Farooq Azam Rathore  ( Department of Rehabilitation Medicine, CMH Lahore Medical College, University of Health Sciences, Lahore. )
Fareeha Farooq  ( Department of Biochemistry, Fatima Memorial Hospital Medical College, University of Health Sciences, Lahore. )

In 2010, Pakistan ranked 43rd in the world in the scientific publications and it is expected that Pakistan will rise to the 27th place by 2018.¹ Nowadays medical writing is no more an optional activity for the undergraduate medical students, residents and faculty members. Students want experience in medical research and writing to secure electives in reputable universities abroad. Residents and trainees need to engage in medical research and writing to learn this science and complete the mandatory thesis/dissertation required as a pre-requisite for the fellowship exam and improve their chances of residency matches abroad. Faculty members are required to teach their students and publish a certain number of manuscripts for academic promotion, improving curriculum vitae and establishing their names as experts in a particular field.
This trend has led to an increase both in the number of scientific journals being published from Pakistan and the number of submissions to international biomedical journals. The pressure to publish combined with lack of formal training in biomedical research and writing leads to many questionable ethical misconducts. Research misconduct and plagiarism has been reported among medical students and faculty.^2-4 Higher education commission of Pakistan has devised a comprehensive plagiarism policy⁵ but there is a lack of understanding of this aspect among students, residents and faculty across the country.⁶ Still there is no excuse for any unethical behaviour, and the offenders might get severe punishments. Therefore it is imperative that any professional involved in medical writing should take extreme caution, not to indulge in deliberate or non- deliberate plagiarism.
One of the means to avoid and detect plagiarism is the use of plagiarism detection softwares.^7,8 Although some of them are subscription based , many free resources and softwares are also available. These tools and softwares can be used by the authors to screen their manuscripts before submission for possible plagiarism and similarity index and by the editors to detect plagiarism in the submitted articles.
Screening of articles with these softwares can help in detecting plagiarized manuscripts early so that they can be rejected before the formal peer review process. This will reduce the manuscript processing costs to the journals and reduce the peer reviewer's burden by asking them to review only genuine good quality papers. In addition it would be an incentive to the hardworking and honest researchers who do not indulge in objectionable practices of medical writing.
An overview of the selected plagiarism detection softwares and their website links are given in the Table.

This is not a comprehensive list and we have only presented a sample of the many sources available online. Also all are not complementary and require a subscription.
A file is uploaded for comparison or text is entered in the search box on these websites. These websites then compare the document text against millions of articles, databases and web pages online. A report is generated which, in most of the cases not only highlights the suspicious and plagiarized material but also gives a reference to the documents from where the material might have been taken. Some of the websites and softwares give an estimate of the similarity index.
It is recommended that the universities and teaching institutes including the medical colleges and the CPSP should procure these resources and check the thesis, assignment and dissertations for possible plagiarism. Students, residents and faculty can themselves use these resources to screen their manuscripts. In addition emphasis on ethical issues encountered in medical research and writing should be included in the undergraduate medical school curriculum and post graduate residency training. Students should know ethics of medical writing to avoid deliberate plagiarism and questionable publication. This will result in better and high quality scientific publications from Pakistan.

1. Scimago Lab blogs. Forecasting exercises. (Online) (Cited 2014 May 29). Available from URL: http://www.scimagolab.com/blog/wp-content/uploads/2012/04/forecasting-excercise.pdf.
2. Bilic-Zulle L, Frkovi? V, Turk T, Azman J, Petrovecki M. Prevalence of plagiarism among medical students. Croat Med J 2005; 46: 126-31.
3. Okonta P, Rossouw T. Prevalence of scientific misconduct among a group of researchers in Nigeria. Dev World Bioeth 2013; 13: 149-57.
4. Dhingra D, Mishra D. Publication misconduct among medical professionals in India. Indian J Med Ethics 2014; 11: 104-7.
5. HEC Plagiarim policy. (Online) (Cited 2014 May 29). Available from URL: http://www.sbbu.edu.pk/QEC/Plagiarism%20Policy.pdf.
6. Murtaza G, Zafar S, Bashir I, Hussain I. Evaluation of student\'s perception and behavior towards plagiarism in Pakistani universities. Acta Bioethica 2013; 19: 125-30.
7. Garner HR. Combating unethical publications with plagiarism detection services. Urol Oncol 2011; 29: 95-9.
8. Bischoff WR, Abrego PC. Rapid assessment of assignments using plagiarism detection software. Nurse Educ 2011; 36: 236-7.
9. Overview of Plagiarism detection software. (Online) (Cited 2014 Jun 2). Available from URL: http://www.cshe.unimelb.edu.au/assessinglearning/03/plagsoftsumm1.html.