There may be more aberrations in the moral and ethical behavior of scientists and physicians now than in the past. Fraud and misconduct in research have become a major stress point for both science and medicine. The "premed syndrome" (cheating in medical school and dishonesty during residency training) and fraud in medical practice are well known. Further, studies show that medical students are lenient towards dishonesty in education and practice. One result is that researchers and faculty members may turn to fraud when faced with the pressures to excel, produce, publish, be promoted, and win tenure. Also, physicians' ties to research and commercial endeavors raise questions of conflict of interest that may tarnish the medical image and compromise research findings. An AAMC ad hoc committee on research fraud identified three steps institutions might take: determination of the magnitude of the problem by a formal study; institution of guidelines for research, publication, and promotion; and establishment of policies for investigating allegations of fraud. Because of the problems of dishonesty, fraud, and conflict of interest, academic medical institutions must establish codes of conduct to govern professional life.