Worked Examples: You Discover a Colleague Has Falsified Their Logbook

Falsifying a logbook, portfolio, or any academic record is a serious breach of professional integrity. It is dishonest, it undermines trust in the profession, and — in clinical contexts — it can endanger patient safety. This lesson works through detailed scenarios involving academic dishonesty, with full SJT-style analysis.

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Why Logbook Falsification Matters

The Connection to Patient Safety

Logbooks and portfolios exist to document that a medical student or doctor has completed specific training, observed required procedures, and achieved defined competencies. If these records are falsified:

• A student may progress without having genuinely achieved the required standard
• A doctor may be signed off as competent in a procedure they have never performed
• Patient safety is directly at risk — the entire competency framework depends on honest documentation

The Professional Integrity Issue

Falsifying records is:

• Dishonest — it misrepresents what actually happened
• A breach of GMC standards — Good Medical Practice requires honesty in all professional matters
• An abuse of trust — supervisors, examiners, and patients rely on the accuracy of these records
• Potentially fraudulent — in serious cases, it could constitute fraud

The SJT Angle

The SJT tests whether you can:

1. Recognise the seriousness of the issue
2. Act despite the personal discomfort (especially if the person is a friend)
3. Use the proportionate response — neither ignoring it nor dramatically overreacting
4. Prioritise patient safety and professional standards over personal loyalty

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Key Principles

1. Falsification is always wrong — There is no circumstance in which fabricating logbook entries is acceptable
2. You have a duty to act — The GMC requires you to raise concerns about dishonesty
3. Speaking to the person first may be appropriate — For minor issues, giving them a chance to correct the record
4. Reporting is mandatory for serious cases — You must report through the appropriate channel
5. You are not responsible for the outcome — Your duty is to raise the concern, not to investigate or adjudicate

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Scenario 1: A Friend Has Signed Themselves Off for a Procedure They Did Not Attend

The Situation

You and your friend are on the same surgical placement. Your friend was absent for an afternoon when the consultant supervised students performing suturing. When you see your friend's logbook later, you notice they have recorded attending the suturing session and have forged the consultant's signature.

Analysis

This is a clear case of falsification:

• They were not present at the session
• They have fabricated an entry
• They have forged a supervisor's signature

This is serious because:

• They may be assessed as competent in suturing without having been trained
• Forging a signature is potentially criminal
• It undermines the integrity of the assessment system

Worked Response (Appropriateness Format)

Action A: Ignore it — it is not your business and you do not want to get your friend in trouble.

Rating: Very inappropriate You have a professional duty to act when you witness dishonesty that could affect patient safety or undermine professional standards. Ignoring it is a failure of professional integrity.

Action B: Speak to your friend privately. Explain that what they have done is serious and encourage them to correct the record themselves.

Rating: Appropriate, but not ideal This is a reasonable first step for a friend, as it gives them the opportunity to do the right thing. However, because the falsification involves a forged signature and a clinical competency, you should also be prepared to escalate if they refuse.

Action C: Report the falsification to your clinical supervisor or placement lead without speaking to your friend first.

Rating: Very appropriate Given the seriousness of the issue (forged signature, clinical competency), direct reporting is justified. The SJT would rate this as very appropriate because the priority is patient safety and system integrity.

Action D: Confront your friend publicly during a teaching session and demand they confess.

Rating: Very inappropriate This is disproportionate and unnecessarily humiliating. Raising the concern should be done through proper channels, not in a public setting.

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Scenario 2: A Colleague Has Exaggerated Their Experience

The Situation

A fellow medical student mentions casually that they have "rounded up" their procedure counts in their portfolio — they performed three cannulations but recorded five. "Everyone does it," they say. "You need the numbers to pass."

Analysis

This is less severe than forging a signature, but it is still falsification:

• The recorded numbers do not reflect reality
• The student may be signed off as meeting a competency threshold they have not reached
• "Everyone does it" is not a justification — it is a rationalisation

Worked Response (Importance Format)

How important is each of the following in deciding how to respond?

Factor 1: Whether rounding up procedure counts is common among other students.

Rating: Not important at all The prevalence of dishonesty does not make it acceptable. "Everyone does it" is never a valid justification in professional ethics.

Factor 2: Whether the student genuinely intends to gain the missing experience before qualifying.

Rating: Of minor importance Intention to catch up is somewhat reassuring, but the current record is still dishonest. The portfolio should reflect what has actually been done, not what the student plans to do.

Factor 3: Whether the discrepancy could affect patient safety.

Rating: Very important If the student is signed off as competent in a procedure they have not sufficiently practised, patients could be harmed. This is the core issue.

Factor 4: Whether the student is your friend.

Rating: Not important at all Personal relationships should not affect your professional obligations. The duty to act applies regardless of who is involved.

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Scenario 3: You Find Out After the Fact

The Situation