The 4 stages of post-exam grieving

I made an enormous mistake today, and I wandered down a dark, ugly path. I saw it coming, and I did nothing to avoid it. I suppose it was fairly inevitable. To be fair, it would have taken extreme willpower and even courage in the face of peer pressure not to commit this mood-souring blunder.

After my infectious disease exam, today, I discussed my answers with a classmate.

Unless you're more laid back than I am or you're smarter than I am, discussing the exam only leads to heartache. It catalyzes the post-exam grieving experience. Without this nudge, you might have remained forever in the wonderful beginning-stage of ignorant bliss. True, there is a chance you are only prolonging the inevitable because, eventually, you will find out your grade. The truth is, however, that by that time you will probably be in a much calmer state. You will be better prepared to receive the news, good or bad, of how you performed on the test. It’s also true, however, that we’re all a bit obsessive compulsive in medical school. So, you can’t wait until then. You’ve gotta find out now.

And so, today, I discussed my exam with a friend, and I experienced the stages of post-exam grieving. You might have also experienced it. It goes like this:

Stage 1: Ignorant Bliss

First, you walk out of the exam feeling like you probably got all 122 questions right. It's hard to believe, but you feel there's a good chance you actually aced it. You have never aced a test in medical school, but you studied hard and this test might be the one. It’s incredible! You now face the difficult choice of studying for your next test or going home and celebrating.

However, a friend asks you about a question on the test. One thing leads to another, and you discuss all the questions you might have been a tad unsure about (but which, of course, you were originally sure you guessed correctly).

Stage 2: Disappointment, anger, and revenge

A short conversation and several minutes later, you are writhing about the stupid questions you missed and the incompetent professor who wrote them. You reflect, thoughtfully, that out of all the many professors who lectured you on this subject, all of the questions you know you missed came from just one of them. You start scheming about what you're going to say on the evaluation of that professor and dream about how your well-placed words will stick it to him. Your insightful comments will unmask both his lack of intelligence in addition to his ineptitude at teaching to the rest of the faculty and the administration. Surely, they must not know about this professor’s serious flaws; otherwise, he wouldn't be teaching. It's your chance to make a difference. Oh boy oh boy, time to funnel this disappointment into something that will benefit the rest of the student body and, perhaps, the world.

Stage 3: Mellowing out and acceptance

You begin to write the scathing aforementioned evaluation. But then, as you begin to write it, the feelings of anger and resentment start to fade away. Truthfully, you want them back. It felt good to be mad at the professor and to have an excuse for your shortcomings, to have an excuse for the fact that you studied some of the wrong things too long and some of the right things too little. But, writing it served the same outlet that exercise or music or a number of other venues would have served, and now you have released some of that negative energy and can only look to the future.

What's done is done, and you start to accept it. You accept that you didn't ace the test, you accept that you didn't get the highest score in the class, and you accept that other students who probably didn't work as hard as you did probably still did better than you. You accept the ugly principle of diminishing returns and agree than maybe you won’t study as much next time.

Then, you continue to move on.

Stage 4: Optimism

Your feelings morph from that of acceptance into the higher level of optimism. It’s not just true that there are other people in the class who did better than you, but it’s also true that you are certain you passed. Not only did you pass, but you’re still confident that you did pretty well. You’re not sure if it’s “AOA well”, but you don’t really care. You realize that you’ve learned a lot of things that will help you on your rotations, and you look forward to it. Looking forward to that day, you are reminded of the medical school Bohemian Rhapsody parody (see below) and can’t resist but hum along to yourself “grades don’t really matter… to meeeeeee”. You know what? Life is actually pretty good. You’re one step closer to being a doctor!!!

But, you’re still going to write that evaluation…



I am a medical student at BCM and all thoughts are my own. I am not a doctor. Please read the disclaimer.
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