Cheating is undesirable and unethical, but, unfortunately, sometimes it does occur. Recent events at 3 American Board of Medical Specialties specialty boards1,2 have illustrated that the medical certification industry is not immune from this phenomenon. Although there are numerous moral and professional implications involved with cheating, we wish to address the implications of cheating from a psychometric perspective. Our intent is to highlight some of the less obvious ways in which all American Board of Family Medicine (ABFM) diplomates possibly could be impacted should those diplomates and candidates resort to cheating on examinations.