essay uni pdf

Essay and dissertation writing skills

Planning your essay

Writing your introduction

Structuring your essay

• Writing essays in science subjects
• Brief video guides to support essay planning and writing
• Writing extended essays and dissertations
• Planning your dissertation writing time

Structuring your dissertation

• Top tips for writing longer pieces of work

Advice on planning and writing essays and dissertations

University essays differ from school essays in that they are less concerned with what you know and more concerned with how you construct an argument to answer the question. This means that the starting point for writing a strong essay is to first unpick the question and to then use this to plan your essay before you start putting pen to paper (or finger to keyboard).

A really good starting point for you are these short, downloadable Tips for Successful Essay Writing and Answering the Question resources. Both resources will help you to plan your essay, as well as giving you guidance on how to distinguish between different sorts of essay questions. 

You may find it helpful to watch this seven-minute video on six tips for essay writing which outlines how to interpret essay questions, as well as giving advice on planning and structuring your writing:

Different disciplines will have different expectations for essay structure and you should always refer to your Faculty or Department student handbook or course Canvas site for more specific guidance.

However, broadly speaking, all essays share the following features:

Essays need an introduction to establish and focus the parameters of the discussion that will follow. You may find it helpful to divide the introduction into areas to demonstrate your breadth and engagement with the essay question. You might define specific terms in the introduction to show your engagement with the essay question; for example, ‘This is a large topic which has been variously discussed by many scientists and commentators. The principle tension is between the views of X and Y who define the main issues as…’ Breadth might be demonstrated by showing the range of viewpoints from which the essay question could be considered; for example, ‘A variety of factors including economic, social and political, influence A and B. This essay will focus on the social and economic aspects, with particular emphasis on…..’

Watch this two-minute video to learn more about how to plan and structure an introduction:

The main body of the essay should elaborate on the issues raised in the introduction and develop an argument(s) that answers the question. It should consist of a number of self-contained paragraphs each of which makes a specific point and provides some form of evidence to support the argument being made. Remember that a clear argument requires that each paragraph explicitly relates back to the essay question or the developing argument.

• Conclusion: An essay should end with a conclusion that reiterates the argument in light of the evidence you have provided; you shouldn’t use the conclusion to introduce new information.
• References: You need to include references to the materials you’ve used to write your essay. These might be in the form of footnotes, in-text citations, or a bibliography at the end. Different systems exist for citing references and different disciplines will use various approaches to citation. Ask your tutor which method(s) you should be using for your essay and also consult your Department or Faculty webpages for specific guidance in your discipline. 

Essay writing in science subjects

If you are writing an essay for a science subject you may need to consider additional areas, such as how to present data or diagrams. This five-minute video gives you some advice on how to approach your reading list, planning which information to include in your answer and how to write for your scientific audience – the video is available here:

A PDF providing further guidance on writing science essays for tutorials is available to download.

Short videos to support your essay writing skills

There are many other resources at Oxford that can help support your essay writing skills and if you are short on time, the Oxford Study Skills Centre has produced a number of short (2-minute) videos covering different aspects of essay writing, including:

• Approaching different types of essay questions  
• Structuring your essay  
• Writing an introduction  
• Making use of evidence in your essay writing  
• Writing your conclusion

Extended essays and dissertations

Longer pieces of writing like extended essays and dissertations may seem like quite a challenge from your regular essay writing. The important point is to start with a plan and to focus on what the question is asking. A PDF providing further guidance on planning Humanities and Social Science dissertations is available to download.

Planning your time effectively

Try not to leave the writing until close to your deadline, instead start as soon as you have some ideas to put down onto paper. Your early drafts may never end up in the final work, but the work of committing your ideas to paper helps to formulate not only your ideas, but the method of structuring your writing to read well and conclude firmly.

Although many students and tutors will say that the introduction is often written last, it is a good idea to begin to think about what will go into it early on. For example, the first draft of your introduction should set out your argument, the information you have, and your methods, and it should give a structure to the chapters and sections you will write. Your introduction will probably change as time goes on but it will stand as a guide to your entire extended essay or dissertation and it will help you to keep focused.

The structure of  extended essays or dissertations will vary depending on the question and discipline, but may include some or all of the following:

• The background information to - and context for - your research. This often takes the form of a literature review.
• Explanation of the focus of your work.
• Explanation of the value of this work to scholarship on the topic.
• List of the aims and objectives of the work and also the issues which will not be covered because they are outside its scope.

The main body of your extended essay or dissertation will probably include your methodology, the results of research, and your argument(s) based on your findings.

The conclusion is to summarise the value your research has added to the topic, and any further lines of research you would undertake given more time or resources. 

Tips on writing longer pieces of work

Approaching each chapter of a dissertation as a shorter essay can make the task of writing a dissertation seem less overwhelming. Each chapter will have an introduction, a main body where the argument is developed and substantiated with evidence, and a conclusion to tie things together. Unlike in a regular essay, chapter conclusions may also introduce the chapter that will follow, indicating how the chapters are connected to one another and how the argument will develop through your dissertation.

For further guidance, watch this two-minute video on writing longer pieces of work . 

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Quick Guide to Essay Writing

A quick guide to essay writing exploring the reasons why tutors ask students to write essays.

• Quick Guide to Essay Writing (PDF 2.09 MB) Download

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How to Use Track Changes in Word for Your Essay? [For Students]

My essays and assignments were far from perfect, but I managed to get through them thanks to teachers who pointed out my mistakes. After correcting those errors, I had to send the revised versions for review, making sure to highlight where I made changes. If you need to highlight changes in your document to help your teacher or reviewer track your revisions, I'll show you how to track changes in Word for students.

How to Compare and Highlight Differences in Two papers?

Students often share group project documents to collaborate on adding their parts or revising the content. But what if you forgot to enable the "Track Changes" feature? Fortunately, WPS Writer, a free office suite solution, offers a "Compare" tool. This tool allows students to compare the original document with the revised version to track or acknowledge any changes made. The tool is very straightforward, so let's simplify the steps for comparing documents.

Step 1 : Let's open the original or updated document in WPS Writer.

Step 2 : Go to the "Review" tab in the toolbar and click on the "Compare" button.

Step 3 : Select "Compare..." from the drop-down menu.

Step 4 : The Compare dialog will open. First, browse and upload the original and revised documents by clicking on the "Folder" icon.

Step 5 : Once the documents are selected, click on the "More" button for advanced settings.

Step 6 : In the "Comparison settings" section, choose what to include in the comparison.

Step 7 : In the "Show changes" section, select how to view differences and where to display them in the document.

Step 8 : After exploring advanced settings, click "OK" to proceed.

Step 9 : And here we have the comparison details. It appears that my group member decided to remove some words from a passage that I wrote.

Comparing documents is useful in academic settings as it allows you to learn more in a group setting. Just like how I reviewed the changes made by my group members and tried to understand their purpose, which helped me learn from my mistakes. Additionally, comparing documents can help track changes made by group members at a glance, saving time compared to scrolling through the entire document.

Word is a great tool, especially for students who need to write essays. However, if you want to ensure compatibility across devices—whether mobile, Windows, or Mac—WPS Office is a better choice. It's a free office suite that works with all Word document versions and can even convert your papers to PDF without compromising the original formatting.

How to Use Track Changes in Word for Revising Your Essay?

When writing an essay and you want to draw attention to a specific part, especially one that marks a significant change or correction, highlighting is an effective method. By highlighting, you can ensure that your reader or reviewer notices the changes quickly, making it easier to identify key sections of your work. This is particularly useful when collaborating with teachers or peers for feedback and revisions. Follow these steps to learn how to track changes in Word.

Step 1 : Firstly, let's open the report document in WPS Writer to make some revisions.

Step 2 : Now, to remember the changes made, head to the Review tab and click on the "Track Changes" button. Alternatively, use the shortcut key "Ctrl +Shift + E" to activate this feature.

Step 3 : You'll notice the icon changes color from white to gray, indicating that Track Changes is now active.

Step 4 : Scroll down and make changes in the document; added content will be highlighted in a different color.

Step 5 : Similarly, if content is removed, it will be struck through to highlight the changes

Step 6 : To adjust settings like highlight color or author name, click on the small arrow in the "Track Changes" icon.

Step 7 : Now select "Track Changes Options.." to customize the settings.

Step 8 : Here, you can change how content insertion or deletion is highlighted in the "Markup" section.

Step 9 : In the Balloons section, users can choose whether revisions appear inline or in a separate pane on the right side of the WPS Writer interface.

Step 10 : Once changes are made, exit the Track Changes option dialog by clicking "OK".

Step 11 : Furthermore, click on the small arrow in the Track Changes icon and select "Change username".

Step 12 : Here, students can update the username, ensuring it reflects their preference. Sometimes, your nickname may be shown based on your email ID, so it's possible to change it if needed.

As a student, particularly when tackling projects and theses, the ability to track changes over time is crucial. WPS Writer excels in this area.  When I receive feedback from instructors, I utilize the "Track Changes" feature. This allows me to easily see their suggestions and incorporate them into my work while retaining a record of the original text. The "Compare" feature comes in handy when collaborating with classmates. It helps us effectively visualize and merge changes made by different team members.  Overall, WPS Writer's constant evolution provides a comprehensive set of features and tools that streamline my workflow and simplify academic life.

Use AI Tools to Perfect Your Paper

As a student, you might wish things were a bit less tedious so you could focus on your studies instead of worrying about the tiny details. This is where WPS Office can make a huge difference. It not only saves you from the hassle of manual tasks like formatting and highlighting, but also provides the tools to create, edit, and organize your work efficiently. Whether you're preparing a thesis, crafting an assignment, or writing an essay, WPS Office has you covered.

WPS AI takes this further by offering assistance to correct grammar and spelling errors, ensuring your document looks professional and polished. It can even generate paper outlines and suggest topic ideas, giving you a head start on your assignments. With these capabilities, you can let WPS Office handle the heavy lifting while you concentrate on creating meaningful content. It's an invaluable tool for students who want to focus on the quality of their work without getting bogged down in the technicalities.

To ensure your thesis or assignment is error-free, let's utilize WPS Writer's AI Spell Check feature.

Step 1 : Open your document and activate the "AI Spell Check" option located at the bottom of the screen.

Step 2 : If you see a word or phrase highlighted with a colored line, simply click on it.

Step 3 : A panel for WPS AI Spell Check will appear on the right side, offering suggestions.

Step 4 : Review the suggestions provided and select the most suitable one.

Besides WPS AI Spell check, WPS Writer's AI feature is an excellent tool for tackling projects. It assists in creating detailed outlines, offering valuable assistance from start to finish. Let's delve deeper into its capabilities.

Step 1 : First, open WPS Office and click "New" on the left side.

Step 2 : Then, select "Docs" to start a new document.

Step 3 : Now, click "WPS AI" at the top right.

Step 4 : A panel for WPS AI will appear on the right.

Step 5 : With WPS AI, I usually share project details and let it create an outline for me.

Step 6 : After getting the outline, I review it and make any changes needed. Finally, I click "Insert" to add it to my document and format it the way I like.

Bonus Tips: How to Convert Word to PDF without losing Format

WPS Office goes beyond traditional word processing software.  It offers a comprehensive set of PDF tools that empower students to efficiently manage their documents.  Fueled by advancements in AI, WPS PDF delivers an increasingly immersive learning experience.

Students can leverage WPS Writer to meticulously format their work.  With the seamless conversion to PDF offered by WPS Office, all those formatting efforts are preserved, ensuring a polished final product.  Furthermore, the versatile WPS PDF tools allow for further manipulation and management of these documents.

Here's a simple way for students to convert their papers to PDF using WPS Writer:

Step 1 : Open your paper in WPS Writer and click on the Menu button at the top left corner.

Step 2 : Then, select the "Export to PDF" option from the menu.

Step 3 : In the Export to PDF dialog box, choose "Common PDF" from the "Export Type" dropdown, and then click "Export to PDF" to convert your Word document to PDF .

FAQs about Remove Page Breaks in Word

1. can everyone see the tracked changes in word.

Yes, by default, the tracked alterations are visible to all individuals who access the document. However, you have options to control visibility. You can safeguard the tracked changes with a password or limit editing to specific users, ensuring that only authorized individuals can see or modify the tracked modifications. This feature is particularly beneficial for maintaining confidentiality and control over sensitive information within your document.

2. What is the purpose of using track changes in Word for essays?

Tracking changes in Word serves multiple functions when working on essays:

Revision Tracking: It records all modifications made to the document.

Collaboration: It enables collaboration among peers or instructors.

Feedback: It allows others to give feedback on the essay's content and structure.

3. What is the significance of using WPS Office for demonstrating track changes in Word?

Employing WPS Office to demonstrate track changes in Word holds significance due to its compatibility across various devices and operating systems, including mobile phones, Windows PCs, and Mac computers. It ensures that students can effectively engage with the track changes feature regardless of the device they are using.

Highlight And Track Your Change With WPS Office

When you're tracking errors and correcting them in your work, you would want to highlight the changes to ensure your teacher notices and gives you credit for the corrections and of that you must know how to track changes in Word for students. WPS Office is an excellent choice for students, offering intuitive tools to make highlighting and tracking changes simple. It's designed with students in mind, making it easier to get your work done efficiently. Download WPS Office today to streamline your editing process and ensure you earn those extra marks for your efforts.

• 1. How to Do Hanging Indent in Word for Your Essay? [For Students]
• 2. How to Double Space in Word for Your Essay: A Guide for Students
• 3. 10 Best Excel Task List Templates: Track Your Tasks Like a Pro
• 4. How to Turn off Track Changes in WPS Office (Step-by-Step)
• 5. 10 Free Project Tracker Excel Templates: Track Your Projects with Ease
• 6. How can we close Track Changes

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In the campus protests over the war in Gaza, language and rhetoric are—as they have always been when it comes to Israel and Palestine—weapons of mass destruction.

By Zadie Smith

A philosophy without a politics is common enough. Aesthetes, ethicists, novelists—all may be easily critiqued and found wanting on this basis. But there is also the danger of a politics without a philosophy. A politics unmoored, unprincipled, which holds as its most fundamental commitment its own perpetuation. A Realpolitik that believes itself too subtle—or too pragmatic—to deal with such ethical platitudes as thou shalt not kill. Or: rape is a crime, everywhere and always. But sometimes ethical philosophy reënters the arena, as is happening right now on college campuses all over America. I understand the ethics underpinning the protests to be based on two widely recognized principles:

There is an ethical duty to express solidarity with the weak in any situation that involves oppressive power.

If the machinery of oppressive power is to be trained on the weak, then there is a duty to stop the gears by any means necessary.

The first principle sometimes takes the “weak” to mean “whoever has the least power,” and sometimes “whoever suffers most,” but most often a combination of both. The second principle, meanwhile, may be used to defend revolutionary violence, although this interpretation has just as often been repudiated by pacifistic radicals, among whom two of the most famous are, of course, Mahatma Gandhi and Martin Luther King, Jr . In the pacifist’s interpretation, the body that we must place between the gears is not that of our enemy but our own. In doing this, we may pay the ultimate price with our actual bodies, in the non-metaphorical sense. More usually, the risk is to our livelihoods, our reputations, our futures. Before these most recent campus protests began, we had an example of this kind of action in the climate movement. For several years now, many people have been protesting the economic and political machinery that perpetuates climate change, by blocking roads, throwing paint, interrupting plays, and committing many other arrestable offenses that can appear ridiculous to skeptics (or, at the very least, performative), but which in truth represent a level of personal sacrifice unimaginable to many of us.

I experienced this not long ago while participating in an XR climate rally in London. When it came to the point in the proceedings where I was asked by my fellow-protesters whether I’d be willing to commit an arrestable offense—one that would likely lead to a conviction and thus make travelling to the United States difficult or even impossible—I’m ashamed to say that I declined that offer. Turns out, I could not give up my relationship with New York City for the future of the planet. I’d just about managed to stop buying plastic bottles (except when very thirsty) and was trying to fly less. But never to see New York again? What pitiful ethical creatures we are (I am)! Falling at the first hurdle! Anyone who finds themselves rolling their eyes at any young person willing to put their own future into jeopardy for an ethical principle should ask themselves where the limits of their own commitments lie—also whether they’ve bought a plastic bottle or booked a flight recently. A humbling inquiry.

It is difficult to look at the recent Columbia University protests in particular without being reminded of the campus protests of the nineteen-sixties and seventies, some of which happened on the very same lawns. At that time, a cynical political class was forced to observe the spectacle of its own privileged youth standing in solidarity with the weakest historical actors of the moment, a group that included, but was not restricted to, African Americans and the Vietnamese. By placing such people within their ethical zone of interest, young Americans risked both their own academic and personal futures and—in the infamous case of Kent State—their lives. I imagine that the students at Columbia—and protesters on other campuses—fully intend this echo, and, in their unequivocal demand for both a ceasefire and financial divestment from this terrible war, to a certain extent they have achieved it.

But, when I open newspapers and see students dismissing the idea that some of their fellow-students feel, at this particular moment, unsafe on campus, or arguing that such a feeling is simply not worth attending to, given the magnitude of what is occurring in Gaza, I find such sentiments cynical and unworthy of this movement. For it may well be—within the ethical zone of interest that is a campus, which was not so long ago defined as a safe space, delineated by the boundary of a generation’s ethical ideas— it may well be that a Jewish student walking past the tents, who finds herself referred to as a Zionist, and then is warned to keep her distance, is, in that moment, the weakest participant in the zone. If the concept of safety is foundational to these students’ ethical philosophy (as I take it to be), and, if the protests are committed to reinserting ethical principles into a cynical and corrupt politics, it is not right to divest from these same ethics at the very moment they come into conflict with other imperatives. The point of a foundational ethics is that it is not contingent but foundational. That is precisely its challenge to a corrupt politics.

Practicing our ethics in the real world involves a constant testing of them, a recognition that our zones of ethical interest have no fixed boundaries and may need to widen and shrink moment by moment as the situation demands. (Those brave students who—in supporting the ethical necessity of a ceasefire—find themselves at painful odds with family, friends, faith, or community have already made this calculation.) This flexibility can also have the positive long-term political effect of allowing us to comprehend that, although our duty to the weakest is permanent, the role of “the weakest” is not an existential matter independent of time and space but, rather, a contingent situation, continually subject to change. By contrast, there is a dangerous rigidity to be found in the idea that concern for the dreadful situation of the hostages is somehow in opposition to, or incompatible with, the demand for a ceasefire. Surely a ceasefire—as well as being an ethical necessity—is also in the immediate absolute interest of the hostages, a fact that cannot be erased by tearing their posters off walls.

Part of the significance of a student protest is the ways in which it gives young people the opportunity to insist upon an ethical principle while still being, comparatively speaking, a more rational force than the supposed adults in the room, against whose crazed magical thinking they have been forced to define themselves. The equality of all human life was never a self-evident truth in racially segregated America. There was no way to “win” in Vietnam. Hamas will not be “eliminated.” The more than seven million Jewish human beings who live in the gap between the river and the sea will not simply vanish because you think that they should. All of that is just rhetoric. Words. Cathartic to chant, perhaps, but essentially meaningless. A ceasefire, meanwhile, is both a potential reality and an ethical necessity. The monstrous and brutal mass murder of more than eleven hundred people, the majority of them civilians, dozens of them children, on October 7th, has been followed by the monstrous and brutal mass murder (at the time of writing) of a reported fourteen thousand five hundred children. And many more human beings besides, but it’s impossible not to notice that the sort of people who take at face value phrases like “surgical strikes” and “controlled military operation” sometimes need to look at and/or think about dead children specifically in order to refocus their minds on reality.

To send the police in to arrest young people peacefully insisting upon a ceasefire represents a moral injury to us all. To do it with violence is a scandal. How could they do less than protest, in this moment? They are putting their own bodies into the machine. They deserve our support and praise. As to which postwar political arrangement any of these students may favor, and on what basis they favor it—that is all an argument for the day after a ceasefire. One state, two states, river to the sea—in my view, their views have no real weight in this particular moment, or very little weight next to the significance of their collective action, which (if I understand it correctly) is focussed on stopping the flow of money that is funding bloody murder, and calling for a ceasefire, the political euphemism that we use to mark the end of bloody murder. After a ceasefire, the criminal events of the past seven months should be tried and judged, and the infinitely difficult business of creating just, humane, and habitable political structures in the region must begin anew. Right now: ceasefire. And, as we make this demand, we might remind ourselves that a ceasefire is not, primarily, a political demand. Primarily, it is an ethical one.

But it is in the nature of the political that we cannot even attend to such ethical imperatives unless we first know the political position of whoever is speaking. (“Where do you stand on Israel/Palestine?”) In these constructed narratives, there are always a series of shibboleths, that is, phrases that can’t be said, or, conversely, phrases that must be said. Once these words or phrases have been spoken ( river to the sea, existential threat, right to defend, one state, two states, Zionist, colonialist, imperialist, terrorist ) and one’s positionality established, then and only then will the ethics of the question be attended to (or absolutely ignored). The objection may be raised at this point that I am behaving like a novelist, expressing a philosophy without a politics, or making some rarefied point about language and rhetoric while people commit bloody murder. This would normally be my own view, but, in the case of Israel/Palestine, language and rhetoric are and always have been weapons of mass destruction.

It is in fact perhaps the most acute example in the world of the use of words to justify bloody murder, to flatten and erase unbelievably labyrinthine histories, and to deliver the atavistic pleasure of violent simplicity to the many people who seem to believe that merely by saying something they make it so. It is no doubt a great relief to say the word “Hamas” as if it purely and solely described a terrorist entity. A great relief to say “There is no such thing as the Palestinian people” as they stand in front of you. A great relief to say “Zionist colonialist state” and accept those three words as a full and unimpeachable definition of the state of Israel, not only under the disastrous leadership of Benjamin Netanyahu but at every stage of its long and complex history, and also to hear them as a perfectly sufficient description of every man, woman, and child who has ever lived in Israel or happened to find themselves born within it. It is perhaps because we know these simplifications to be impossible that we insist upon them so passionately. They are shibboleths; they describe a people, by defining them against other people—but the people being described are ourselves. The person who says “We must eliminate Hamas” says this not necessarily because she thinks this is a possible outcome on this earth but because this sentence is the shibboleth that marks her membership in the community that says that. The person who uses the word “Zionist” as if that word were an unchanged and unchangeable monolith, meaning exactly the same thing in 2024 and 1948 as it meant in 1890 or 1901 or 1920—that person does not so much bring definitive clarity to the entangled history of Jews and Palestinians as they successfully and soothingly draw a line to mark their own zone of interest and where it ends. And while we all talk, carefully curating our shibboleths, presenting them to others and waiting for them to reveal themselves as with us or against us—while we do all that, bloody murder.

And now here we are, almost at the end of this little stream of words. We’ve arrived at the point at which I must state clearly “where I stand on the issue,” that is, which particular political settlement should, in my own, personal view, occur on the other side of a ceasefire. This is the point wherein—by my stating of a position—you are at once liberated into the simple pleasure of placing me firmly on one side or the other, putting me over there with those who lisp or those who don’t, with the Ephraimites, or with the people of Gilead. Yes, this is the point at which I stake my rhetorical flag in that fantastical, linguistical, conceptual, unreal place—built with words—where rapes are minimized as needs be, and the definition of genocide quibbled over, where the killing of babies is denied, and the precision of drones glorified, where histories are reconsidered or rewritten or analogized or simply ignored, and “Jew” and “colonialist” are synonymous, and “Palestinian” and “terrorist” are synonymous, and language is your accomplice and alibi in all of it. Language euphemized, instrumentalized, and abused, put to work for your cause and only for your cause, so that it does exactly and only what you want it to do. Let me make it easy for you. Put me wherever you want: misguided socialist, toothless humanist, naïve novelist, useful idiot, apologist, denier, ally, contrarian, collaborator, traitor, inexcusable coward. It is my view that my personal views have no more weight than an ear of corn in this particular essay. The only thing that has any weight in this particular essay is the dead. ♦

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Guest Essay

In Medicine, the Morally Unthinkable Too Easily Comes to Seem Normal

By Carl Elliott

Dr. Elliott teaches medical ethics at the University of Minnesota. He is the author of the forthcoming book “The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No,” from which this essay is adapted.

Here is the way I remember it: The year is 1985, and a few medical students are gathered around an operating table where an anesthetized woman has been prepared for surgery. The attending physician, a gynecologist, asks the group: “Has everyone felt a cervix? Here’s your chance.” One after another, we take turns inserting two gloved fingers into the unconscious woman’s vagina.

Had the woman consented to a pelvic exam? Did she understand that when the lights went dim she would be treated like a clinical practice dummy, her genitalia palpated by a succession of untrained hands? I don’t know. Like most medical students, I just did as I was told.

Last month the Department of Health and Human Services issued new guidance requiring written informed consent for pelvic exams and other intimate procedures performed under anesthesia. Much of the force behind the new requirement came from distressed medical students who saw these pelvic exams as wrong and summoned the courage to speak out.

Whether the guidance will actually change clinical practice I don’t know. Medical traditions are notoriously difficult to uproot, and academic medicine does not easily tolerate ethical dissent. I doubt the medical profession can be trusted to reform itself.

What is it that leads a rare individual to say no to practices that are deceptive, exploitative or harmful when everyone else thinks they are fine? For a long time I assumed that saying no was mainly an issue of moral courage. The relevant question was: If you are a witness to wrongdoing, will you be brave enough to speak out?

But then I started talking to insiders who had blown the whistle on abusive medical research. Soon I realized that I had overlooked the importance of moral perception. Before you decide to speak out about wrongdoing, you have to recognize it for what it is.

This is not as simple as it seems. Part of what makes medical training so unsettling is how often you are thrust into situations in which you don’t really know how to behave. Nothing in your life up to that point has prepared you to dissect a cadaver, perform a rectal exam or deliver a baby. Never before have you seen a psychotic patient involuntarily sedated and strapped to a bed or a brain-dead body wheeled out of a hospital room to have its organs harvested for transplantation. Your initial reaction is often a combination of revulsion, anxiety and self-consciousness.

To embark on a career in medicine is like moving to a foreign country where you do not understand the customs, rituals, manners or language. Your main concern on arrival is how to fit in and avoid causing offense. This is true even if the local customs seem backward or cruel. What’s more, this particular country has an authoritarian government and a rigid status hierarchy where dissent is not just discouraged but also punished. Living happily in this country requires convincing yourself that whatever discomfort you feel comes from your own ignorance and lack of experience. Over time, you learn how to assimilate. You may even come to laugh at how naïve you were when you first arrived.

A rare few people hang onto that discomfort and learn from it. When Michael Wilkins and William Bronston started working at the Willowbrook State School in Staten Island as young doctors in the early 1970s, they found thousands of mentally disabled children condemned to the most horrific conditions imaginable: naked children rocking and moaning on concrete floors in puddles of their own urine; an overpowering stench of illness and filth; a research unit where children were deliberately infected with hepatitis A and B.

“It was truly an American concentration camp,” Dr. Bronston told me. Yet when he and Dr. Wilkins tried to enlist Willowbrook doctors and nurses to reform the institution, they were met with indifference or hostility. It seemed as if no one else on the medical staff could see what they saw. It was only when Dr. Wilkins went to a reporter and showed the world what was happening behind the Willowbrook walls that anything began to change.

When I asked Dr. Bronston how it was possible for doctors and nurses to work at Willowbrook without seeing it as a crime scene, he told me it began with the way the institution was structured and organized. “Medically secured, medically managed, doctor-validated,” he said. Medical professionals just accommodated themselves to the status quo. “You get with the program because that’s what you’re being hired to do,” he said.

One of the great mysteries of human behavior is how institutions create social worlds where unthinkable practices come to seem normal. This is as true of academic medical centers as it is of prisons and military units. When we are told about a horrific medical research scandal, we assume that we would see it just as the whistle-blower Peter Buxtun saw the Tuskegee syphilis study : an abuse so shocking that only a sociopath could fail to perceive it.

Yet it rarely happens this way. It took Mr. Buxtun seven years to convince others to see the abuses for what they were. It has taken other whistle-blowers even longer. Even when the outside world condemns a practice, medical institutions typically insist that the outsiders don’t really understand.

According to Irving Janis, a Yale psychologist who popularized the notion of groupthink, the forces of social conformity are especially powerful in organizations that are driven by a deep sense of moral purpose. If the aims of the organization are righteous, its members feel, it is wrong to put barriers in the way.

This observation helps explain why academic medicine not only defends researchers accused of wrongdoing but also sometimes rewards them. Many of the researchers responsible for the most notorious abuses in recent medical history — the Tuskegee syphilis study, the Willowbrook hepatitis studies, the Cincinnati radiation studies , the Holmesburg prison studies — were celebrated with professional accolades even after the abuses were first called out.

The culture of medicine is notoriously resistant to change. During the 1970s, it was thought that the solution to medical misconduct was formal education in ethics. Major academic medical centers began establishing bioethics centers and programs throughout the 1980s and ’90s, and today virtually every medical school in the country requires ethics training.

Yet it is debatable whether that training has had any effect. Many of the most egregious ethical abuses in recent decades have taken place in medical centers with prominent bioethics programs, such as the University of Pennsylvania , Duke University , Columbia University and Johns Hopkins University , as well as my own institution, the University of Minnesota .

One could be forgiven for concluding that the only way the culture of medicine will change is if changes are forced on it from the outside — by oversight bodies, legislators or litigators. For example, many states have responded to the controversy over pelvic exams by passing laws banning the practice unless the patient has explicitly given consent.

You may find it hard to understand how pelvic exams on unconscious women without their consent could seem like anything but a terrible invasion. Yet a central aim of medical training is to transform your sensibility. You are taught to steel yourself against your natural emotional reactions to death and disfigurement; to set aside your customary views about privacy and shame; to see the human body as a thing to be examined, tested and studied.

One danger of this transformation is that you will see your colleagues and superiors do horrible things and be afraid to speak up. But the more subtle danger is that you will no longer see what they are doing as horrible. You will just think: This is the way it is done.

Carl Elliott ( @FearLoathingBTX ) teaches medical ethics at the University of Minnesota. He is the author of the forthcoming book “The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No,” from which this essay is adapted.

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