The thing that gets me is that these people are all really smart. If someone is willing to lie and do math, why not work at an unscrupulous pharma/finance company? They'd make way more money and do way less work. I'd even argue that fraud in the private sector is less unethical - if investors give money to a fraud they deserve to lose it, and regulators take an adversarial stance and have whole orgs (in theory) policing fraud like the SEC and FDA.

It takes a really particular kind of scumbag to seek a position of public trust, make a bunch of trainees financially and professionally dependent on them, accept taxpayer money intended to help cancer patients, then commit fraud.