The use of essay mills and other online sites to buy academic work is a global industry estimated to be in the hundreds of millions of dollars. The practice is known as "contract cheating" (Clarke & Lancaster, 2006), and it occurs when a student engages with a third party to complete academic work on their behalf. Canada lags behind other nations in terms of research and awareness about what contract cheating is, how extensive the industry is and the implications for students, institutions and society, but we are beginning to make advances in scholarship, awareness and advocacy. In this presentation, I synthesize available evidence about contract cheating, highlighting what is known about this form of misconduct in medicine and health sciences.