Two vast fields of ethics are very relevant in the context of medical education: bioethics and research integrity.Yet, curiously, the instruction in these two areas shows a significant imbalance in medical schools across Europe. The teaching of bioethics has become over the past few decades an inescapable component of medical education in most European countries. Medical students are formally instructed about the ethical principles that should guide healthcare practice; they learn about the features of the physician-patient relationship and the importance of guaranteeing patients’ free and informed consent; they discuss various ethical dilemmas about the beginning and the end of life, research involving human subjects, genetic testing, resource allocation in health care, etc. In contrast, little attention is still paid to the instruction of medical students in research integrity, that is, in the ethical rules that govern the procedures for producing scientifically valid research results.

The fact is that both bioethics and research integrity are crucial constituents in the education of future medical doctors. However, they pursue different goals:  while bioethics has primarily to do with preventing harm to patients and research subjects, scientific integrity has to do with truthfulness in science, that is, with the imperative that the research results that are disseminated correspond to the real data and real authorship.

It must be stressed that honesty, veracity and transparency are not a merely marginal, but rather an essential component of any scientific endeavor worthy of its name. As we know, there are honest and dishonest ways of doing science. Fabrication and falsification of data, plagiarism, dishonesty in presentation and publication, and undisclosed conflicts of interest are the most common examples of scientific misconduct. These practices attack the very heart of scientific research, as these behaviors involve acts of deception of society and the scientific community. Ultimately, they contradict the very purpose of scientific research, which is the search for truth.

Why do medical students need to receive instruction in research integrity? They need to be instructed in this area because, sooner or later, many of them will be directly or indirectly involved in scientific studies; they will conduct scientific research themselves or will at least collaborate in some way with research conducted by colleagues (for instance, recruiting patients for studies); they will author or coauthor scientific papers; they will give presentations at conferences, etc. For all these reasons, and more, they need to receive, as early as possible, effective instruction about how to do research in a proper and ethical manner. This demand is, of course, even more urgent in the case of those students who have already completed their medical education and are starting a PhD degree.

Beyond these practical reasons, we should not forget that every scandal of unethical behavior by scientists harms their reputation and breaks the trust of society in science. Furthermore, the ultimate ground for promoting instruction in research integrity is that scientific misconduct is contrary to the interest of researchers themselves in being good scientists and in making a real –not fictitious– contribution to social wellbeing and to scientific progress. The circumstance that cases of misconduct are more prominent in the biomedical sciences than in other disciplines (Goodstein, 2010) makes it even more imperative to ensure that medical students and young researchers in medicine receive proper education in research integrity.

Certainly, since the late 1990s, various European academic institutions and funding agencies have developed guidelines and procedures to handle allegations of scientific misconduct and apply sanctions. This has been an important first step to tackle this problem. However, this merely ‘external’ and ex post facto response to misconduct is clearly insufficient. As the old dictum goes, ‘to prevent is better than to cure’. Experts in the field insists that, among the various efforts aimed at promoting scientific integrity, “the educational goal is the most important one”, because “ethical conduct is not likely to occur without effective education” (Resnik, 2003).

The challenging question is: how to ensure ‘effective education’ in research integrity? In this regard, experts insist that learning objectives should not be restricted to a mere transfer of knowledge(for instance, of guidelines and procedures). Rather, it should tend towards a more ambitious goal: enabling students to develop the practical skillsand to internalize the moral attitudes they will need to adequately manage dilemmas concerning the responsible conduct of research (Antes and DuBois, 2014).

Among the various initiatives in Europe aiming to address this difficult challenge, not only in medicine but in all disciplines, the INTEGRITY Project is one of the most recent and promising ones. It aims to identify tools and methods that could contribute to improving the current teaching of scientific integrity in Europe. The vision is that the evidence-based approach adopted by the Project will serve as a starting point to design new educational tools for formal and informal education, as well as in testing innovative curricula within teaching programs. The results and recommendations resulting from this Project are expected to help bridging the current gap between the teaching of the two ethical fields mentioned above. In other words, it can contribute to raise awareness that just teaching bioethics is not enough and to improve the current situation.