Students get sick around exam time. Cold, damp weather, combined with lack of sleep, poor diet, and stress, is a recipe for illness. I'm sure that the students who woke up last week and thought, "I don't feel well enough to write a midterm exam today" truly didn't feel very well.
But what degree of unwellness is sufficient excuse for not writing an exam? Feeling tired after only having five hours sleep? Allergies acting up? A cold? Stomach pain? Influenza? Mononucleosis? Pregnancy? A concusion? Shoulder injury? Broken wrist?
I know of no generally agreed cut-off, no list of illnesses that are acceptable grounds for exam deferral. The standard wording for a medical certificate is "I have examined this patient while s/he was sick/injured, and based upon my medical opinion, I can confirm that the medical condition of the patient is sufficiently severe to prevent him/her from attending school or completing academic work".
[Update] But what does "sufficiently severe to prevent" mean? Would the student be in physical danger if he/she attempted to write the exam? Endanger the lives of others? Be physically unable to lift a pencil and start writing? Or would the student just not get as high a grade as he would do if he had been feeling better?
Even if a doctor has reservations about the student's claims, there is a risk attached to refusing to write a note - the student might be harmed by doing poorly on an exam - and little cost (to the doctor) to writing one. Given the absence of clear guidelines and the downside risks of not believing a student, the average doctor probably does what I would do in that situation: take a quick look at the student, verify that he or she is looking tired and run down (most are this time of year), sign the note, charge the student $15 or $25, and go on to the next appointment.
If I am correct in supposing that there are few obstacles - other than time and money - to getting a doctor's note, why do institutions of higher learning place so much weight on them?
My guess is that - like so many things - reliance on doctors' notes continues because it is cheaper and easier than the alternatives. Universities could hire their own in-house doctors to verify students' medical conditions - but that would be expensive, and potentially a violation of a student's right to privacy. Professors could offer any student who wished it the option of writing a deferred exam, no questions asked. Yet making up multiple exams is time consuming. Moreover, making it easy for students to defer is not obviously in students' best interests, given the human tendency to procrastinate and delay the inevitable. And then there are those who wish to defer the deferred exam. I've heard of some innovative professors who allow students to set their own due dates, or allow students to hand in some assignments late in exchange for handing in other assignments early. This is a great idea, but involves a lot of record keeping, and is easier to implement for assignments than exams.
So I don't have a good solution to the status quo. For midterms, I let people transfer the weight to the final exam, no questions asked, and replace the midterm grade with the final grade if people do better on the final exam (this way a student cannot possibly be harmed by writing the midterm, and I don't have to arrange for half a dozen students to write deferred midterm exams). But students do have the option of deferring the final exam - if they can produce a doctor's note.
Does anyone out there share my cynicism? Have creative alternatives to the status quo?