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.
The beginning areas of the video game The Secret World are in New England, and it unironically nails this vibe really well.