Pass-fail in medical school. But the stress remains.

Greetings from the library. I’m writing to you through caffeine jitters, wrapped in a scarf that doubles as a blanket. I’ve marked my territory with my things: several Apple products, remnants of oatmeal in a mason jar, a sketchbook exhibiting my best attempt drawing the inside of a skull, and the most-essential item: my planner, detailing all the tasks I now avoid.

I’m in the midst of my first round of medical school finals and, as you may have guessed, I’m a little stressed.

Stress and I go way back. I remember bursting into tears as an eight-year-old, worried about an upcoming math test. I cried and cried, until my parents sent me to bed, promising that they’d wake me up early to review my multiplication tables. I have no recollection of how I did on that test, but I like to imagine that acing my third-grade exam was the first time stress paid off.

While I haven’t polled every first-year Stanford med or physician-assistant student, I would hazard to guess that most of my peers have a long-lived love-hate relationship with stress. Most of us made it this far by juggling a dozen tasks at a time, which is impossible to do gracefully. I’d bet that every single one of my classmates has, at one point in time, cried in a library, screamed into a pillow, fought with a loved one without reason, or had nightmares about exams. I personally have experienced all of the above and, while I’m not always proud of my response to stress, I also know how good stress has been for me.

Stress accompanied me on blistering Chicago-winter nights as I dragged my double-socked feet to the library. Stress supported me when, upon bombing my first attempt at the MCAT, I had to tend to my wounded ego and start the whole process over again. Stress propelled me through job presentations, medical school applications, and interviews. It got me here. And now that I’m here, I’ve been advised to let it go.

“You should really relax into the pass/fail mentality. There’s no need to stress.”

This is a common refrain from upperclassman, trying to calm down nervous first-years. “OK,” I say. But how, after decades of experiencing and even embracing stress, are we just supposed to reject it overnight?

I would argue that we shouldn’t. Although the rewards of an “A” no longer exists, there is a far more important end goal. My fellow students and I aren’t cramming knowledge into our brains just to do well on tests; we cram to do well so that we can learn how to care for patients. Patients won’t hand us multiple choice exams, and they won’t reward us with grades. Rather, they’ll assess our ability to listen, to diagnose, and to treat their illnesses. So although we are no longer being graded, the stakes of our education have never been higher.

With these new stakes, I don’t intend to leave my old friend, stress, behind. Instead, I’ll work to approach our relationship differently. While it might be acceptable to bite my nails or shed a few tears when studying alone in a cubicle, those tactics won’t work in front patients; I’ll need to find new ways to express and cope with the inevitable challenges of becoming and being a physician.

And so, I’m starting now, in the library, with this little study break. Writing through it, I’m ready to return to the books clearheaded, carrying a little less stress as I go.

Orly Farber is a medical student who blogs at Scope, where this article originally appeared.

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