Professional Integrity · Ranking sample

Dr. Maya Lin is finishing documentation in the clinic workroom when she notices her…

Read the scenario, answer it, then compare yourself to the answer key. Every option includes a rationale and a transferable principle.

v2064Professional IntegrityRankingapproachableProfessional + Communicator, Collaborator

Rank in order the following actions for Dr. Lin to take in response to this situation (1 = Most desirable; 5 = Least desirable).

Dr. Maya Lin is finishing documentation in the clinic workroom when she notices her co-resident, Dr. Jordan Reed, updating his official residency procedural logbook. Jordan logs independent procedural credit for three knee joint arthrocenteses performed earlier that morning. Maya personally assisted on all three cases and knows Jordan merely observed the attending physician perform the procedures from across the examination table. When Maya privately asks about the entries, Jordan dismisses her concern, claiming that everyone logs observed procedures as independent to fulfill mandatory program quotas before CaRMS and graduation deadlines. Maya knows the residency program requires honest logging to certify clinical competence for independent practice.

Ranking scale: 1 is most desirable and 5 is least desirable. Use each rank exactly once. Pick one rank per option.

A. Explain clearly to the colleague why false logging compromises safety, urging him to correct the entries himself.

B. Warn the colleague that she will report the falsified logs to program leadership unless he corrects them.

C. Report the fraudulent logbook entries immediately to the residency program director without further discussion with the colleague.

D. Advise the attending physician who performed the injections that the colleague logged them as independent credit.

E. Ignore the conversation and mind her own logbook, viewing peer logging practices as the program's responsibility.

Use each rank exactly once

Samples are graded anonymously. Nothing is saved.

Show answer and rationale

A. Explain clearly to the colleague why false logging compromises safety, urging him to correct the entries himself.

Key: 1

This is rank 1 because it addresses the ethical breach directly, collegially, and non-judgmentally at the peer level before formal escalation. It offers the co-resident an immediate opportunity to rectify the dishonest entry while underscoring the serious implications for patient safety and professional standards. To rank lower, it would have to be confrontational, passive, or prematurely punitive.

Address peer ethical breaches directly and collegially, providing opportunity for voluntary correction.

B. Warn the colleague that she will report the falsified logs to program leadership unless he corrects them.

Key: 2

This is rank 2 because it establishes clear, uncompromising professional boundaries and gives the colleague a final chance to uphold integrity before formal institutional intervention occurs. While slightly more adversarial than an educational first conversation, it appropriately prioritizes patient safety and accountability. It ranks below Rank 1 because constructive dialogue is preferable to an immediate ultimatum.

Set firm accountability boundaries with transparent consequences when addressing documented peer dishonesty.

C. Report the fraudulent logbook entries immediately to the residency program director without further discussion with the colleague.

Key: 3

This is rank 3 because, while it upholds program standards and ensures institutional awareness of dishonesty, escalating immediately without attempting a firm peer-level discussion damages collegial trust. Direct local resolution should be attempted first unless severe patient harm is imminent. It would rank higher if the colleague had already adamantly refused to correct the fraudulent record.

Reserve direct program escalation for unrectified ethical breaches following transparent peer discussion.

D. Advise the attending physician who performed the injections that the colleague logged them as independent credit.

Key: 4

This is rank 4 because it involves an intermediary clinical supervisor who is not directly responsible for residency curriculum governance, avoiding the proper formal channels. While informing the involved preceptor is relevant, doing so before clarifying the issue with the peer or approaching the residency director represents awkward, indirect escalation. It would rank higher if the preceptor signed the logs.

Utilize established academic accountability pathways rather than triangulating uninvolved clinical supervisors.

E. Ignore the conversation and mind her own logbook, viewing peer logging practices as the program's responsibility.

Key: 5

This is rank 5 because willful blindness to fraudulent credentialing undermines the medical profession and directly risks future patient safety if an incompetent physician is certified. Professional self-regulation requires residents to actively challenge dishonesty rather than looking away. It would rank higher only if Maya were unsure of the factual basis of the fraud.

Uphold professional self-regulation by actively rejecting passive complicity in credentialing fraud.

Exam context: FMProC assesses professional integrity alongside three other attributes. This is an unofficial worked example, not a live exam item.

Educational scenario only. Not clinical or professional advice.