Test anxiety

[wrkndply]

I’ve been having pretty bad test anxiety leading up to my usmle step 3 exam. Any advice or resources to deal with this? I know it is irrational but the anxiety just consumes me in the days leading up to the exam.

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[BoardingDoc]

I’ve been having pretty bad test anxiety leading up to my usmle step 3 exam. Any advice or resources to deal with this? I know it is irrational but the anxiety just consumes me in the days leading up to the exam.

Did you have the same anxiety leading up to step 1 and 2? If so, do whatever worked for you those times. If not, stop worrying. Step 3 is literally the easiest test you are required to take to become a doctor.

 

[Apollyon]

There was an old saying about studying for these tests: "Step I, 2 months. Step II - 2 weeks. Step III - a #2 pencil".

 

[Chemist0157]

Take solace in knowing you have had to do much worse by that point. You can handle it if you have handled everything else.

 

[Slatches]

I’ve been having pretty bad test anxiety leading up to my usmle step 3 exam. Any advice or resources to deal with this? I know it is irrational but the anxiety just consumes me in the days leading up to the exam.

Do the nbme and pass that to boost your confidence. Oh, and make sure you know how to navigate the cases on day 2.

 

[Piebaldi]

I’ve been having pretty bad test anxiety leading up to my usmle step 3 exam. Any advice or resources to deal with this? I know it is irrational but the anxiety just consumes me in the days leading up to the exam.

I had the same issue, and I know of others who have had the same issue, with some people needing to take a few anxiolytics for a few days before the exam. Test taking anxiety has some irrationality but at the same time has some reasonable rationality as well (I was also consumed with anxiety for step 3, had a bad computer malfunction on test day - I hate prometric!, and ended up failing by a few points so I had to re-take). Passed on second attempt - I'm certainly not the typical so dont take me as an example - so the anxiety I guess had some rational and some irrational components. If you can I would get a prescription for a few days of anxiolytics to help. Best of luck!

 

[futuredo32]

I have the same issue. I barely passed all steps of the Comlex and had to take the psych boards 3x, the third time I got special accomodations for my generalized anxiety disorder. Maybe therapy and meds for the day of the exam?

 

[<L>]

I'm pretty sure I killed (or let die, I guess...I couldn't figure out what was wrong) one of my virtual patients on day 2, and I still passed with plenty of points to spare.

 

[Mass Effect]

Did telehealth for anxiety management worked for anyone?

Trying our medications like Valium and Xanax are good unless their effects are not exploited.

It just helps to curb sudden pangs of anxiety in which a person feels that he will just lose it! Feels like nervousness in arms and cold sweats. It is not a good feeling. But realize that after the test has been given, your brain still remembers all the codes that were fed in the brain during course preparation

I'm sorry, who are you? Because you're giving insanely bad advice. Benzos are the worst thing you can give while studying/testing.

 

[90sportsfan]

I think everyone has some level of test anxiety, so comfort in knowing that your not alone. Although, I have to admit that given the number of tests we take during medical school, the overall impact of the anxiety has diminished for me a lot. It's like the more you're exposed to something, the less scary it becomes. The fact that you've gotten all the way through medical school and steps 1 and 2, should give you the confidence to know you will get through step 3.

The worst thing about test anxiety is if it prevents you from being able to go to sleep because the less sleep you have, the harder it is to recall information. Also it becomes a snowball effect because you start thinking about the fact that you can't go to sleep, which further prevents you from going to sleep, and then you start thinking about how that will affect your performance.....

The best thing to do (at least for me) is to just completely calm and relax yourself the day before, so that you are at ease and can get a good night's sleep. If you get a good night's sleep, you will do fine. The anxiety's impact on your sleep the night before is what will mess you up.

 

[CalmAndCollected]

I will echo what people above have said. Step 3 is the easiest test of all the USMLE. If you were able to take the first two and do well, Step 3 will be a walk in the park.

 

[BoardingDoc]

I'm sorry, who are you? Because you're giving insanely bad advice. Benzos are the worst thing you can give while studying/testing.

What? How could taking an amnestic when you're specifically trying to remember things possibly go wrong?

 

[Mass Effect]

Fellow students have tried it in a minimal dose "not while" studying. But during the course of preparation. It depends on how a dose works for one and how for the other. It has a " masking" anxiety impact

As a board-certified psychiatrist, I am quite well aware of what benzos do. Do you have any evidence or expertise to back up your opinion?

 

[Piebaldi]

As a board-certified psychiatrist, I am quite well aware of what benzos do. As I asked earlier in this thread, what are your credentials and do you have any evidence to back up your opinion?

I am not a board certified psychiatrist, however, I will say that as. a fellow anxiety filled test taker, I have myself on occasion taken something like valium for a few days prior to a test to have a general sense of calm. yes however said that they are not a good idea in terms of memory building, but for those of us who have horrible anxiety for test taking, they do the job. hopefully the idea is that enough studying has been done prior and thtfacts and info is stored in longer term memory, so a few days of benzos are not going to be that impactful.

 

[Mass Effect]

I am not a board certified psychiatrist, however, I will say that as. a fellow anxiety filled test taker, I have myself on occasion taken something like valium for a few days prior to a test to have a general sense of calm. yes however said that they are not a good idea in terms of memory building, but for those of us who have horrible anxiety for test taking, they do the job. hopefully the idea is that enough studying has been done prior and thtfacts and info is stored in longer term memory, so a few days of benzos are not going to be that impactful.

They're not a good treatment for test anxiety, particularly for someone in med school where tests are pretty regular. If test anxiety is that bad, therapy is treatment of choice.

 

[Piebaldi]

They're not a good treatment for test anxiety, particularly for someone in med school where tests are pretty regular. If test anxiety is that bad, therapy is treatment of choice.

i'm talking about board exams in particular, not so much tests during med school- hey it worked for me, and i know several classmates who did things similarly. it's not great, but it took care of things at the time. and who has time or the resources for therapy during med school?
And not sure what therapy would do - everyone has a possibility of failing tests. it's not that irrational of a fear. i failed a board exam. passed on retake. it's not in my opinion something that therapy would help with. it's something that can - and does - happen. and can have serious consequences. therapy is better suited for irrational fears, or things that can be solved or that one has some control over.

 

[Mass Effect]

i'm talking about board exams in particular, not so much tests during med school- hey it worked for me, and i know several classmates who did things similarly. it's not great, but it took care of things at the time. and who has time or the resources for therapy during med school?
And not sure what therapy would do - everyone has a possibility of failing tests. it's not that irrational of a fear. i failed a board exam. passed on retake. it's not in my opinion something that therapy would help with. it's something that can - and does - happen. and can have serious consequences. therapy is better suited for irrational fears, or things that can be solved or that one has some control over.

Not sure why you think you need to tell me what therapy can be used for? It sounds like you don't understand what therapy is or that there are different types of therapy. There's specific therapy for test anxiety, in fact, and it has nothing to do with fighting "irrational fears." Who told you that nonsense?

It's also naive to think that at least a portion of your classmates in med school weren't in therapy or some sort. Those of us in psych often have at least a dozen or so med students on our panels.

 

[Piebaldi]

Not sure why you think you need to tell me what therapy can be used for? It sounds like you don't understand what therapy is or that there are different types of therapy. There's specific therapy for test anxiety, in fact, and it has nothing to do with fighting "irrational fears." Who told you that nonsense?

It's also naive to think that at least a portion of your classmates in med school weren't in therapy or some sort. Those of us in psych often have at least a dozen or so med students on our panels.

Educate me - what kind of therapy would be useful for test taking anxiety? I am not saying that no one in med school doesn't do therapy for test taking, i certainly don't know anyone who does, nor do i see how it would be helpful, but certainly open to understanding how it would be helpful for test taking anxiety

 

[Mass Effect]

Educate me - what kind of therapy would be useful for test taking anxiety? I am not saying that no one in med school doesn't do therapy for test taking, i certainly don't know anyone who does, nor do i see how it would be helpful, but certainly open to understanding how it would be helpful for test taking anxiety

APA PsycNet

psycnet.apa.org

 

[gutonc]

Getting faded at work because your job makes you anxious sounds like a great plan.

 

[Mass Effect]

It works for me as a minor tranquilizer because I am used to it. It is my personal experience along with fellow students who have been taking it for thesis preparations and stand up board speeches. How a person tolerates it also matters, I believe. Depending on age, dose tolerance, medical history, or contraindication with other medications. As for the expertise you mentioned, I am an Industrial Psychologist. People at the workplace also do consider taking the medication, especially new workers or internees, battling with anxiety, or having trouble sorting with new assignments.

And prescribing it for such purposes is what's led to the benzo addiction problem we have today.

 

[90sportsfan]

It works for me as a minor tranquilizer because I am used to it. It is my personal experience along with fellow students who have been taking it for thesis preparations and stand up board speeches. How a person tolerates it also matters, I believe. Depending on age, dose tolerance, medical history, or contraindication with other medications. As for the expertise you mentioned, I am an Industrial Psychologist. People at the workplace also do consider taking the medication, especially new workers or internees, battling with anxiety, or having trouble sorting with new assignments.

The challenge is finding a doc who will prescribe it to you. I don't think many PCPs or Psychiatrists are going to just prescribe you valium right before a test. You will be hard-pressed to convince one to, although it seems that you have found one who will (I wouldn't guess that this is common though) And an urgent care place definitely will not. They won't prescribe you a benzo if they are not going to be able to closely follow-up with you.

As mentioned, the biggest impact of anxiety is in the inability to go to sleep the night before. Going to sleep the night before is what will make or break your performance (test, speech). If your anxiety prevents you from getting to sleep, you could fail a test due to inability to recall information; whereas if you had a fresh 7-8 hours of sleep, you might ace that same test.

The impact of anxiety on sleep is a snowball effect because you start thinking about the fact that you can't fall asleep and you keep looking at the time on the clock ticking away (many times you also keep having to go to the bathroom), and that the more time passes (and less sleep you get), you know the worse you'll do, which makes it even worse. It starts to become mental and makes it almost impossible to go to sleep.

 

[clausewitz2]

The challenge is finding a doc who will prescribe it to you. I don't think many PCPs or Psychiatrists are going to just prescribe you valium right before a test. You will be hard-pressed to convince one to, although it seems that you have found one who will (I wouldn't guess that this is common though) And an urgent care place definitely will not. They won't prescribe you a benzo if they are not going to be able to closely follow-up with you.

As mentioned, the biggest impact of anxiety is in the inability to go to sleep the night before. Going to sleep the night before is what will make or break your performance (test, speech). If your anxiety prevents you from getting to sleep, you could fail a test due to inability to recall information; whereas if you had a fresh 7-8 hours of sleep, you might ace that same test.

The impact of anxiety on sleep is a snowball effect because you start thinking about the fact that you can't fall asleep and you keep looking at the time on the clock ticking away (many times you also keep having to go to the bathroom), and that the more time passes (and less sleep you get), you know the worse you'll do, which makes it even worse. It starts to become mental and makes it almost impossible to go to sleep.

The idea that you cannot function at all without getting a specific number of hours of sleep every night and that you should just lie in bed and try harder if you are not falling asleep are items on an instrument called the Dysfunctional Beliefs About Sleep scale. This should tell you something.

 

[90sportsfan]

The idea that you cannot function at all without getting a specific number of hours of sleep every night and that you should just lie in bed and try harder if you are not falling asleep are items on an instrument called the Dysfunctional Beliefs About Sleep scale. This should tell you something.

Never heard of this scale before. Also, I'm not talking about a specific number of hours of sleep every night. I'm talking about the night before a big test or similar important event. Also, the issue isn't that "you cannot function at all;" it's whether you will be at your optimal functioning capacity.

Would you rather take a big, important exam that involves recall a lot of information and critical thinking after having a solid 7-8 hours of sleep the night before or having no sleep (or a few hours of sleep)? I think the answer is obvious......

Have most of us at some point in our lives done well on a big exam with minimal sleep the night before? Probably yes. But the overall point is, getting a good night's sleep the night before a big exam puts you in a better position to be at your sharpest (and do better), and anxiety can impact your ability to get a good night's sleep the night before. That is the point I was making.

Is it still possible to do well and not get a good night's sleep? Of course. But I would prefer to be at my sharpest and have a good night's sleep the night before. I was just pointing out that for many people, anxiety can interfere with that, especially the night before.

 

[Raryn]

Would you advise someone to drink a few shots of tequila the night before a test? Or right before a test? Or during a test?

If the answer to those questions is no, you shouldn't advise them to take benzos in the same scenario. The effects are pretty damn similar.

 

[clausewitz2]

Never heard of this scale before. Also, I'm not talking about a specific number of hours of sleep every night. I'm talking about the night before a big test or similar important event. Also, the issue isn't that "you cannot function at all;" it's whether you will be at your optimal functioning capacity.

Would you rather take a big, important exam that involves recall a lot of information and critical thinking after having a solid 7-8 hours of sleep the night before or having no sleep (or a few hours of sleep)? I think the answer is obvious......

Have most of us at some point in our lives done well on a big exam with minimal sleep the night before? Probably yes. But the overall point is, getting a good night's sleep the night before a big exam puts you in a better position to be at your sharpest (and do better), and anxiety can impact your ability to get a good night's sleep the night before. That is the point I was making.

Is it still possible to do well and not get a good night's sleep? Of course. But I would prefer to be at my sharpest and have a good night's sleep the night before. I was just pointing out that for many people, anxiety can interfere with that, especially the night before.

That's all reasonable enough. "Going to sleep the night before will make or break your performance" sounds much more categorical.

 

[rokshana]

i'm talking about board exams in particular, not so much tests during med school- hey it worked for me, and i know several classmates who did things similarly. it's not great, but it took care of things at the time. and who has time or the resources for therapy during med school?
And not sure what therapy would do - everyone has a possibility of failing tests. it's not that irrational of a fear. i failed a board exam. passed on retake. it's not in my opinion something that therapy would help with. it's something that can - and does - happen. and can have serious consequences. therapy is better suited for irrational fears, or things that can be solved or that one has some control over.

Hear heroin can take care of things too... it’s not great, but...

 

[Piebaldi]

Hear heroin can take care of things too... it’s not great, but...

I thought you got banned?
You really are a toxic person. Why so angry?

 

[rokshana]

I thought you got banned?
You really are a toxic person. Why so angry?

I find it interesting that you feel that you can go toe to toe With a board certified psychiatrist and say your n of 1 of utilizing benzodiazepines for an inappropriate manner to be inappropriate... if you are going to advocate inappropriate use of a medication, then saying it’s the equivalent of recommending another inappropriate medication makes sense.

Your personal experiences and misappropriation of medications is not data... most of the veterans here know how you are, but don’t want the newer posters to think what you are saying about benzodiazepines to be true... a little hyperbolic, but...

 

[Piebaldi]

I find it interesting that you feel that you can go toe to toe With a board certified psychiatrist and say your n of 1 of utilizing benzodiazepines for an inappropriate manner to be inappropriate... if you are going to advocate inappropriate use of a medication, then saying it’s the equivalent of recommending another inappropriate medication makes sense.

Your personal experiences and misappropriation of medications is not data... most of the veterans here know how you are, but don’t want the newer posters to think what you are saying about benzodiazepines to be true... a little hyperbolic, but...

like i said - you are a toxic toxic human being. please don't ever respond to one of my posts again. keep your toxicity to yourself.

 

[rokshana]

like i said - you are a toxic toxic human being. please don't ever respond to one of my posts again. keep your toxicity to yourself.

There is an ignore button... you can use that.
But don’t want me to respond... don’t post.

Though I may have to ignore you for the sake of sanity...never even considered it with anyone, even crayola had the ability to listen and learn...even agree with her many times now...

 

[<L>]

i'm talking about board exams in particular, not so much tests during med school- hey it worked for me, and i know several classmates who did things similarly. it's not great, but it took care of things at the time. and who has time or the resources for therapy during med school?
And not sure what therapy would do - everyone has a possibility of failing tests. it's not that irrational of a fear. i failed a board exam. passed on retake. it's not in my opinion something that therapy would help with. it's something that can - and does - happen. and can have serious consequences. therapy is better suited for irrational fears, or things that can be solved or that one has some control over.

"But it works for me" is the refrain of every single patient I see in my office with a problem with prescribed controlled substances.

 

[Piebaldi]

"But it works for me" is the refrain of every single patient I see in my office with a problem with prescribed controlled substances.

^Rokshana IMG. It's a violation of the forum to have 2 handles you know.
Why don't you go bully the other posters in this thread? Why do you overprescribe meds to your patients with problems with controlled substances? You are part of the problem.

 

[rokshana]

"But it works for me" is the refrain of every single patient I see in my office with a problem with prescribed controlled substances.

And she is pain management too I believe.

 

[rokshana]

^Rokshana IMG. It's a violation of the forum to have 2 handles you know.
Why don't you go bully the other posters in this thread? Why do you overprescribe meds to your patients with problems with controlled substances? You are part of the problem.

Huh? What are you talking about?
And I’m an endocrinologist... thankfully the only controlled substance I prescribe is testosterone.

 

[Mass Effect]

There is an ignore button... you can use that.
But don’t want me to respond... don’t post.

Though I may have to ignore you for the sake of sanity...never even considered it with anyone, even crayola had the ability to listen and learn...even agree with her many times now...

What ever happened to @Crayola227 ?

 

[rokshana]

Continue overstepping over the line and making inappropriate suggestions (aka libel) and continue harassing me and I can assure you that the legalities against you will start. I won't warn you twice.

Isn’t that the fellowship you did? You make mention of it in your posts...

 

[rokshana]

What ever happened to @Crayola227 ?

She posts still , but not as frequently...she’s finished residency so I guess not as much time or interest

But it was nice to see her evolution over the years.

 

[Smurfette]

Let's get this thread back on topic please.

 

[VA Hopeful Dr]

Continue overstepping over the line and making inappropriate suggestions (aka libel) and continue harassing me and I can assure you that the legalities against you will start. I won't warn you twice.

Seriously? Legalities?

First, that's not even good English. Second, are you actually threatening someone on the Internet because they disagree with you?

 

[Mass Effect]

Seriously? Legalities?

First, that's not even good English. Second, are you actually threatening someone on the Internet because they disagree with you?

He even disliked my post for asking about Crayola. lol

Anyway, back on topic -- if you have test anxiety, see a professional. Therapy >>>>>>> benzos every time.

/endthread

 

[calvnandhobbs68]

Just be careful when you go to a doctor asking for benzos...you might not get what you bargained for

 

[dpmd]

Well that escalated quickly. As someone who gets anxious before tests but mostly nausea rather than other effects I find an anti emetic is all I need. I have heard other have good results with propranolol (I really ought to try that sometime for my public speaking anxiety). Thankully none of my anxieties are debilitating. Even without meds I might puke a bit and have diarrhea beforehand but once I start things tend to settle down.