What Causes Your Test Anxiety?

If you are like most test-anxious medical students, your anxiety results from several common causes:

  1. Being afraid that you won‘t live up to the expectations of important people in your life; worrying that you will lose the affection of people you care about if you don‘t succeed
  2. Believing grades are an estimation of your personal worth
  3. Placing too much emphasis on a single test
  4. Giving in to guilt feelings or anxiety as a result of inadequate preparation for tests
  5. Feeling helpless, believing that you have no control over your performance or grades


Many students’ perceptions of what  others expect are inaccurate. If you worry that you will alienate people you care about unless you do well, you may become fearful and anxious that you will disappoint them or make them angry. If you believe that you can‘t live up to the expectations of others, tests may make you especially anxious.

Grades and Self-Esteem

Failing a test or getting a low score for some students translates into “I’m stupid” or “I don’t have what it takes to be a physician” material. These feelings may lead to a loss of self-esteem and more anxiety. One real value of testing is that it gives you an opportunity to find out what information you understand well enough to associate with material that you will learn later. Before your next exam, you can give this material a quick review. Mistakes on a test pinpoint areas that you need to study more thoroughly for the next exam.

Feelings of Helplessness

If you have an external locus of control, you may not see the connection between study and grades. You may become anxious because you cannot predict the outcome of a test. Even if your locus of control is internal, you may feel temporarily helpless in a testing situation when you know you have not studied enough. Feeling guilty for not meeting your responsibilities may cause you to experience test anxiety.

Once you have identified the cause of your test anxiety, you can take steps to eliminate it.

Test Anxiety: Causes and Eliminators

Causes Eliminators
Trying to meet other people's expectations Decide whether living up to these expectations is something you want to do for yourself. Set your own goals and live up to your own expectations.
Fearing loss of affection Understand that people like you and value your presence in their lives for many reasons, none of which is the grade you made on  a test.
Letting grades determine your self-worth Realize that a grade is only an approximate measure of your performance. Grades have nothing to do with you as a person but are a helpful guide to what you need to review.
Placing excessive emphasis on a single test Your course grade may include, in addition to tests, TBL quizzes, self-reflection papers, presentations, lab reports, and class participation. Keep up with the material as if you must take a major test every week to demonstrate what you are learning and how to apply information.
Giving in to guilt or anxiety due to lack of preparation Medical school requires a commitment of time and money. If you are truly well prepared, you will forgive yourself for a few mistakes due to stress or anxiety. If you do feel guilty, it may be because you have not really done your best to make medical school a priority and focus in your life.
Underpreparing and "going blank" The purpose of tests and exams is: (1) to evaluate your retention of course material and (2) to apply the information to demonstrate understanding or to solve new problems. Failing to properly prepare and doing poorly on the exam becomes a self-perpetuating cycle of low effort leading to low grades.
Feeling helpless, with no control over what happens Take charge by developing an internal locus of control. Improve your study habits. Prepare for your next test, starting NOW. Observe the connection between the amount and quality of your studying and the grade you earn.