As a professor I view my main job responsibility as teaching to the best of my ability; I always have. As a teacher I am asked to be a guide, a coach, an assessor, and many other things. I am not asked to be an investigator nor am I qualified to be one.
Students regularly ask for make-up exams. Sometimes they are open about wanting more time to prepare for an exam, not thinking about their colleagues in class who would also benefit from the extra time but instead took the exam as scheduled. Sometimes they are out sick; especially in Winter Term illnesses abound.
Trying to offer a level playing field to students about their grades is one of those things I'm pretty serious about. I don't set a high standard about verifying an illness but I do like to see some form of documentation.
Every now and then a student does not provide any documentation of seeking medical assistance and becomes more insistent as the semester ends that I give them a make-up exam. This is the brinkmanship mentioned in the title.
There are some workarounds; offering an incomplete or requiring a conference with a faculty advisor present. Offering a make-up exam with a letter grade penalty can work as well.
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