Review estimates test anxiety in nearly half of medical students
The pooled estimate varied widely across studies, partly because researchers used different assessment tools and study procedures.
High evidenceReviewSome caution advised
Medical disclaimer: This article summarizes research findings and is for informational purposes only. It is not medical advice.
Editorial illustration — not from the study.
Researchers combined published studies that measured test anxiety among medical students and reported a prevalence estimate. Across the studies, about half of the students were classified as having test anxiety, although the estimates differed substantially between studies.
The analysis found that the assessment tool was the only subgroup factor with a statistically significant effect on prevalence. Differences by gender, year of study, region, timing of assessment, and sampling method were reported as numerical patterns, but the abstract does not establish that these factors caused differences in test anxiety.
What the review examined
The researchers conducted a systematic review and meta-analysis of studies measuring test anxiety among medical students. They searched PubMed, Scopus, Embase, and Web of Science in March 2026 and also checked citations. Thirty-five studies involving 13,489 medical students were included. The researchers used a random-effects statistical model, examined several subgroups, and assessed study quality using an adapted Newcastle-Ottawa Scale for descriptive cross-sectional studies.
What the evidence shows
The overall pooled prevalence of test anxiety was 49.8%, with a 95% confidence interval of 39.9% to 59.6%. Statistical variation between studies was very high: I² was 98.2%. When three studies using a Visual Analogue Scale were excluded, the pooled estimate fell to 44.9%.
The assessment tool was the only subgroup factor reported to have a statistically significant effect. Test anxiety was numerically higher among females than males (52.6% versus 46.3%), among first-year students than fifth-year students (58.6% versus 47.9%), and in South-East Asia and the Middle East than in other reported regions. Estimates were also higher when surveys were conducted during examinations than before or after examinations, and in studies using convenience rather than random sampling. These reported differences should not be interpreted as proof that gender, academic year, region, examination timing, or sampling method causes test anxiety. Publication year was not significantly associated with prevalence.
Where this may apply
These findings may be relevant to medical students in populations and educational settings similar to those represented in the included studies. They do not provide a precise prevalence estimate for every country, medical school, student group, or other university population. The results also do not establish that the reported subgroup differences apply to individual students or explain what causes test anxiety.
The significance
The review indicates that test anxiety was frequently reported among medical students in the studies included. It also shows that the estimated frequency depends substantially on how test anxiety is measured and when it is assessed. This may help researchers compare future studies more consistently, but the analysis does not determine the causes of test anxiety, its effects on individual students, or whether any particular group is at greater risk.
Limitations & evidence assessment
The largest limitation was the very high variation between study results, indicating that the pooled estimate may not represent all medical students accurately. The included research was primarily descriptive and cross-sectional, so it can estimate prevalence but cannot establish cause and effect or changes over time. Studies used different assessment tools, assessment timings, and sampling methods, and the estimate changed when studies using one tool were removed. The abstract does not provide enough detail to judge the individual studies' risk-of-bias results or how representative their participants were. Regional and subgroup estimates may therefore be affected by differences in study methods and sampling.
Why this evidence level: Meta-analysis pooling multiple studies sits at the top of common evidence hierarchies.
Evidence levels are editorial estimates derived from study metadata — they are not clinical appraisals.
// Source
BMC Medical Education · 2026 · DOI: 10.1186/s12909-026-10270-2
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