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

Objective: 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. Method: 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. Results: 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. Conclusion: 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.