• Abdul Najeeb Khan
  • Sohail Ataur Rasool
  • Ambreen Sultan
  • Irum Tahira


Background: To assess examination related anxiety among first professional medical students and to determine the factors contributing to this kind of anxiety among them. Methods: A cross-sectional study using structured self-administered questionnaire was carried out over 10 days in Frontier Medical and Dental College, Abbottabad, in December 2012, using sample size of 200 students,. Survey questionnaire consisted of twenty questions regarding life style, study style, psychological and social problems, and results were analyzed by Visual Analogue Scale (VAS). Result: A total of 200 students out of 220 (90.90%) filled in the questionnaire. There were 61.50% male and 38.50% female students. The average maximum Examination related Anxiety marked on VAS was 47±21. Among different factors contributing to exam anxiety, inadequate rest (89%), irrational thoughts (67.50) and excessive course load (60%) were the most important factors reported by the students. Most of the students were aware of anxiety-reduction techniques but seldom implement them. Conclusion: On a VAS, examination, in its own right, has been established as a definite cause of anxiety, although the magnitude is not alarming. Students who regularly participate in class tests and perform well there, are least affected by this anxiety.Keywords: Anxiety, Visual analogue scale, inadequate rest


Merriam-Webster’s Collegiate® Dictionary, Eleventh Edition.

Tooth D, Tonge K, McManus IC. Anxiety and study methods in preclinical students: causal relation to examination performance. Med Educ 1989;23:416–21.

Parkerson GR Jr, Broadhead WE, Tse CK. The health status and life satisfaction of first year medical students. Acad Med 1990;65:586–8.

Acharya S. Factors affecting stress among Indian dental students. J Dent Educ 2003;67:1140–8.

Alexender DA, Haldane JD. Medical education: a student perspective. J Med Educ 1979;13:336–41.

Miller PM, Surtees PG. Psychological symptoms and their course in first year medical students as assessed by Interval General Health Questionnaire (I-GHQ). Br J Psychiatr 1991;159:199–207.

Vaz RF, Mbajiorgu EF, Acuda SW. A preliminary study of stress levels among first year medical students at the University of Zimbabwe. Cent Afr J Med 1998;44(9):214–9.

Malathi A, Damodaran A. Stress due to exams in medical students —role of yoga. Indian J Physiol Pharmacol 1999;43:218–24.

Bramness JA, Fixdal TC, Vaglum P. Effect of medical school stress on the mental health of medical students in early and late clinical curriculum. Acta Psychiatr Scand 1991;84:340–5.

Shapiro SL, Schwartzge, Bonner G. Effect of mindfullness-based stress reduction on medical and premedical students. J Behav Med 1998;21:581–99.

Saslow G. Psychiatric problems of medical students. J Med Edu 1956;31(1):27–33.

Helmers KF, Danoff D, Steinert Y, Leyton M, Young SN. Stress and depressed mood in medical students, law students and graduate students at McGill University. Acad Med 1997;72:708–14.

Verbuegge LM. Gender and health: an update on hypothesis and evidence. J Health Soc Behav 1985;26:156–82.

Rasor LT, Rasor RA. Test anxiety and study behavior of community college students in relation to ethnicity, gender, and age. Research Report by Community Colleges. 1998; Available at:

Toews JA, Lockyer JM, Dobson DJ, Simpson E, Brownell AK, Brenneis F, et al. Analysis of stress levels among medical students residents and graduate students at four Canadian school of medicine. Acad Med 1997;72:997–1002.

Shaikh BT, Kahloon A, Kazim M, Khalid H, Nawaz K, Khan N et al. Students, stress and coping strategies: a case of Pakistani medical school. Educ Health (Abingdon) 2004;17:346–53.

Verbuegge LM. Gender and health: an update on hypothesis and evidence. J Health Soc Behav 1985;26:156–82.

Hashmat S, Hashmat M, Amanullah F, Aziz S. Factors causing exam anxiety in medical students. J Pak Med Assoc 2008;58(4):167–70.

Rosal MC, Ockene IS, Ockene JK, Barrett SV, Ma Y, Hebert JR. A longitudinal study of students’ depression at one medical school. Acad Med 1997;72:542–6.

Frischenschlaqer O, Haidinqer G, Mitterauer L. Factors associated with academic success at Vienna Medical School:prospective survey. Croat Med J 2005;46:58–65.

Inam SN, Saquib A, Alam E. Prevalence of anxiety and depression among medical students of a private university. J Pak Med Assoc 2003;53(2):44–7.

Aktekin M, Karaman T, Senol YY, Erdem S, Erengin H, Akaydin M. Anxiety, depression and stressful life events among medical students: A prospective study in Antalya, Turkey. Med Educ 2001;35(1):12–7.