Behavioral treatment of debilitating test anxiety among medical students

This article presents and illustrates the behavioral treatment of medical students and physicians whose debilitating test anxiety was associated with their failure to pass the United States Medical Licensing Examination (USMLE) or a specialty board test. Seventy-two medical trainees were treated consecutively because of at least one failure to pass these professional examinations. Behavioral treatment focused on their anxiety, which resulted in the "dual deficits" of poor test preparation, poor test performance, or both. Treatment featured progressive muscle relaxation, systematic desensitization, the self-control triad, behavioral rehearsal, and a psychoeducational component. Ninety-three percent of the clients eventually passed the examination while in treatment. Pass rates for this group were substantially higher than the national average for repeat USMLE test takers. Limitations of this treatment method are that it seemed too elaborate for some medical trainees and was less effective with those who had difficulty evoking anxiety.