Education Lessons Nonfiction Observations

The Oral Exam (X).

Most of my postal mail consists of the following:

  • letters from various organizations and charities soliciting donations
  • letters from schools I have attended soliciting donations
  • recruitment postcards from random medical practices throughout the nation
  • letters from the AMA, requesting that I become a member (they send out at least one letter a month; I wish they’d stop already)
  • letters from the AMA, urging me to sign up for their life insurance and disability policy
  • various advertisements for restaurants, furniture, services, etc.

I continue to daydream about regular exchanges of handwritten letters with people. And it remains a daydream. (Three years later: The best way to get letters is to send letters.)

Correspondence from the American Board of Psychiatry and Neurology is uniform. The envelopes are always 8.5 by 5.5 inches. The logo for the board appears through the plastic window and the address is perfectly centered.

One evening about three weeks after I took the exam, I opened my mailbox and found a solitary letter waiting for me. The white envelope was 8.5 by 5.5 inches. It had heft; there were clearly several sheets of paper in there.

I flipped the letter over to view the sender: The American Board of Psychiatry and Neurology.

My hands immediately began to tremble and I felt a layer of sweat instantaneously form in my armpits.

I wanted to laugh at myself: This is not my usual reaction to mail. I, however, was unprepared to receive this letter. I wasn’t expecting it for another week! I wasn’t ready right now to deal with the prospect of having to take the exam over again, to go through the onerous task of setting up a future date, to resume studying again…

… but you don’t even know if you need to do all that yet.

I hurried into my apartment, silently willing my hands to stop shaking. The points of contact between my fingertips and the envelope were becoming soft; the moisture from my hands were warping the fibers of the paper.

After I turned the deadbolt on the door, I didn’t proceed the usual ritual of “coming home”:

  • toss mail onto table
  • take bag off of shoulder
  • take coat or jacket off, if wearing one, and hang it up
  • take shoes off
  • peel socks off and deposit into laundry basket
  • take lunch sack out of bag and put on kitchen counter
  • take water bottle out of bag and pour any remaining water into a tall tumbler
  • open mail

Instead, I stood in front of my desk, bag, coat, shoes, socks, and anxiety still on. The letter opener swiftly sliced the envelope open and my shaking fingers fished the papers out.

Please say I passed, please say I passed,” I murmured to myself.

Call me weird, but I wanted to remember that moment: Just then, anything was still possible: I didn’t yet know if I passed. I didn’t yet know if I had failed. It was a branch in the decision tree: This bit of knowledge would significantly affect my future behaviors.

(This is called the illusion of control.)

I unfolded the paper and my eyes jumped straight to the word “congratulations”.

A smile spread across my face.

The rest of the letter announced my status as a diplomate of the American Board of Psychiatry and Neurology, that I would be receiving a document attesting this in a few months, blah blah blah.

“Thank God!” I exclaimed.

Relief. A lot of it.

So what advice do I have for other people taking major exams, whether in medicine or not?

  • Learn the content of the exam. You’ve got to know the information that the exam will present. Usually, you already have a sense as to what study strategies work best for you. If you know that you do better with a study schedule, make one up and stick to it. If you know that you study better with other people, set up a study group. If you know that you need a lot of pressure before you’ll get to work, make sure that you have sufficient time nonetheless to get all the information into your head.
  • Learn the format of the exam. If you know how the exam will be administered, that will reduce your anxiety. Should your exam involve interactions with other human beings, this knowledge will also help you appear more calm and confident.
  • Practice. Do practice questions. Do practice exams. When you study, go about it in a way that mimics the actual exam (e.g. talk out loud if it is an oral exam; use a computer if it is a computerized exam; etc.).
  • Spend time on anxiety management. No one wants their emotions to sabotage their efforts. Figure out what works for you to remain (relatively) calm. You will feel anxious and it is up to you to figure out how to keep all of that at bay during the actual event. Whether this means breathing exercises or reciting affirmations or wearing an amulet that you can rub or whatever, have a plan as to how you will manage stress. It’s important.
  • Reward yourself for your efforts. Treat yourself to something you enjoy both before and after the exam. There is more to life than the exam (though it may not seem like it) and engaging in those little pleasantries in life will help remind you that you are more than just a Test Taker.
  • Let go after the exam is done. Easier to say than it is to do. Obsessing over the exam when you can’t do anything about it is draining. Figure out methods to sufficiently distract yourself so you don’t fall victim to your anxieties. (This could easily fall under “anxiety management”).