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Stress at Exam Time, (the S word)

October 15, 2014

Stressed about Exams?

Staying on top

Most subject lecturers use a mix of assessment methods these days. You need to know accurately what these are in order to allocate your time smartly.  You can cruise to exam time with 30% already achieved and much less stress.  If its too late for that, then read on.

Studying smart

Don’t skip that last lecture when the lecturer gives you big hints about the exam. The course content is always too much to cover in a few hours. Get opinions from trusted smart students about which topics are most likely and take a look at past papers.

Study planner

Make a day by day plan for the 2 weeks before the exams. Include a night or day off in it.  Stick it on your wall and cross off bits as you achieve them.  Include in it some mixed methods such as group study, but only if it benefits you too.  There are some friends you may need to hide from as they prefer to suck you into their stress whirlpool with no useful outcome.  Schedule into your planner SLEEP, EAT, and EXERCISE. Ignoring these three things will result in ineffective and inefficient study…. being at your desk but not being there…a complete waste of time. Schedule a 5-10 minute break from the computer every hour.

Sunshine and exercise 

You can do these together. There is increasing evidence that the increased oxygen to your brain during 30 minutes of exercise will really help it to buzz for the following hour. (Make use of that at your desk and defer the shower for a bit!)  For the same reason, exercise being a stimulant, it is not a good idea to do it too close to bed-time.


Even those people who think they can get by on 4 hours sleep, perform much better on testing (concentration, memory and decision making) if they get 7-9 hours a night. There will be times when this just isn’t possible, but what you should not do, and what our doctors see all the time, is students who turn night into day. This sets up a vicious cycle that they try to break with downers (sleeping pills) and uppers (caffeine etc). This situation will definitely impair your brain function.

Set a time for going to bed and for waking up.

Don’t sleep during the day.

Smiling Mind 

Everyone is subject to stressors. “Stress” is not a medical condition and you won’t find many doctors happy to write it on a Medical Certificate, otherwise everyone in the world would get one! Anxiety is an abnormal response to stressors. Once out of control, a person’s autonomic nervous system kicks in. The pulse races and adrenaline enables you to run fast for your life. The trouble is that won’t help get you through two weeks of swot vac. You will lie awake at night watching your mind chase itself round in circles.  If this is happening to you, there are a lot of self-help programmes available. The types of medicines doctors prescribe for long term anxiety conditions take many weeks to work and side effects to navigate though.  The medicines used occasionally for the relief of severe immediate anxiety won’t do your brain function any favours.  If you think this is happening to you, you could try learning some mindfulness and relaxation techniques.


If you are struggling with anxiety early in your Uni course, get help from the University counselors sooner rather that later. 


You can include in this caffeine, cigarettes (nicotine and cannabis) alcohol and sugar. 

So how much caffeine is too much? 

Coffee is useful for alertness and up to 400mg a day is pretty safe.  This is about 4 Café coffees, 6 instant coffees or black teas, or 2 high-energy drinks.  Remember that the effect may peak several hours after the drink so avoid it late in the evening. Some individuals are susceptible to much lower caffeine doses. In excess, symptoms such as insomnia, irritability, fast pulse, high blood pressure and stomach irritation will occur.  Cigarettes and alcohol also cause stomach irritation, as do headache tablets such as aspirin and nurofen. Mixing these is a recipe for gastritis where the lining of the stomach starts to break down causing severe upper abdominal pain. Make sure you have extra water and if you need to cut back on caffeine drinks, do it gradually by alternating with decaf coffee or green tea. 

Sugary snacks and junk food which hit the blood stream quickly usually make your blood sugar take a dive an hour or two later. This will make you sleepy. It is smarter to snack on more complex carbohydrates and proteins such as hikers’ trail mixes of fruit and nuts.


In Chinese as well as Western medicine, unfavourable eating habits include skipping breakfast, eating too quickly, eating too late at night and suddenly changing your diet. The last thing you need when you are busy studying is to spend time trying to see a doctor. Irregular meals, too much caffeine, smoking and certain headache tablets often create a perfect storm for the lining of the stomach.  The other stomach problem we see a lot at exam time is gastroenteritis.  You may think you are saving time be eating take-away and left overs during swot-vac, but you are taking a risk with food hygiene. You can lose several days being ill with vomiting and diarrhoea. If you need to eat out more, choose somewhere they stir-fry fresh ingredients in front of you. Eat more fruit and vegetables and avoid the trap of heavy carbohydrate meals that will make you fat and sleepy as well as stressed.

Sitting position

If you are staring at a computer or hunched over a book for hours on end, be aware of the position of your neck, shoulders and back.  Put your lap-top on some books to get it at eye level and have walk-away breaks every hour. It can be very difficult to settle muscle spasms once they have occurred.

Sick certificates

So, hopefully, all the tips above have worked for you and you are ready to rock up to your exam in a moderately good frame of mind.  You will get a good sleep the night before, have your bag prepared with all the bits and pieces you will need…spare calculator batteries, water, layers of clothing for best temperature control and you will ARRIVE EARLY after a meal of fruit and proteins.   Avoid your stress-head chatty friends and maybe do a mindfulness exercise quietly somewhere.  In reading time you will read the instructions twice even three times, divide your time and start with what you know best. 

If, mid-exam you start to panic or go blank, ask the invigilator for a toilet break to clear your mind and try again.

If you were not able to complete the exam, or were sick in the immediate lead up to it, or you couldn’t get to the exam because of a health problem, you will need a Medical Certificate.  The doctor seeing you needs to see you at the time you are sick and needs to know exactly the nature of your illness or health issue. They are not obliged to write a certificate if they don’t believe you were genuinely unwell.  


Dr Maggie Phillips

Dr Maggie Phillips has over thiry years experience as a General Practitioner and has a broad clinical skill base including significant expertise in the discipline of Travel Medicine.

Full professional biography