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Absenteeism and under-achievement in final year medical students.

BACKGROUND
Absenteeism among medical students has received little attention in the literature. The aim of this study was to determine the causes of absenteeism from didactic lectures in ophthalmology and its correlation with performance in formative assessment.


METHODS
The attendance of 101 final year medical students for lectures in ophthalmology was studied in three parts: terms 1, 2 and 3. Based on the attendance in all three terms, students were divided into groups I to V, where group I students had good attendance in all three terms down to group V, with very poor attendance in one or more terms. The marks scored in the first, second and third terminal theory tests were tabulated separately. Results of the second and final professional examinations were assessed for the five groups of students. Students were asked to list the causes of absenteeism in a proforma. Data were analysed by regression analysis and Chi-square test. Significance was obtained at 5% level.


RESULTS
In each formative assessment, higher attendance was associated with better marks (p < 0.0001). Illness, family commitment, teacher/topic, or lecture period spent in an extended clinical posting were cited as causes of absenteeism in 62.6% of instances. Six of the 10 students who failed the ophthalmology professional examination were in groups IV and V and had failed the second professional examination as well. They were designated low achievers, as were 3 students who made several attempts to pass the second professional examination and failed in ophthalmology despite a fair-good attendance.


CONCLUSION
Learner absenteeism may contribute to low achievement. However, absenteeism may be symptomatic of low achievers. Low achievers or students with learning handicaps must be identified before admission or early in the medical course and encouraged to improve their performance and thereby enhance their self-esteem. A support group of family, peers, faculty and psychologists could help.