Self-reports suggest >50% of university students cheat at some point in their academic career (Christensen Hughes JM, McCabe DL. "Can J High Educ" 36: 49-63, 2006), although objective values of academic misconduct (AM) are difficult to obtain. In a physiology-based department, we had a concern that students were altering written tests and resubmitting them for higher grades; thereby compromising the integrity of our primary assessment style. Therefore, we directly quantified the prevalence of AM on written tests in 11 courses across the department. Three thousand six hundred and twenty midterms were scanned, and any midterm submitted for regrading was compared with its original for evidence of AM. Student characteristics, test details, and course information were recorded. On a department level, results show that this form of AM was rare: prevalent on 2.2% of all tests written. However, of the tests submitted for regrading, 17.4% contained AM (range: 0-26%). The majority of AM was conducted by high-achieving students, (60% of offenders earned >80%), and there was a trend toward women being more likely to commit AM (P = 0.056). While our results objectively show that this type of AM is low, we highlight that large competitive courses face significantly higher prevalence, and high-achieving students may have gone underreported in previous literature. Vigilance should be employed by all faculty who accept tests for regrading.