Academic performance in the context of a "three excused absences" psychiatry clerkship policy

In order to better manage medical student absences during the psychiatry clerkship, a policy allowing students to miss up to 3 days without penalty was developed. The purpose of this study was to describe absence patterns and compare academic performance between students with and without absences.

Authors reviewed the academic record of 3rd-year medical students rotating through the psychiatry clerkship between July 1, 2009 and June 30, 2011. The number of clerkship absences during the 6-week rotation, NBME shelf performance, and clinical evaluation scores were extracted. The sample was dichotomized into "absent" and "non-absent" groupings, and mean NBME shelf exam and subjective grades were compared by Student's t-test.

During this period of observation, 249 students (57.5%) had no absences; 96 (22.1%) had one absence; 62 (14.3%) had two absences; 25 (5.8%) had three absences; and 1 (0.2%) had four absences. Students with no absences had higher mean NBME psychiatry shelf exam scores than students with ≥1 absences. Mean clinical grades, which include a professionalism component, and final course letter grade distribution did not differ significantly between absent and non-absent students.

Given that students with absences seemed as academically successful as students who were not absent, we conclude that this policy may effectively manage commonly-expressed attendance concerns.