From NATIONAL JOURNAL OF MEDICAL RESEARCH

Volume 2Issue 4Oct Dec 2012 Page 435

EFFECT OF EXAMINATION STRESS ON THE PLASMA

CORTISOL LEVEL by Rachit M Joshi1, et al.

Summary
The medical profession is always to be a favorite in the public, but the effort to get the
profession is very difficult and not kidding. Medical students take on a lot of pressure in their
academic. This study is conducted to provide data and re-arrange the effects of stress academic
examination on plasma cortisol levels. Almost any type of physical or mental pressure can
cause several minutes to increase the secretion of the adrenocorticotrophic hormone and
consequently also cortisol.
In the case of mental stress, it is believed to be derived from increased activity in the
limbic system, especially in the amygdala and hippocampus regions, both of which then send
signals to the posterior medial hypothalamus. Cortisol has a direct negative feedback effect on
1) the hypothalamus decreases Corticotrophin release hormone formation and 2) anterior
pituitary gland reduces ACTH formation. Both of these feedbacks help to regulate the plasma
concentration of cortisol. However, the stimulus of stress is the prepotent; they can always
break through the direct inhibitory feedback of this cortisol, which causes periodic
exacerbations of cortisol secretion several times during the day or prolonged cortisol secretion.
The main pressure for the first batch is the amount and complexity of the material being
studied plus the increasing pressure due to fierce competition either from getting better grades
or being superior to their counterparts. The method is an extended follow-up study performed
on first-generation MBBS medical students who conducted their first test by measuring their
plasma cortisol levels at the pre-examination stage and post-examination stage under fasting
conditions.
Serum cortisol is estimated by Byer's Advia Centuse using Chemiluminescence
technique with calibration and inbuilt control. The results obtained was to be analyzed
statistically using paired 't' test. The result is that we find that medical students in the pre test
stage have significantly higher plasma cortisol values than they were after the exam.
It can be concluded with the help of the results obtained that the examination is as
situational stress that results in anxiety, reflected as disturbed homeostasis in the body such as
altered hypothalamus-pituitary-adrenal axis, resulting in elevated plasma cortisol levels.
Medical students and lecturers should be aware of the negative consequences of stress faced
by counseling to avoid factors that can affect themselves and health problems. The education
system needs to develop better evaluation techniques to strive for students for the common
good.

Point of view
I think this research is very good and very helpful for medical students because with
this research, we as medical students can know the effect of prolonged stress and continuous
pressure to cortisol hormone which will cause disturbance in body, and this research makes the
lecturers can be thinking of how students do not feel difficulty to understand this heavy
material. Perhaps by making the material visualized, learning outside the classroom, the
delivery is interesting. And for medical students should study in the group, do not learn abruptly
before the exam, maximized every time for the output of the test results are also good. But in
this research still not explained clearly the effects of increased hormone cortisol and body
mechanisms such as what can cause disturbances in the body. Thus, I am as a reader plead for
a continuation in this research for the good of medical students together.

Bibliography
Joshil, Rachit M et al. 2012. Original Article: Effect Of Examination Stress On The Plasma
Cortisol Level. Volume 2. Issue 4 . India.

Name : Ira Resmi Melani

Number : 16910045