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During the exam, a student should be calm and as cool as possible. Experts tells that during the exam, emotions and worriedness are the stumbling blocks. Doing well on the exam is not just about knowing, but being able to make decisions more fundamentally. Answering the each presented question requires to understand what is being presented, what is most important and therefore, what must be done.

The fact is that the exam brings strong emotions. Without emotion, no decision would ever get made. The key to successful decisions is having the right emotional reactions. Making the best use of your emotional reactions in the exam has a great deal to do with your final outcome.

How Emotions works during the Exam:

All choices involve emotion.

The inner sense you have that one option is better than another is the result of the emotional valence you give to each option. Options which trigger our most positive reactions are the ones we end up choosing. A strong positive valance makes us comfortable with our choice and a negative valence tells us what to avoid.

Emotion is the voice of experience, whispering in our ear and pushing us towards a particular option. Our emotional responses both frame our choices and guide us what action to take within that frame. This means that emotions are the essential guide helping you to a better USMLE result if properly attuned. They are also the culprit that holds you back if they are out of tune.

Control your Anxiety

When first thinking about the USMLE or any other standardized exam, most people think about “test anxiety”. If you have high anxiety it is hard to concentrate on answering the questions. So if you can’t focus properly, it is almost impossible to apply all of the knowledge you have learned.

For people who suffer from test anxiety, the entire exam becomes a strong negative valance to them. This diverts their mind from the questions and not to be engaged in the options that facilitates choice. The details of options may not even be seen and any positive valences they carry are swept away in the test anxiety flood.

Sources of Choices:

The valences we give options presented on an exam can come from a number of different sources.

Familiarity: We feel more positive about something we have seen before. If you look down over a set of presented options and recognize something you have studied, that recognition provides a positive valence inducing a desire to select that option.

Availability: Associations which come quickly to mind require less effort, simplify our world, and give us a more positive feeling. Everything we encounter triggers association within us. Those associations which come most readily to mind are likely to be more dominant, carry the most positive valences.

Don’t fear, be Confident:

When you are well prepared, you are confident. When you are not well prepared, you fear. It’s really as simple as that. Think about your preparation for the USMLE as essentially a contest between fear and confidence:

Fear is aversive. It leads to thoughts of escape. In the face of fear we do not want to engage and solve, but disengage and run. Fear drives us to act, but drive out rational cognitive analysis at the same time. Due to fear, we seek to get an answer in order to get rid of the question. And our whole motive changes from getting the great score to simply getting rid of the bad feeling.

Confidence is positive. When we are confident a problem is not a burden, but something which energizes us as we seek to understand and to master. From this perspective, each question becomes a challenge and our goal is transformed from avoidance to one of mastery. It takes the first step to success by assuming that we will succeed.

Medical School vs USMLE:

The USMLE is both more comprehensive and more integrated than the exams you faced in medical school. The set of material to be tested is vast and taken from a variety of sources. The presentation of that material is often unique to the test-takers experience.

Each USMLE question presents a set of information scattered through the question stem like the pieces of a puzzle. The student’s cognitive task is to gather these pieces, assemble them to solve the puzzle, and then, in a flash of insight, recognize the picture provided. To select the best answer, the valances of the options must come from the clues provided in the question stem.

Unlike many medical school exams where the emotional response to the options guides the student to answer, on the USMLE, the question sets the frame, both cognitively and emotionally. The value of each presented option is determined by the context of the question stem.


Can you handle this exam? The fact is that of course you can. Perhaps you have not done everything right or perfectly in your entire career – that does not matter. No one expects perfection. All anyone expect is for you to be the physician you are. A physician does not walk into the examination room with fear and trepidation, but with confidence. Each patient is not a problem. The patient is your job. Tending to the patient is your calling.

You learn this new process by practice. Doing practice questions helps to assess your knowledge level, but also offers an arena for you to develop an approach to questions that is more likely to lead to the best USMLE answers. Take the time to get the process right. Getting the right source of emotional valence on your USMLE questions will lead you to the ultimate emotional valence we call success.

The content is taken and reposted from THE PINNACLE from BECKER