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I get so nervous during exams it's amazing how much material I can't remember. I start becoming super nervous a week before an exam. Every day that passes I become more and more nervous. Also, when I study a lot I get even more nervous like what if I spent all this time studying and still do bad. How do I fix this?
 

gannicus89

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You can try meditating- focusing on a calming idea/image while you think of positive affirmations regarding how much you know, your performance on the test, etc. You might want to consider therapy as well, possibly talk to a school counselor. It always helps to force yourself to "see" reason. If you've prepped a lot, done decently on your practice problems, you should do reasonably well on the real thing.
 

Azete

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I had crippling test anxiety at one point -- I would routinely take exams with a heart rate close to 200 for the entire duration (sometimes multiple hours).

I tried everything, including a number of prescribed medications, with no net benefit. I went to my school's learning center, and their suggestions made things worse if anything. It wasn't until I adopted a consistent yoga practice that I noticed a genuine improvement; after a year I was essentially anxiety free. I was so hesitant because I just saw yoga as "hippie" stuff, but it honestly changed my life. I think the root of my problem was poor sleep (quality, not duration), which yoga helped fix -- but that's just a guess.

I wouldn't even recommend paying for a class. There are cheap apps that are just as good and allow you to do it in privacy, and in an environment you like.
 
Dec 9, 2013
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All the above are great suggestions depending on how you operate. I would suggest picking up the book called "The Upside of Stress" by Kelly McGonigal. It talks about the science behind stress and why if we can change our perspective of it (for example, a heart rate of 200 is trying to get more blood to our brains to perform better), nervous people can preform better than their non-nervous peers. Really well-written and easy read while simultaneously being motivating and educational.
 
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Doug Underhill

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It talks about the science behind stress and why if we can change our perspective of it (for example, a heart rate of 200 is trying to get more blood to our brains to perform better), nervous people can preform better than their non-nervous peers.
This is interesting. I have noticed that a lot of high MCAT achievers are really anxious.
 
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This is interesting. I have noticed that a lot of high MCAT achievers are really anxious.
I really struggled with test anxiety and test based courses my freshman and sophomore years of college. I learned to accept my anxiety and see it as my body's way of telling me how invested I was in something and its way of trying to help me out. I ended up doing pretty well on the MCAT (36) because the stress brought me focus. I think most people with anxiety would agree that trying to be 'calm' almost always makes you more stressed because you can't achieve that calm, which can be viewed as a failure. This book just put into words the mentality that worked for me.
 

Pastamahn

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I really struggled with test anxiety and test based courses my freshman and sophomore years of college. I learned to accept my anxiety and see it as my body's way of telling me how invested I was in something and its way of trying to help me out. I ended up doing pretty well on the MCAT (36) because the stress brought me focus. I think most people with anxiety would agree that trying to be 'calm' almost always makes you more stressed because you can't achieve that calm, which can be viewed as a failure. This book just put into words the mentality that worked for me.
Only on SDN would people think of a 36 as only doing "pretty well"
 
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Only on SDN would people think of a 36 as only doing "pretty well"
Not exactly the take home from my post, but valid point. As someone who has a history of pretty poor testing results for reasons that are beyond my knowledge and capabilities, I don't put too much weight in test scores (yes, even the MCAT).
 

Azete

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I really struggled with test anxiety and test based courses my freshman and sophomore years of college. I learned to accept my anxiety and see it as my body's way of telling me how invested I was in something and its way of trying to help me out. I ended up doing pretty well on the MCAT (36) because the stress brought me focus. I think most people with anxiety would agree that trying to be 'calm' almost always makes you more stressed because you can't achieve that calm, which can be viewed as a failure. This book just put into words the mentality that worked for me.
I think there's some validity to this, but in my case it wasn't so much the anxiety that didn't allow me to focus -- it legitimately became fear of heart failure. Hard to focus when you think you're dying.
 

Dr.TonySoprano

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go see a therapist and see if he/she recommends anxiety medication such as Lexapro
 
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I think there's some validity to this, but in my case it wasn't so much the anxiety that didn't allow me to focus -- it legitimately became fear of heart failure. Hard to focus when you think you're dying.
I once got so nervous during a 2 hour lab test that the hand I wasn't using to write turned white and numb. I literally was so nervous my body went into a shock response and limited blood flow to my extremities. I get the feeling that you're gonna die. Definitely seek out some professional help and maybe look into biofeedback if your stress response is more physical than mental.
 

Azete

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I once got so nervous during a 2 hour lab test that the hand I wasn't using to write turned white and numb. I literally was so nervous my body went into a shock response and limited blood flow to my extremities. I get the feeling that you're gonna die. Definitely seek out some professional help and maybe look into biofeedback if your stress response is more physical than mental.
This was all in the past, I've managed to overcome my problems since then. I was just adding another perspective on it.
 

altblue

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Lack of sufficient preparation can also contribute to test-taking anxiety.
Poor or inefficient study habits can also significantly contribute to feeling overwhelmed while preparing for exams. As can a lack of sleep and exercise.
 

Moose A Moose

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I get so nervous during exams it's amazing how much material I can't remember. I start becoming super nervous a week before an exam. Every day that passes I become more and more nervous. Also, when I study a lot I get even more nervous like what if I spent all this time studying and still do bad. How do I fix this?
Just think when you have a real patient coding in front of you...











That exam still seem so bad?
 

Azete

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Just think when you have a real patient coding in front of you...



That exam still seem so bad?
In fairness that's more of an acute, unexpected stress. Most anxious people are usually pretty good in those circumstances.
 

Law2Doc

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In fairness that's more of an acute, unexpected stress. Most anxious people are usually pretty good in those circumstances.
I'd say on call during residency that's really not going to be as acute and unexpected as you think. It's really the very rare patient that's totally fine one minute and codes the next. You'll more likely know at sign out that you have a crop of people who are probably going to try and die on you sometime later in the night. Basically a bunch of ticking time bombs. The stress will build because you know it's less of a question of if but when. So yeah that's not a good situation for an anxious person.
 
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Azete

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I'd say on call during residency that's really not going to be as acute and unexpected as you think. It's really the very rare patient that's totally fine one minute and codes the next. You'll more likely know at sign out that you have a crop of people who are probably going to try and die on you sometime later in the night. Basically a bunch of ticking time bombs. The stress will build because you know it's less of a question of if but when. So yeah that's not a good situation for an anxious person.
I suppose it depends on the residency but good points nonetheless. I wasn't suggesting that habitual anxiety is conducive to success in medicine, just that these people are generally very capable in emergency situations.
 

Law2Doc

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I suppose it depends on the residency but good points nonetheless. I wasn't suggesting that habitual anxiety is conducive to success in medicine, just that these people are generally very capable in emergency situations.
I actually think test "anxiety" is often a misnomer. With the exception of the person in this thread who reported pulse changes, most people with test anxiety in my experience have fewer manifestations. They most often just go blank. Or they find themselves fighting with an inner demon that makes them doubt everything they thought initially was the right answer. Or they get distracted, or become apathetic and start guessing rather than working things out, or don't read/misread the questions because their focus is on all the consequences of failure.

And I think (as you kind of suggested) very little of this occurs in real life but is not all that uncommon on standardized tests. Which is maybe an argument for more practical (on the job) versus standardized testing, because many of the people who are good standardized test takers really aren't better clinically (we all know them) -- we aren't really testing for and rewarding the right skillset, just the one easiest to test.
 
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~bleepbloop~

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I have probably taken about 60% of my finals sick because of the anxiety (extended amounts of cortisol can the lower immune system). What I noticed for me was that around finals I would drink a lot of coffee, and it would make my anxiety worse, and would in turn make my studying less effective...which would make my anxiety worse. So I don't drink coffee anymore. I also organized my calendar a bit to make sure I study every day and also to make sure that I also spent time reviewing things so that information is more likely to become a part of my long term memory (read a book about mnemonic devices and/or long-term memory like "How we learn and why it happens"). In my calendar, I made sure to also make time for personal/social needs, because those are important too. My suggestion would be to do something akin to a breathing exercise, developing a study routine, and maybe staying away from caffeine. And if the anxiety is hindering with you functioning normally, see a therapist/psychiatrist. But really do some more research because everyone is different.

http://apt.rcpsych.org/content/11/6/432
 
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