The students were from five different faculties. Roughly half of the cases dealt with by the UMSU saw the person expelled or facing expulsion. Six of the cases are awaiting appeals to the academic board. UMSU advocacy and legal division manager Phoebe Churches said the high cost of healthcare – international students usually can not access Medicare, though they can access financial assistance through Overseas Student Health Cover – had helped to create a market for bogus certificates. “In the context where it may be quite challenging to get a medical appointment on the same day – and the cost of a medical appointment for an international student can be between $70 and $100 – this might create a market for the documents, which can go for as little as $20,” said Ms Churches.

Medical certificates are used as evidence for special consideration, which can allow students to do things such as re-sit examinations. There are two types of fake certificates: legitimate “Healthcare Professional Report” forms with a falsified stamp and forged signature, or medical certificates with a fake letterhead of a real clinic. It is understood the fake letterhead often bears no resemblance to the real clinic’s letterhead, and the doctor listed as a practitioner does not work for the cited clinic. Baidu was one of the platforms where students were looking for medical certificates. Credit:Carlos Barria In the past, some students questioned over fake documents have tried to contact the “online doctor” to confirm the certificate's legitimacy, but the account has blocked them and the username removed.

In one case, a student told the UMSU that she was approached by a person in a CBD medical clinic waiting room. UMSU president Desiree Cai said international students were often under enormous pressure to perform because their families had made significant financial sacrifices for their overseas education. "Termination of enrolment for many would be devastating. Specifically, to be expelled from university would involve not only a major financial burden, but also the loss of face for these students and their families," she said.

"For many international students, there are also already substantial hurdles to being at, and performing at Australian universities – the language barriers that they may face, and the hardships associated with being away from home all add up." The union is calling for greater education for international students around the seriousness of the penalties. Ms Churches said a spike in similar cases in 2013 eased after students were warned of harsh penalties in videos and posters published in both Mandarin and English. Loading She said the recent “unprecedented rise” could be because the message had been forgotten or not seen by newer students, or because the university was more rigorously checking medical certificates.

Most Australian universities warn against the practice in their integrity or student procedure policy, warning that making a false declaration or statement such as a false medical certificate amounts to serious student misconduct and, in some cases, fraud. Most universities assess each attempt individually and punishments differ between institutions. Last year, documents obtained through a freedom of information request showed the University of Sydney suspended or expelled 65 students in three years for forging or illegally purchasing doctor’s certificates. The University of Melbourne told The Age in a statement that it was aware of an increase in the number of people trying to get away with using fake certificates, but stressed it was still a small percentage of the overall student population. It did not specify how many of the 18 students expelled this year were international students. “The university is concerned about the issue of academic integrity on many levels and students presenting false documentation to gain academic advantage was one aspect of this,” director of students and equity Elizabeth Capp said.

She said the university had noted an increase in the number of forged medical certificates being presented last year. However, she said presenting false documentation was just one aspect of academic integrity. “The university takes a range of actions to ensure authenticity of student documentation, including preventative and educative measures, and continues to work with all students to provide advice about unscrupulous operators who offer fraudulent documentation services. "We also maintain a register of medical practitioners and websites of interest in this regard, and have this year implemented more rigorous systematic auditing of medical documentation”. The practice is not new, with a 2007 report by the Department of Immigration and Citizenship (DIAC) into fraud, malpractice and error in the international education sector noting the practice could even jeopardise student visas. “There have been numerous cases of students submitting bogus medical certificates or medical certificates containing false information, after they had been reported by their education provider for breaching the conditions of their visa. DIAC has referred dozens of medical practitioners to the NSW Medical Board and several have been disciplined or prosecuted," the report read.