The impact of student attendance at learning sessions on their exam performance is controversial, with reports of declining attendance associated with technologies such as lecture capture (Edwards & Clinton, 2019). Students may prefer to access material online rather than engage with academic staff (O’Malley et al. 2018), but poor attendance may have a detrimental effect on performance (Mills et al. 2009). Relatively little is known about this relationship in medical students, but we hypothesised that attendance in Year 1 would predict medical student performance in assessments throughout their 5-year programme. The study was approved by the Faculty Ethics Board (ERGO II #9191). The Medicine programme in Southampton had an annual entry of approximately 200 students over the course of the study. Attendance of Year 1 students was monitored by signing in at random lectures one or more times a week and in the majority of small-group sessions (tutorials, workshops & practical classes). The number of sessions attended by each student was expressed as a percentage of the total number of monitored sessions. Using a simple regression model, Year 1 attendance scores were correlated with student performance in each decile in the end-of-year assessments in Year 1, in Year 2 (another preclinical year) and in the written papers of Finals examinations (in Year 5). Comparisons between groups were made using the Mann-Whitney U test. Significance was accepted at p<0.05. Attendance was monitored in 33 lectures and small-group sessions across Year 1, producing an attendance score for 197 students who sat the assessments at the end of year. Linear regression showed a highly significant correlation between attendance and Year 1 assessment decile (r2= 0.74, p<0.005). The same cohort’s Year 1 attendance also correlated significantly with their performance in Year 2 assessments (r2= 0.84, p<0.001). A positive relationship was further seen between Year 1 attendance and Final Year assessment performance in the 57% of students who progressed to Final Year on schedule (r2= 0.37, p=0.06, n=112). Students with attendance scores above 80% in Year 1 were significantly more likely to progress to Final Year on schedule compared to those with lower Year 1 attendance (p<0.05). Our 5-year study at a UK medical school shows that good student attendance in Year 1 not only correlates with assessment performance in the pre-clinical years of the programme but also predicts whether students will progress on schedule to Year 5 and correlates with their performance in Finals exams. This initial analysis suggests that encouraging good pre-clinical attendance in order to fulfil professionalism requirements for medical students may also improve their academic and clinical performance across the Medicine programme.