One of the biggest obstacles to getting through PA school or passing your PANRE is anxiety. Seth Godin talks about the “lizard brain.” Steven Pressfield calls it “the resistance.” Either way it’s the portion of your brain that is in charge of your fear and your sex drive. The lizard brain wants nothing more than for you to be safe, and it wants it desperately. It will use every trick to keep you from moving forward in order to keep you safe. It is the voice saying that you are not smart enough and not good enough. That voice is trying to keep you from doing something it perceives as dangerous.
The Evidence
The lizard brain will tell you that you are not a good test taker and never have been. It will list every piece of evidence it can find to make its case. It can be extremely convincing.
- “In the fourth grade, Mrs. Crabtree took off a point on a test because your minus sign was crooked. You must be bad at taking tests.”
- “In 8th grade you studied really hard for a test and only got an 89%. This must mean you’re not good enough.”
- You haven’t studied enough.
- Pretty much everyone is smarter than you
- A computer exam? You can’t even work a computer
The lizard brain will use all of this as evidence to convince you that you’re not capable, that you’re not a good test taker and that you should stay home where it’s safe. That’s really the goal of the lizard brain. Keep your head down. Stay safe.
The lizard brain knows that if you hide under your bed everything will be ok. No one will find you there, you will be safe. In fact, if you can hide under your blankets, under your bed that would be even better. You would definitely be safe there.
The ancient battle continues
The lizard brain is responsible for more exam failures than any other single factor I’ve been able to find. The good news is that you wouldn’t have come this far if you didn’t already know how to fight it. You fought it when you applied to PA school and you fought it at interviews. You fought it on first dates and when your filled out your PA school applications. You’ve fought it from behind a podium and at an 8th grade dance. You haven’t necessarily won all of these fights, but you have fought the lizard brain thousands of times.
Many students complain of suffering from “test anxiety.” I don’t believe in test anxiety. I believe people put themselves into situations that they haven’t prepared for and then are terrified when they try to perform in those situations. That doesn’t mean you haven’t been successful in the past, but it’s a lot like Indiana Jones diving under a closing stone door while being chased by spear wielding aborigines. Yes he may escape with the treasure, but only just barely — and it’s so terrifying that you never want to do it again.
You need to go into your exam well prepared. Prepared with medical knowledge of course, but just as important you need to be prepared to fight the lizard brain.
Most people have a few tricks they’ve developed over the years to fight the lizard brain, but these are usually inadequate. You can easily be surprised and overwhelmed by the size and strength of the lizard brain as the PANCE approaches. It grows from a tiny squeaky voice months before, into a huge green fire breathing dragon on the day of the exam. Students often walk in on test day and try to use willpower to overcome thousands of years of evolution telling them to run screaming from the building. This plan hasn’t worked well for them in the past and that was usually against the tiny version of the lizard brain. Fighting this dragon now becomes the focus and the medical knowledge is a distant second.
Step one
Giving the lizard brain a name is step one. Call the resistance what it is removes some of it’s power. Test anxiety sounds scary, but the lizard brain could really care less about the exam. The lizard brain is afraid that you will be killed, maimed or otherwise so damaged that you will be unable to reproduce. So far even in the worst case scenarios, I have never heard of anyone dying during the exam. No matter what you will live. If you can stop and think and breath most of the fear is really silly.
Passing the PANCE is easy. Defeating the lizard brain is hard. You need to prepare for both opponents, the test and the resistance.