Know more? Email us Students practice on a latex dummy at the University of Sydney's medical school. Credit:Michele Mossop Among the latest documents is a scanned version of an entire psychiatry exam as well as answers to several paediatrics, psychiatry and community papers. Universities closely guard the security of medical exams, with most papers never published publicly so that future doctors can respond instinctively in exam situations. The last paper published by the university was the faculty's 1900 anatomy and physiology examination. But a student, who asked not to be named, said the program's continual re-use of questions has put examination integrity at risk.

"This is because the Sydney Medical Program recycles its questions from a single database instead of using an independent examining agency," the student said. The University of Sydney. Credit:Paul Jones In a statement, the university's medical school admitted to recycling questions. "The Medical School changes exam questions year on year while also re-using a proportion of questions but there is no evidence that students are benefiting from the reuse of questions," a spokesman said. The University of Sydney medical school examination from 1900. Credit:University of Sydney

The spokesman said previously used questions are monitored for any changes in performance in subsequent examinations. The review checks if there is a higher than average number of students getting the answer right or wrong compared to previous years. On average 1.5 per cent of questions per exam are removed on this basis. "All Medical School students are now required to sign a confidentiality statement saying that they will not record the questions," the spokesman said. Among the owners of the documents are senior doctors currently working in Sydney's hospitals, the document metadata reveals. "What's being done by future doctors is wrong and needs to be stopped in a way that can only be brought about through public scrutiny," said a student connected to the network. In 2013, students at the University of Adelaide's medical school faced expulsion after they took photos of an examination paper and shared them with students who had yet to sit the exams.

Students in the Sydney exam sharing network also colluded on exams by memorising individual questions and then sharing them in a single document. "Remember this is the effort of students. Please consider this carefully when you want to widely distribute this document," the document states. The Vice-President of the Australian Medical Association, Stephen Parnis, said the AMA was aware of a small number of students cutting corners inappropriately to achieve outcomes in exams that they might not deserve. "Ethical behaviour doesn't begin and end with patient care," he said. "It is also essential in the work of students and teachers. Without confidence in the doctor in front of you, medical care is very difficult to deliver." Dr Parnis said security breaches could put the reputation of qualifications at risk.

"An Australian medical degree is an international passport. When every phone is a camera, it is important to make sure that security protocols are employed," he said. In the wake of the Adelaide scandal, the chair of South Australia's Medical Board, Anne Tonkin, published a paper in the British Medical Journal describing a culture that perpetuated cheating. "Academic staff, including myself, had been aware for about 10 years that students were using a type of "exam recall" to collect questions from multiple choice question exams, we did not take it seriously enough," she wrote. "Developments in technology have resulted in a highly efficient system for students to recall entire exams with great accuracy." The Adelaide medical school also reused exam questions from past years. Dr Tonkin sad the collusion by students was a serious breach of security.

"It called into question the school's ability to certify that graduating students were competent and knowledgeable," she said.