Parcelas de comprobación de formas de siembra en trigo y cebada (a) Cultivo de trigo

it became even more of a looming concern and once the intensive study period began (the intensive time varied beginning in early May for most but earlier for some who decide to take the exam prior to mid-June) there was little else that occupied the lives of the students. Excerpts from discussions with three different students follow:

It was mostly like all I did all day every day. I had a study schedule that I worked from and I would get up in the morning, study, take my dog for walk, study, eat launch, study, eat dinner, and study a little more. It’s pretty all encompassing. You know with a couple of fun things thrown in - my sister got married – that was a perk. (GS- M2)

For the intensive study period you have to be all in. For some its 4 weeks, for some 6 – beyond that, there’s no way because you’re burnt out and maybe you don’t even realize it. Your days are solely focused on the schedule and you literally do nothing else – same thing every day. Some take time for food shopping… I didn’t even do that, I had it delivered. (MF – M4)

I don’t do anything else. It’s funny like I didn’t leave my house for like 6 or 7 weeks only to go to school. I didn’t do anything and that like stinks. It’s awful; like my friends are always texting me but I just don’t go. I started studying in the fall so I’m just exhausted. It’s the spring now, and I just start my day an hour earlier. I usually get up about 5:15 or 5:30, catch the train and study on the way

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into school, by 7. Study an hour before school. In class from 8 – 12. Work

through lunch and do something within the block. I go to lecture and lab; I’m one of those people. After that I usually go home right away. I live with my parents – like an hour home, which stinks…but 2 solid hours of study, so I get home, eat, try to work out and then study till 10 or 11 and just do it again. (RD-M2)

Students try to squeeze as many hours of study into a given day, allocating little time for anything else. The monotony of their exam preparation efforts is also apparent in that it’s the same thing all day, every day. In addition to the all-consuming nature of the study period, it was evident that the exam also had an effect on the emotional state of students. One M4 shared:

I was in the middle of study and my wife called to ask if I could pick up my son at daycare ... I’m like, I can’t? And she said, what? And I’m like, let me play this out for you quickly because I don’t have a lot of time. Fifteen minute there, fifteen minutes back, twenty minutes talking to someone, now we’re at 50 minutes. I said, getting him settled back at the house, an extra 10 minutes with a snack or something now we’re at an hour. I’m getting to bed at 11 o’clock and getting up at 3 o’clock to make up for that lost hour and she’s like, I have never ever seen you this intense, ever. I love you, it will be okay. I think you need to go… and that’s when I left and was like out and away for a week. (BM- M4)

This particular student, a father, relayed that he was so stressed that he was

uncharacteristically short and even angry with his family. Because the exam and its significance weighed so heavily, he and other students felt as though everything else in their lives had to be curtailed or put on hold. These beliefs and behaviors often impacted

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other aspects of their lives, including social relationships. The stress and intensity of the need to study changed the typical demeanors of some, precipitating negative

consequences.

Students in M3 and M4 years who had taken the exam unanimously agreed that particularly during the intensive study period, nothing else in their lives received much, if any attention. This attitude was similarly reflected among staff and faculty who

commented on how students had “taken over the building” and were “camping out in every nook and cranny” they could find. I have also observed students in the building studying from very early in the morning (6am) until later in the evening (8pm) and learned from facilities workers that they sometimes have students in the building until midnight.

Every day that I get here at 7am, there are already students spread out in various study spots all over the building. It appears as though they have an enormous amount of material at their sides; in addition to books and computers, they have plenty of food, extra clothes, and one student even has a pillow…. Every evening that I stay late (7pm) there are still M2 students here studying; same students, same places. They look extremely intense and I rarely notice them interacting…. with anyone. (field notes, May 4, 2016)

The intensive nature of the study was best revealed, however, through their own

descriptions of how “the test becomes their lives”. Schedules devised by the students to guide the intensive study period also clearly indicated that there was time for virtually nothing beyond study as students prepared for the test (Appendix C). The intense and comprehensive focus on the test leaves little time available for wellness activities,

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including sleep, socialization, or exercise, thereby negatively impacting medical student well-being.

Theme 2: Isolation and dropping out. For many students, studying for the