Medical School Attendance is Significantly Lower in Preclinical Students Who are Experiencing Psychological Distress

Attendance at scheduled learning activities enhances medical students’ education and demonstrates professionalism. This study explores the relationship between attendance and psychological distress in a cohort of medical learners. We recorded the attendance of pre-clinical students at compulsory activities over two years. Counselors in our learner support program were asked to anonymously indicate whether individual learners had sought assistance for psychological distress. The study protocol was approved by the University of Alberta’s Research Ethics and Privacy Offices. One hundred and seventy students recorded 965 absences. The mean (SD) of absences per student was 5.68 (5.56). Twenty one (12%) students had significant psychological distress. There was a negative correlation (r = 0.33) between absences and academic performance. The correlation between absences and psychological distress was moderate (r = 0.63). The mean (SD) number of absences among students without distress was 4.37 (3.46). Among those with distress, the mean (SD) number of absences was 14.95 (8.32). The difference was significant (p < 0.0001) with an effect size of Cohen’s d = 3.06. In the culture of medical school, absences are often interpreted as a lack of moral fitness for the profession, and attendance policies are designed accordingly. However, absenteeism may be symptomatic of psychological distress. If so, institutional regulations could be modified to address this more effectively.