you know, i think all of these are pretty reductive ways of approaching this situation. surely self-policing of standards is a central feature of professionalism, whether we're talking about medical practice or just medical school. but the harm done by a cheating student pales in comparison to that of a physician practicing unethically, and the response of a peer can be calibrated with this in mind. i suspect what the interviewer is looking for here is some sort of expression of empathy: why is this student cheating? is just struggling with the material? is something going on in his personal life? maybe the best first approach would be to bring this up with the cheating student himself, and see if there is a way to offer help, maybe in the form of tutoring, or whatever; we're all going to be doctors in the not-too-distant future, so it's important that we all have a good handle on whatever material it is the person is struggling with. i disagree that going directly to administration, regardless of circumstances, is the most ethical course, and i would welcome discussing this with whoever in the administration thinks that punishing me for thinking this way is in the best interests of the school