The report was commissioned by the university after 20% of sixth-year medical students in 2019 were caught having not met attendance requirements on overseas placements.
The panel headed by Emeritus Prof Nicholas Glasgow, of the Australian National University, was told there was a pervasive belief among students that insufficient attendance was common and had been so for years.
However, the university’s expectation was that students would work for 11 of the 12 weeks of their placement.
The most extreme instances of wrongdoing reported to the panel involved medical staff at overseas institutions encouraging non-attendance, signing their end of placement report on the first day of the placement.
It found the systems in place at the university were inadequate to deal with such behaviour and written guidance did not have explicit attendance requirements.
Although the issue came to light in 2019, the report found it was "highly likely that less than 11 weeks of attendance in clinical placements was indeed happening prior to 2019".
Exotic stories of overseas travels and holiday snaps from students in previous years may have led students to believe there was a tacit encouragement to bend the rules.
It also received one statement that said the elective was unchanged for 30 years.
There were several system level issues identified.
The programme did not have an academic lead to ensure good practices, students were relied upon to assess the suitability of placements and supervisors, and there were no electronic systems in place to keep track of students or capture absences while they were overseas.
Once students returned to New Zealand, only one of the medical school’s three clinical sites interviewed and debriefed students.
The report also considered whether university staff were aware of the problem before the issue came to light.
It found one case previously where a graduate confessed to a staff member years after their graduation that they had not attended any part of the elective and had heard of other students who had done the same.
The staff member said they had passed the information on to senior leadership but understood a decision was made that no action could be taken.
Staff also said they spoke to students about flexibility, choice, having fun and making the most of opportunities, but never with the intent to encourage insufficient attendance.
The report said staff members consistently reacted with shock, disbelief and a sense of betrayal upon learning of their students’ behaviour.
Medical students who were caught in 2019 undertook remedial work that included community service, further academic work and a reflective personal essay.
The panel heard submissions that these punishments were cruel, unnecessary and punitive.
University acting vice-chancellor Prof Helen Nicholson said the university accepted the findings of the report and needed to significantly strengthen its administration of overseas electives.
The university had repaid $156,000 to the Tertiary Education Committee in light of the inadequate attendance.
The money was a reimbursement for funds received and passed on to students as a trainee intern grant.
Each intern receives a $26,756 grant covering their training for the whole of the year, of which the overseas placements form a portion of up to 12 weeks.
Prof Nicholson was pleased that staff members were cleared of encouraging the dishonesty, and said there were no clinical concerns about the clinical competency of the involved students.
The medical school put changes in place to remedy the system level issues and more closely monitor students overseas.
A dedicated staff member had been employed to oversee the programme, software was in use to electronically monitor placements and regular contact with students was required while they were overseas.
