Throughout my years so far of medical school, caffeine has supplied that extra energy needed to get me through the late nights before deadlines and exams. There is also another well-recognised group of students, well-recognised at least in the USA – those who illegitimately acquire drugs, such as Adderall, in the run up to, and even during, exams. A study published in the Journal of Attention Disorders identified that 56% of student patients with attention-deficit hyperactivity disorder (ADHD) had been approached by other students to acquire their ADHD medications; just under half of these ADHD patients complied. Of course, these stimulants can also be obtained with a simple internet search of symptoms to then present to the physician. Evidence demonstrates that these drugs can significantly bolster the score of an exam and so we ask, is it wrong for students to use these drugs for enhancing their grade?

The immediate concern here is deception toward the physician with the result that the prescribing doctor is placed in a position where he/she can unknowingly cause harm, especially when students may be tempted to increase the dosage for a greater effect. Another question arises as to how valid university results become in the long term if they are based on individuals who are transiently improved with drugs. More seriously, could the illegitimate use of these drugs pressure other students who feel the rise in class competition to acquire such medication? Clearly, using these medications for a purpose other than for health reasons is unacceptable. But attempts in reducing improper drug use will not be easy. Education regarding the detrimental effects to health could deter some, as could improving the medical knowledge among clinicians to limit inappropriate prescribing. For me, the onus for stopping improper use principally lies with the students themselves. It is this group who can truly foster their own healthy education by relying on their own raw talent alone, and in so doing, promote a better education system for all.