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Professors discuss ditching the doctor’s note for sick students

Frustrated educators and overcrowded health centres share the need for a new remedy.

BY SHAWNA WAGMAN | FEB 08 2016

One afternoon last November, a dozen Carleton University professors and instructors gathered for a meeting organized by the university’s educational development centre to discuss the challenges of dealing with sick notes, the documentation that students are sometimes required to produce to verify an illness and justify extensions on assignments or exam deferrals.

Kim Hellemans, undergraduate chair in the department of neuroscience, chose to attend after becoming exasperated by the workload of juggling student requests for deferrals due to illness and other reasons. “I lose track of who has written what [exam or assignment] and when,” she said to her colleagues, many of whom nodded knowingly. “I fear what’s happening at Carleton is that it’s too easy to defer an exam.”

While some departments may set their own rules, there is no school-wide policy at Carleton on deferrals for sick students – outside of the final exam period, during which students must apply in writing to the registrar’s office in order to officially defer an exam, noted Maureen Murdock, director of Carleton’s health and counselling services, who attended the meeting. “The physician’s note is just saying this person was sick on this date,” she said. “There’s no policy on campus that says you have to accept it.”

Ms. Murdock, who tracks university sick note policies across North America, said some school administrators are moving to a no-note policy, while others are coming up with alternative arrangements, including the use of so-called student self-declaration forms. More common, however, are the use of verification-of-illness forms which require a physician’s assessment of the degree and dates of “incapacitation” – from severe to moderate to slight to negligible.

Sick notes can be a huge burden to the people writing them, said Ms. Murdock. The group of physicians who provide medical services at Carleton wrote 2,350 sick notes for students, staff and faculty in a 12-month period in 2013-14, she said. “It’s a waste of our resources to have students come to the clinics just for sick notes,” she said, and “it increases the wait for students who want to be seen because they are ill.” If it was up to her, Ms. Murdock said she would abandon the need for medical notes altogether. “When I call my employer and say I’m sick, I don’t have to bring a note,” she pointed out.

That’s the same thinking that led Jane Collins, nurse manager in the student health centre at Saint Mary’s University, to stop writing sick notes in 2013 (with exceptions for mental health issues and chronic conditions). In an interview with CBC News at the time, she argued that medical clinics should be taken out of the equation when it comes to academic accommodations. The website of the health centre at University of Alberta, meanwhile, outlines its preference that students stay at home to recover from acute illnesses rather than waiting for a note in a doctor’s office. The physicians will still write notes when medical attention is required, but the university policy emphasizes that students should first contact instructors, by phone or email, to request an absence or extension. (Note, or no note, it’s at the instructor’s discretion to accept the request).

In an effort to smooth the sometimes uncomfortable process of note negotiations between professors and students, at Queen’s University students who visit the university webpage on sick notes are encouraged to print out a letter outlining the school’s policy for their instructors, along with an optional self-declaration of illness form used to declare one’s own non-serious illnesses in writing. It’s a system based on trust and instructors are free to accept the form or not.

Carleton film studies professor Marc Furstenau came to the sick notes meeting feeling irked after receiving a growing number of apparently fake medical notes from students. Dr. Furstenau had become accustomed to negotiating extensions directly with students rather than asking for notes. He did, however, include the faculty’s sick note policy on every syllabus; it stated in bold uppercase text that, in film studies, late assignments are not accepted unless there is medical documentation. He believed, until recently, that he was obliged to include it, just like policies that inform students about accommodations for religious reasons and for disabilities. Even so, Dr. Furstenau admits he always took out the part about needing to produce an obituary or a copy of the death certificate in the case of death of a close relative. “I thought, I’m not going to ask them that!”

Another professor in the room said she had a much stricter policy around documentation. If a student said their cat had dental surgery, she said she’d ask to see the vet bill; if the student said they went to their grandmother’s funeral, she’d ask for the obituary and a boarding pass if travel was required.  A photo of the student’s prescription bottle could be used to prove the dates of illness as well.

The discussion turned to the ways that professors might be able to differentiate between the genuinely ill students and those who might be taking advantage of the system to unfairly buy themselves extra time. Dr. Furstenau shared a sick note strategy that had been adopted by some of his colleagues: designing courses for which only the best five out of seven assignments (or some percentage of quizzes) count towards the final grade. The first two times a student is ill, struck with a migraine or stressed out and misses a test, the zero gets tossed out – no note required. In the previous term he decided to test out another arrangement: he gave students no specific deadlines for the two course assignments, as long as they got them in by end of term.

“It allows me to say, ‘I don’t need to hear anything about your life, I don’t need any excuses from you,’” said Dr. Furstenau. In a class of 18 students, 17 of them submitted the assignments on or before the last day. One asked for an extension and accepted the penalty. “I think they realised that having had such latitude, there was really no excuse not to get them all in by the end of term.”

Colleague Dr. Hellemans seemed unconvinced. The issue “speaks to the culture at large, of accountability and entitlement and that’s what I think needs to change,” she said. “The current system is not working.”

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  1. Dee dee / February 12, 2016 at 16:41

    The University of Alberta has moved to not requiring sick notes for students either several years ago, and replaced them (in some cases) with Statutory Declarations with Faculty/Department staff trained as Commissioner of Oaths.

  2. Lucy / March 3, 2016 at 18:15

    I came to the school’s healthcare center to get a doctor’s note. The nurse checked on me, and concluded that I had a flu, with headaches, vomiting, joint pain, fever, etc. Then she just smiled and said “Here we don’t give out doctor’s note for a flu or cold, only for really serious illnesses”

    Cool! So I have to go write my midterm now, with chances that I will either puke in the classroom or run off to the washroom in the middle of it?

    And then the other clinics were full by the time I called. I live in Montreal, and don’t speak French so it was even harder to look up the clinics. I bet some people who were waiting at the clinics were also students like me asking for a doctor’s note.

    Seriously, do professors not even know their students enough to tell who’s faking and who’s not to the point that schools have to give a “no note” policy now? Why don’t they just give students an option of submitting assignments or exams whenever they want as long as its by the end of the semester?

    • Joe / October 26, 2016 at 14:22

      Interesting… I’ve never had trouble finding a clinic as an anglophone in Montreal, nor have I had difficulty with giving students extensions for legitimate illness. But yes, as per your example, some students do seem more dedicated to victimhood than to their studies. Unfortunately, this also seems to carry over into many workplaces. In the mean time, I find it easier to accept nearly all excuses no matter how suspicious – giving extensions to these cases typically gives the student another chance to fail. I help the student as much as possible, and let them fail if that is their dedication.

  3. Anon / September 27, 2016 at 11:12

    Sounds like the one professor has let her position of authority get to her head.

    I don’t understand why someone who pays thousands or possibly tens of thousands of dollars to be somewhere — that many countries offer for free — would have to jump through hoops to miss a day.

    The students’ tuition helps pay for faculty salaries. It seems backwards to me that the one paying the way is the one taking all the flak.

    If a student wants to miss 30 days, that’s their prerogative. The professor should have absolutely no say, as it doesn’t affect them or their class.

    I’m not a student, but I know many people in my hometown who struggle to comply with crazy professor’s’ absurd demands. They shouldn’t have to show a vet note, or an obituary. How cold hearted can you be? Definitely not the type or people we want molding our countties young minds. Lest they grow up with authority complex themselves.

    Some profs ban laptops, or make other nonsensical rules. If you’re paying ridiculously inflated prices to be there, you should be granted the freedom to study and take notes in whatever fashion suits you best.

    There’s no room for totalitarianism when it comes to paving the way for the future.

    • Dr. Exasperated / October 6, 2016 at 03:28

      I am a university lecturer in Australia, and as part of a role as coordinator for a unit I must deliberate on extension requests.

      One person posting here (Anon) has suggested that university lecturers let the power go to their head, and should simply allow a free for all kind of policy since the students are paying for their degree.

      I think this poster has a warped view of higher education. Paying to attend university does not give someone a guarantee that they deserve to pass the course. Also, allowing people free reign on these kinds of things introduces a host of logistical problems in regards to returning student assessments back in a timely manner so that students can use the feedback to help them learn.

      There is no enjoyment on the lecturer’s part when it comes to deliberating on extension requests. Quite the opposite actually. The lecturer’s primary concern is with the students that are working hard and deserve to be there. The students that abuse the system and get extra time to complete assessments are a serious problem that weighs heavily on the mind.

      Recently I have had a bad time with numerous extension requests sent to me, many of which I suspected were false. Even with medical notes usually the medical note is very vague and without some serious detective work (which I do not have time for) it is difficult to judge how legitimate any particular case is.

      I like the sound of a policy mentioned in this article where the deadline for a major assessment is set at the end of semester and therefore no extension requests are considered (as the student has more than ample time, approx 12 weeks, to complete the assignment). I am going to investigate at my institution if I am able to enact that policy and hopefully I can try it next year.

      A colleague of mine tried a trick this semester where he asked anyone requesting an extension to also provide the draft of their assignment (where they are currently at) with the request. This action had a dramatic impact on the number of requests made, and I think sheds some light on to just how many requests are indeed false.

  4. VS / October 26, 2016 at 18:16

    Hi all-
    This is a great discussion. It’s important to understand that there are systemic reasons why we must track attendance and be on top of it for students. At my university, if an audit occurs, there could actually be financial aid implications for a student. Further, for higher education commissions regulating/accrediting/authorizing programs, this data may be important.

  5. Emeritus faculty member / October 14, 2020 at 13:54

    Having taught a class of 1,200 students for many years, no, I do not know them all well enough to know who is genuinely ill. However, some of students who end up in my office who clearly have done little work predictably ended up requesting deferrals. We have an “optional sick note policy”, so I usually did not ask for one. The students who were genuinely very ill and required medical attention always produced a note. All the other students did is give themselves more opportunities to fail. I made sure that the replacement exam was different from the original one. Very, very few of those students with no documented illness or excuse actually passed the deferred exam.