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Med School Graduation—the Final Exam

The author, third from left with Einstein classmates (from left) Alex Levine, Ryan Linzer, Daniel Mitchel, Sharon Lam, Niloo Sima (left to right).

I’m graduating from Einstein [next week], and as the day approaches, I like to recall how blessed I am to have the opportunity to become a physician. As medical students and M.D.s, we are privileged to learn about and participate in a profession that we love while getting the opportunity to help our communities.

Looking back, I’m certain many of my peers felt that the most stressful parts of medical school were the standardized exams we expected to excel at, though we sometimes fell short of our academic goals. We entered medical school primed to receive high scores; after all, the Medical College Admission Test scores played a huge role in our getting into medical school. That’s why, for those following in my footsteps, I’d like to share what I’ve learned about dealing with the stress of these exams. While such tests often open doors and provide opportunities, it is important to keep in mind that mediocre scores will not automatically harm your career prospects.  

Coping with Exam Expectations

Typically, we have sought to achieve testing success throughout our academic journeys. Just getting into medical school means setting incredibly high standards and expectations. For some students, this means overcoming structural barriers to higher exam performance. Once we arrive at medical school, we must adjust to the even higher expectations of our MD program.

We always want to achieve top grades. But the reality is that only some of us reach that level of exam success—and standardized curves have shown this to have been historically true. The goal should be excellence. But managing stress and its impact on our education is why I recommend adjusting expectations. Students shouldn’t sacrifice sanity and positive self-perception for the sake of a grade, especially once they realize that success itself, not the margin by which they achieve it, is what’s most important.

My epiphany came during my surgical clerkship—the most challenging six weeks of my medical school career. The long hours at the hospital were followed by even longer hours of studying for the National Board of Medical Examiners surgery subject exam, which was brutal. I thought that with all my hard work and sacrifice, I would surely get honors.

Well, that didn’t happen. I succeeded in passing the test, but not in the way I had hoped or expected. And you know what? It was okay. As time passed, I realized how small my disappointment was in the grand scheme of things. In retrospect, I was more disappointed in how I had neglected my health (eating whatever was easy and forgetting about the gym), while also brushing off my family, just so I could study harder. This experience taught me the limits of what I’m willing to give up. That’s a question all medical students must answer for themselves. We all must make sacrifices in our careers, but the sooner students learn their risk-to-benefit ratios, the happier they will be with their decisions. That’s why I advise new students to focus not just on their grades but also on the people who matter most to them.

Attitudes and Exams

Dealing with the stress of exams also requires adjusting one’s attitude. I learned that it is better to smile through my struggles, because the difficulties I experienced were temporary. The stress that comes from having to perform well on standardized exams or to meet other objective metrics is sometimes overwhelming. But it’s important for students to remember that they can monitor their responses to these stressors and seek help. You are not alone on this journey.

Additionally, many of those people offering support to students have invested a lot to help them take big exams. So rather than worrying about metrics, it’s important for students to concentrate on the human connections and practical insights they encounter through their clinical years at medical school. Time will pass, and unlike the clerkship grade you received two years ago, those interactions and relationships will stay with you forever. Focusing on the people you meet and the role you can play in your future patients’ lives will give you a reason to smile.

I want the next generation of students to know that as they pass through medical school, they should take pride in their contributions to their medical teams and the positive impact they’ll have on their communities. Despite what metrics of success such as Alpha Omega Alpha, United States Medical Licensing Examination Step scores, or where we match tell us, the greatest indicators of our success are who we are as physicians and as human beings. These exams aren’t easy, but you can handle them, whatever the outcome. So embrace the journey, learn from your mistakes, and focus on what matters most to you.

Jose is a Cuban immigrant and first-generation doctor. He is an incoming internal medicine resident at NYP-Columbia. He’s a simple man who loves trying new food, watching his Miami Heat team, and making his family proud. 

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