In college, I would vomit before every exam. Talk about psychosomatic! It was debilitating and honestly kind of embarrassing that something that was so casual for everyone else felt like a completely devastating experience for me – every single time. I was told I would eventually get used to it. Desensitization from years of test taking would rip the anxiety out of me and cast it away! After eight years of school and hundreds of tests later, I still feel the nausea, but I’m not hurling up my insides any more! 

How’d I do it? They’re not wrong when they say it takes a little practice, and this article has some great tips for you to start with! For me, being proactive is what helped most and it took a couple years of experimenting, but I think I finally found a system that works: 

#1 Ready your mantras, or pick one of my favorites! 

For every major graded evaluation, whether it be a written exam or OSCE, I picked a mantra. It may sound a little cheesy, but saying them aloud, plastering them on the corkboard above my desk, sticking post-its on my mirror in the bathroom – all of these things helped me find my confidence in the moments when it was lost.

  1. Preparation is greater than fear 
  2. Discipline is the bridge between goals and accomplishments 
  3. Grades are not equivalent to self worth 
  4. Look how far you have come 
  5. You are exactly where you are meant to be. You belong here. 

#2 Hype up playlists are fantastic 

While studying for Step 1, I felt the doom and gloom of test anxiety accompanying me every day. My friends (who are amazing) decided to support me in the best way they could in the time of COVID and the virtual world – they made me a Spotify playlist. Filled with feel-good, empowering and crush-that-exam anthems; listening to it while reviewing or after a long day of reading helped me find the extra strength that I needed to get through each day! 

#3 The ritual is not ridiculous, if it helps

So you may not love lavender, but I find it extremely relaxing. When I was in college, I went to the local drugstore and picked up everything I could find in lavender – body wash, shampoo, soap, lotion – you name it! And I created myself a little pre-exam ritual that I perform until now (post-graduate and all). I would stop all studying – and I mean all studying at 8pm the night before, take a hot shower with all my lavender goodies and have a cup of tea, watch a movie (Lord of the Rings, Harry Potter and Pride and Prejudice were my usual picks), and head to bed at 10pm! 

Just like my pre-exam ritual, I also have an exam day ritual that I think is akin to any of the Game Day rituals our professional athletes stand by. Armed in all my lucky clothes after another morning shower drenched in lavender, I would walk into my exam room blasting my favorite feel-good playlist, refusing to talk to anyone until afterward. I never brought any notes or sources with me because I didn’t want to be tempted to cram. It may sound a little ridiculous, but I have always found that letting myself relax and trusting in my knowledge gave me the extra push I needed to put my best foot forward on exam day!

#4 Stop when you are tired 

Sometimes we make the mistake of forcing our brains to keep going because of our internal panic. What we don’t realize is that we’re causing ourselves more harm than good. There were many, many days that I came close to pulling an all-nighter – setting alarms for midnight and 2am, heading to bed for a nap at 4am, waking up at 5:30am for a shower, a bite to eat and some more studying – and I found that on days that I forced myself to keep going, I ended up doing worse! So now, when my brain starts to get fuzzy and I notice I’m no longer remembering or can’t answer any more questions correctly, I stop. I have a hot cup of tea and head to bed. Some things have to wait until tomorrow.

#5 On the day of the exam, cultivate your calm

Do whatever you can to help you settle your nerves. Listen to music. Have a light breakfast. Bring some snacks or candy. If your exam is in a place you’re unfamiliar with, drive there and take a look around. Take note of where the bathrooms are and what the test-taking venue looks like. If you’re at school, walk to the building a little early, but pause at a bench or under a tree for some deep breaths. I have found that my mind really is over matter and by allowing myself the opportunity to be calm, I embrace the tranquility of my confidence. 

I absolutely still struggle with test-taking. If you asked any of my friends, they’d tell you the same. The key thing to remember is that your test-taking anxiety will not prevent you from reaching your true potential as a physician unless you let it take control. If anything, it allows us the opportunity to muddle through medicine and emerge triumphant. In spite of our own struggles, it allows us to reach back to those that follow, laughing at the memory of when we used to vomit in the bathroom.

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