Please don’t ask about my test scores, Mom

Being a medical student in a family that does not have any doctors, honestly, has many perks. Although I may not have all the experience a tenured physician has in diagnostics and clinical management, I recognize the importance my current exposures in medicine give me in addressing the concerns of my family members. While answers may not always come to me immediately when I’m asked things like, “Son, why am I being prescribed this blood pressure drug?” My comfort with utilizing trusted, updated medical information sources such as UpToDate helps out a great deal. I am joyful knowing that I am able to help alleviate any family members’ questions, even though my answers often end with: “Please go see your doctor.”

Many families are proud of their medical students — mine is no exception. As much as I love answering questions about medicine and medical school from loved ones, though, there is one question that continues to make me weary.

That question is this: “How did you score on your test, Casey?”

Results published from a survey subjected to nine medical schools across the state of Florida in 2018 showed that nearly one-third of students cited “performance pressure” (e.g., test scores, class rankings) as a “major stressor” associated with depression and burnout. This correlates to a study of students in four Southeastern U.S. allopathic medical schools published in 2012. The authors of the latter study reported that the greatest stressors perceived by first- and second-year medical students were “pressures at school,” while “competitiveness for residency” was most stressful for third-year medical students. (Note that both of these stressors are heavily impacted by academic performance.)

Please do not get me wrong — stress is a vital component in promoting individual growth and should be embraced. Learning how to foster appropriate coping mechanisms to stress (e.g., exercising, communicating, etc.), while put under intense training conditions, can help medical students develop resiliency and better qualities of life. Families, then, tend to be essential resources for helping us as students develop the work ethics and coping mechanisms needed to persevere through medical school (and beyond).

However, unless we initiate a conversation about our test scores and/or class percentiles (i.e., out of excitement or to ask for help), we tend to appreciate not talking about them. We spend great amounts of time conversing with our medical school peers and faculty about topics like these that any time we can have throughout the week to give it a rest is a relief. Further talking about these subjects during private conversation or in full-fledged familial gatherings against our initiation can potentiate the stress we already feel to perform at academically high levels.

Our test scores do act as important reflections of our abilities as students to retain and apply medical knowledge sufficient for becoming practicing physicians. But more importantly, our test scores do not — or, rather, should not — define who we are as medical students and the types of careers we wish to fulfill as practicing physicians.

No matter how good or bad our scores may be relative to our peers, as long as we work hard, passing each course and exam we take, we (and our loved ones) ought to know that we do have what it takes to be called an “MD” or “DO.” Yes, this is not to say our scores (both in our coursework and on our board exams) can help us match into one residency/specialty versus another. With both the USMLE Step 1 and COMLEX Level 1 moving to pass/fail scoring system beginning during the 2022-2023 testing cycle, more emphasis is being put towards the connections we make in school and the dedication we show towards our aspiring specialties.

This move by both national board examination committees validates the need for everyone involved in medical education, including our families who support us, to continue addressing the well-being of us — the students. Whether this updated pass/fail system puts future students in better headspaces during their early medical school years will be known in time.

While I understand that various families and cultures may view medical school in different ways, the dedication we, as students, must put towards our studies is relatively similar and must be honored. This includes not provoking unwanted conversation regarding our tests and coursework.

In families that have a doctor (or doctors), this may be more understandable. In families that do not, however, please be patient and keep your minds open towards giving us the freedoms we need to complete our studies without dwelling on them (especially while we prepare for our board exams, especially during the COVID-19 pandemic).

As I am pursuing to become the first medical doctor in my family, alongside many of my classmates and other students who are venturing the same, the discrepancies explained above are from observations of both my feelings and theirs.

Continue to support your medical student son(s) and/or daughter(s) because we cannot do it without you. But, please, be careful when asking about our test scores.