Majority suffer at the hands of a skiving minority

Editor - Last month's "Medical schools: the makings of a liar" was interesting because my medical school has a similar policy for absences.¹ We are expected to sign in for small group sessions and some lectures and practical classes. Typically, I have to sign in two or three times every day. Apart from the frustration of not being able to deal with domestic crises as described, such frequent monitoring of attendance has serious implications for the learning process.

Firstly, signing-in creates a large administrative burden for staff and creates disruption in small group sessions that may only last 30 minutes. Secondly, it creates a feeling of distrust between staff and students. As a mature student on a graduate entry programme, I am somewhat affronted that my daily movements are monitored so closely. I have given up a career, sold my home, and relocated to become a medical student. It is unlikely that someone in my position would undertake their studies lightly. Thirdly, such a controlled environment does not give medical students enough opportunity to develop their own learning style or tackle personal weaknesses. For example, it seems absurd that a student with a first class degree and doctorate in biochemistry should be obliged to attend basic biochemistry classes when they could be concentrating on other subjects which are not so familiar, for example, anatomy.

This is at odds with the General Medical Council's guidelines: "Students should have time for reflection and personal growth, to catch up on elements they have missed because of illness, or other good reasons, and to deal with difficulties in coming to terms with a particular part of the curriculum."² Clearly a balance needs to be struck. There is a good case for making clinical teaching compulsory, and there will always be those who do not attend classes for frivolous reasons. It seems unfair, however, that the majority should be penalised for the potential actions of a small minority.

1. Medical schools: the makings of a liar. studentBMJ 2005;13:175. (April.)
2. General Medical Council. Tomorrow's doctors. London: GMC, 2003. www.gmc-uk.org/med_ed/tomdoc.pdf (accessed 21 Apr 2005)