The reason behind the situational judgement test is that you cannot prepare for it. To answer the questions you have to rely on your undergraduate training. This means people can’t take your money or write answers for you.”

Questions are released Monday 10th October 2011.

Maham Khan is a Clegg scholar and final year medical student, Imperial College London.