“What is the topic we need to discuss when it comes to medical students’ wellbeing?” I asked my classmates.
“Approaching exams, at what point do we say our knowledge is ‘good enough,’” said one.
“Perfectionism when learning in a broad and deep subject area. Comparing ourselves to peers.”
Is that three topics, or one?
Exams put pressure on medical students, and pressure brings out our flaws. Because entrance requirements favour students with an excellent track record in exams, many medical students have high expectations to live up to. Many have never failed. Fear of failure motivates many of us to study until we burnout, to isolate ourselves from our peers (the competition), and to feel like our self worth, based on achievements, is slipping down in value.
Though you might catch me daydreaming about a parallel universe where I don’t need to take exams for the rest of my life, I recognise that exams are necessary. For the sake of patients, we need to show that we have sufficient knowledge and skill to be safe doctors—not only at graduation, but throughout our careers.
If only we could take exams without the drawbacks. Having seen some of my peers unwind in their attitudes towards exams—while others spiral into ever more disciplined suffering—I believe that there are steps we can take towards better wellbeing in exam seasons.
Some steps happen at a structural level. When Cambridge Clinical School decided to update its pathology exam, infamous amongst student for its high volume and niche content, the faculty saw an opportunity to integrate student feedback. Since 2016, the assessment of clinically-relevant pathology has been spread over several exams, with all questions framed in clinical scenarios. On top of this, examiners now deliver optional “Demystifying assessments” talks and Q&A sessions in each year of clinical school.
Some steps happen at an interpersonal and individual level. Could we be more cooperative, rather than competitive? Could we embrace the uncertainty that comes with a lack of syllabus? Could we find worth in “good enough” and not only “best”?
I invite you to join me to discuss this topic and share ideas in a Twitter chat hosted by The BMJ (@bmj_latest). Students and doctors, join in using the hashtag #BMJDebate. Between 20:00 and 21:00 (BST) on Monday 13th May, I will be online as @StudentBMJ, taking your answers to the following questions and discussing the topic of medical school exams and wellbeing:
- How do exams affect your wellbeing?
- Do perfectionism and competitiveness lead to success?
- Have you failed an exam? What was it like, and what happened next?
- Do you have any tips/examples of revision techniques that have improved your wellbeing?
- Could medical schools do more to support students during exam periods? Any examples of good practice?
And at 17:00 (BST) on Friday 17th May, I am meeting up with a doctor and a student to take these questions further. I will be joined by intensive care consultant and OnExamination’s lead clinical editor Matt Morgan, and medical student, Youtuber, and Sharp Scratch podcaster Ryhan Hussain, to discuss exams and medical student wellbeing, live on Facebook.
If you’re preparing for exams right now, that’s two revision breaks to look forward to.
Laura Nunez-Mulder is BMJ Editorial scholar
|The Twitter chat and Facebook Live are part of The BMJ’s Wellbeing campaign, a campaign calling for doctors to be able to take the breaks that they need for their wellbeing and for patient safety.
You can take part in the campaign by sharing your examples of where things are changing for the better or where more work needs to be done through social media using #giveusabreak.