Using a recent case of research fraud as a basis, this article examines the pathogenesis of fraud in medical science and suggests some remedies. Among causative factors are the "pre-med syndrome," the extraordinary size of science (which makes supervision of young investigators difficult), and competition, both professional and economic. Remedies include more careful selection of personnel, reduction of excessively large research groups, and closer examination of work at all levels—the laboratory, the academic department, and the institution. Each institution should have in place mechanisms to investigate research fraud when it is uncovered.