Medical School - Clinical

7 Tips for Managing USMLE Test Anxiety (Before, During, and After the Exam!)

Medical school students perform best on their USMLE when they’re calm and confident. Learn how to manage your USMLE anxiety so you ace the board exams.

You’ve studied, you’ve taken the practice tests, and you know your stuff. You should be ready for the USMLE exam. Yet, you find yourself breaking into cold sweats and tossing and turning in bed over the potential outcomes of the exam. You’re trying to relax, but sometimes it feels like test anxiety is taking over your life.

There are loads of ways to manage your test anxiety before, during, and after your USMLE. Whether you work best when you feel strong and confident, or whether being comfortable and relaxed is the best way to soothe your pre-test anxiety, we’ve got you covered. 

Read on to learn the best tips for staying calm, cool, and collected and getting some shut-eye so you can get a great score and impress potential residencies.

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Before the Test

#1 – Build your stamina

If you’re not working on your stamina before the exam, you’re setting yourself up for burnout before the test is only half over! After all, the USMLE is a 9-hour-long testing session– longer than the average day at work or school and far more mentally taxing. 

To build your stamina, set up practice exams with friends that span the same duration as the USMLE. It probably won’t be fun, but the confidence and ability to succeed that you take away from these practices will be well worth the time.

#2 – Treat your body like a temple

You don’t need to start getting full body waxes and become a monk in the mountains. There are just a few main elements here that you need to focus on:

  • Sleep well
  • Eat nutritiously
  • Stay hydrated
  • Take vitamins
  • Limit caffeine and alcohol
  • Take time for exercise and meditation 

Your body will thank you, and so will your mind! Come test day, you’ll be glad you spent some weeks focusing on your health. Focus on a fulfilling self-care routine that makes you feel like you’re ready to take on the world.

#3 – Know what makes you comfortable & confident

This seems obvious, but you’d be surprised how many people think they need a coffee when they really need a chamomile tea. The reality is that people perform at their highest level differently. Some people need music, some need snacks, some need caffeine, some need a massage. Figure out how to make yourself comfortable so that you feel confident, and you’ll already be two steps ahead of everyone else in the room.

During the Test

#4 – Breathe 

There are so many breathing exercises that you can use to calm your racing heart and sharpen your mind during the USMLE exam. Here is a great article on some of the most popular breathing exercises, but when in doubt, remember box breathing

Box breathing is super simple to do and remember:

  1. Inhale for 4 seconds
  2. Hold for 4 seconds
  3. Exhale for 4 seconds
  4. Hold for 4 seconds

Repeat until your mind is calm. 

A box has four sides, and each “side” is four seconds, so this one is impossible to forget – even when you’re panicking.

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#5 – Be kind to yourself

Nobody knows everything about everything. Chances are, you’ll get some questions wrong, and that’s ok. Remind yourself of your strengths and how far you’ve come to get to this exam, and don’t let yourself get sucked down the rabbit hole of “should haves” or negative self-talk. 

It’s a tough test, and if you simply do your best, you’ve already succeeded. Being unkind to yourself will only hurt your chances of scoring well. 

#6 – Recognize when you need to refocus

If you’ve read the same question five times and it still just looks like a jumble of random letters, it’s time to refocus. Take a deep breath, do a round of box breathing, look up and focus on something else in the room, shake your head or roll your neck – and get your head back in the game. 

In Josh Waitzkin’s revolutionary book on mental and psychological performance, The Art of Learning, he describes how in high stakes chess competitions, he would sometimes leave the table to go to the bathroom or to go for a quick walk down the hallway and back. When he’d return to the table, he’d return refreshed and with his competitive edge restored. 

After The Test

#7 – Recognize what you have control over

For many students, waiting for the results may feel more difficult than actually taking the exam. The best way to combat your after-test anxiety is to realize that no matter what the results are, you will be just fine. Recognize what you have control over: after the test, you have no control over the results. What you can control is what you do with the time you spend waiting. Use it wisely, take care of yourself, and give yourself some grace. 

MedSchoolCoach Helps You Ace Your USMLE Exam

Test anxiety is a real thing, and the board exams are a major milestone in your education and future residency. Recognize and acknowledge your anxiety, and find ways to manage it before, during, and after the USMLE. 

If you need additional support to help you ace the boards, MedSchoolCoach offers professional USMLE tutoring services from tutors who scored 260+ on their own USMLEs and have mastered every facet of the exam. 

Schedule a free consultation and see how our USMLE tutoring services can help you. 

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Amber Kelm

Amber is a writer for She has more than 15 years' experience writing well-researched, engaging content that helps students achieve their dream of becoming a physician.

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