EXAMINATION-INDUCED ANXIETY AMONG MEDICAL STUDENTS: A REPEATED-MEASURES STUDY USING THE HAMILTON ANXIETY RATING SCALE

ABSTRACT OBJECTIVES To evaluate changes in examination-related anxiety before and during examinations among first- and second-year MBBS female students using the Hamilton Anxiety Rating Scale (HAM-A). METHODOLOGY A repeated-measures observational study was conducted at the Department of Physiology, Peoples University of Medical and Health Sciences for Women, Shaheed Benazir Abad, from April to October 2020. A total of 110 healthy first- and second-year MBBS students were recruited using non-probability convenience sampling. Anxiety levels were assessed using the HAM-A questionnaire two weeks before examinations and again during the examination period. Paired t-tests were used to compare pre- and during-exam anxiety within groups, and independent t-tests were used to compare first- and second-year students. RESULTS First-year students demonstrated a significant increase in anxiety during examinations (17.16±10.62) compared with before examinations (8.00±9.15; p<0.001). Second-year students also showed a significant increase (12.96±9.28 vs 8.05±7.68; p<0.001), but their anxiety levels remained significantly lower than those of first-year students during examinations (p<0.01). Most HAM-A symptom domains, including anxious mood, tension, insomnia, autonomic symptoms, and somatic complaints, worsened significantly during the examination period, particularly in first-year students. CONCLUSION Examinations are associated with a marked escalation of anxiety symptoms among medical students, with first-year students being particularly vulnerable. These findings emphasize the need for structured psychological support and stress-management interventions during the early phase of medical education.