covered a variety of test-taking strategies  and memorization techniques which you have  

followed to a T. You've done everything you can  to prepare for your exam, and now test day is  

here. Let's talk about what you can do in these  last few hours to maximize your performance. 

Dr. Jubbal, MedSchoolInsiders.com. Whether you're studying for a final exam,  

the SAT, the MCAT, or the USMLE, these tips  and strategies will help you optimize the  

hours leading up to your exam. Let's start with what  

to do the day before the exam. When preparing for an exam, it is crucial  

to be efficient with your studying so you can  get the most out of the time you have available;  

however, it is equally important to know when you  have done enough and it is time to give your brain  

a rest. It's common for students to spend every  waking hour before an exam cramming every bit of  

information into their heads. The expectation is  that seeing the information one last time right  

before the exam will lead to a better score;  however, it usually ends up doing the opposite. 

Exam preparation is a marathon, not a sprint. If  you exert all your mental energy just before the  

exam, you are bound to gas out while taking it.  This is especially true regarding exams like the  

MCAT or the USMLE which are more time-intensive  and mentally demanding. If you spend months  

studying for an exam, it is unlikely that you are  going to learn any meaningful amount of additional  

information in the few hours before you take  it. You have already done everything you can.  

Now the best thing to do is give yourself a  rest. Additionally, reviewing material that  

you aren't confident about can end up causing you  unnecessary stress and anxiety. In turn, this can  

lead you to perform worse than you otherwise  would have if you hadn't reviewed at all. 

I recommend stopping studying  12-18 hours before the exam,  

depending on the test. This will give you ample  time to relax and decompress, ensuring that you  

come into the exam fresh and ready to crush it. Preparing everything you need the day before  

is another way to minimize exam day stress.  Planning out what you are going to wear,  

what you are going to eat for breakfast, and what  time you're going to leave ahead of time will all  

decrease any uncertainty on the morning of the  exam. You won't be rushed, and are less likely  

to forget something critical. If you are taking an  exam like the MCAT or USMLE at a testing center,  

consider driving to the testing center the day  prior. Doing so will ensure you know where the  

testing center is, how long it takes to get  there, and where you need to park. Anything  

you can do ahead of time to make sure you are  well-prepared will pay dividends come exam day. 

The last, and arguably most important, thing to  do the day before the exam is to make sure you get  

adequate sleep. Research has shown that acute  sleep deprivation negatively impacts cognition.  

It causes drowsiness and fatigue. It reduces  attention. It hinders working memory,  

which is necessary for remembering things for  immediate use - think passage-based exams like the  

MCAT or USMLE. It diminishes place keeping, which  includes the ability to carry out instructions. It  

hinders cognitive flexibility and the ability to  adapt to uncertain or changing circumstances. All  

of this translates into decreased performance on  exam day. The best thing you can do for yourself  

before an exam is to make sure you get some sleep. Start by establishing a consistent nighttime  

routine and follow it the night before the  exam. I have discussed this topic in-depth  

in my Anatomy of a Perfect Night Routine video. First, fall asleep at a consistent time. This will  

make it easier to both fall asleep and wake up at  your intended time. In the week leading up to your  

exam, get in the habit of going to bed and waking  up at the same time that you plan to on exam  

day. Next, practice good sleep hygiene and set  up your bedroom for optimal sleeping conditions.  

Lower your body temperature by turning down  the AC. Avoid things that stimulate you such  

as backlit screens and high-intensity music.  Instead do activities that help you relax  

such as deep breathing, meditation, or reading. Now that you have your perfect nighttime routine,  

avoid anything that will negatively impact your  sleep. One of the biggest temptations while  

preparing for an exam is caffeine; however, you  need to be mindful of your caffeine consumption  

the day before the exam. The half-life of caffeine  is approximately 5 hours, so if you have it too  

late in the day, you may have a difficult time  sleeping at night. I would recommend avoiding  

caffeine consumption after 2 PM or sooner to  ensure it does not negatively impact your sleep. 

The next one should go without saying but  avoid alcohol. Alcohol consumption won't  

only disrupt your sleep, but also impair  memory consolidation. It derails melatonin,  

human growth hormone, disrupts REM sleep, and  will significantly impair your performance. 

Sometimes even when you've done everything right,  you'll still have nerves and find it difficult to  

fall asleep the night before. In these cases,  there are some things that you can take to  

facilitate falling asleep. This is not medical  advice and is for information purposes only.  

Common over-the-counter solutions used by students  include diphenhydramine, also known as Benadryl,  

or exogenous melatonin. However, either  can lead to grogginess the next morning. 

Andrew Huberman, Professor of Neurobiology at  Stanford University School of Medicine, instead  

recommends a cocktail of magnesium threonate,  theanine, and apigenin to facilitate sleep onset.  

Magnesium helps to regulate neurotransmitters  that are directly related to sleep. Theanine is  

an amino acid found in tea leaves that promotes  relaxation and facilitates sleep by affecting  

neurotransmitters in the brain such as GABA,  serotonin, and dopamine. Apigenin is a derivative  

of chamomile that helps decrease anxiety and  initiate sleep by hyperpolarizing neurons in  

the forebrain. And remember to consult with a  physician before taking any of these supplements. 

You've followed all these steps, gotten  a wonderful night's sleep, and now the  

day of the exam is here. Now what do you do? Good nutrition starts with adequate hydration.  

The human body is comprised of 60% water, and  the brain is made up of 73% water. After sleep,  

we are particularly dehydrated. Research has shown  that even mild dehydration can negatively impact  

cognition. Additionally, the scientific literature  has shown that the brains of dehydrated adults  

show evidence of increased neuronal activation  when performing cognitively engaging tasks. This  

indicates that their brains are working harder  to complete the same task. For these reasons,  

making sure you drink water in the morning before  an exam is essential. You do need to be mindful  

of how much water you are drinking, however.  Too much and you may find yourself running to  

the restroom repeatedly during your exam. A tall  glass or two in the morning and a water bottle on  

hand during your exam should be adequate. The next thing to focus on is breakfast.  

Your brain accounts for 2% of your total  body weight and yet it demands about 20%  

of your resting metabolic rate. During  cognitively demanding tasks, it can demand  

even more. It should come as no surprise then  that breakfast consumption has been shown to  

have a transient beneficial effect on cognitive  function compared to fasting. More specifically,  

it has been shown to improve attention, executive  function, and memory. Skipping breakfast on  

exam day should be avoided, especially if you're  taking a longer exam like the MCAT or the USMLE.  

For these exams, breakfast alone isn't even  enough. You should also bring snacks with you to  

the testing center to eat during your breaks. This  will ensure that your brain is adequately fueled  

to take on the cognitive demands of the exam. Now the question of what to eat. Although  

research regarding the effect of breakfast  composition on cognitive performance is limited,  

the general consensus is that a breakfast  composed of low glycemic index foods is superior  

in facilitating cognition compared to a breakfast  composed of high glycemic index foods. This means  

that things like pop tarts, sugary cereal, and  juice or other sugary drinks should be avoided.  

These foods may make you feel good initially,  but they often lead to a crash shortly after.  

Instead, try to eat a more balanced meal  containing a mix of complex carbohydrates,  

proteins, and fats. Complex carbohydrates and  starches will be slower digesting and will  

provide you with more sustained energy. An example  of a balanced breakfast might be something like an  

omelet with steamed veggies and whole-grain toast. Your choice of beverage with breakfast is also  

important. One of the best choices is  water. Plain and simple. That being said,  

for many people breakfast also includes  caffeine – more specifically coffee.  

Although coffee isn't necessarily a bad choice  for caffeine, it may not be the most optimal. The  

high dose of caffeine in coffee is isolated and  can give you a jittery feeling. For this reason,  

I believe that tea is a wonderful alternative. Tea  has less caffeine, but it also has theanine. You  

may recognize this amino acid from earlier in  the video. Theanine has been shown to promote  

relaxation and facilitate sleep. In your morning  cup of tea, however, the concentration is going to  

be much less than you would find in a supplement.  The combination of caffeine's stimulating effect  

with theanine's relaxing effect creates a calm,  focused state as opposed to a jittery one. 

Now that you've dialed in your nutrition, it's  time to leave for the exam. I recommend getting  

to the testing center early to minimize stress.  For the MCAT, USMLE, or similar standardized exam,  

arrive at least 30 or 45 minutes prior to  your scheduled start time. This will give  

you ample time to get to the testing center and  respond to any minor issues that might come up. 

The final exam day tip is to not stand in  your own way. It is normal to feel stressed  

or anxious before an exam, but you can't let your  negative self-talk get in the way of your success.  

If you do, your self-doubt will throw you into a  negativity spiral. The key difference between high  

scorers and low scorers is that high scorers know  how to control their self-talk. They transform  

the negative self-talk into positive self-talk. The trick to doing this starts with understanding  

that the physiological response to fear and  excitement are nearly identical. Both stimulate  

the sympathetic nervous system – the body's fight  or flight response. The difference between the  

two is that fear is unpredictable and activates  the amygdala, while excitement does not. This is  

why some people love skydiving, and some people  don't. Those that love it are confident they'll  

make it to the ground safe and sound. Those that  don't are not so sure. When circumstances become  

unpredictable, excitement transforms to fear.  If you can change your perspective and view your  

physiologic response before an exam as excitement  instead of fear, you can make your self-talk  

serve you. Take the unpredictability out of it.  Remind yourself that you've prepared and you're  

ready to rock and roll. Invite the challenge,  it's time to see what you got in store for it. 

If you follow these tips, you will be well on your  way to crushing any exam that stands in your way.  

But you don't have to do it alone. If you're  trying to get into medical school or match into a  

desirable residency, you'll need to not only crush  your college coursework, the MCAT, and USMLE,  

but also shine on your personal statement,  secondaries, interviews, and other soft components  

of your application. At Med School Insiders,  our tutors and advisors can help you get there.  

We've had over 4,000 customers so far and have an  industry-leading 99% customer satisfaction rating.  

That's not an accident — we've obsessed and  invested heavily over the past few years  

in creating our proprietary systems that allow  us to consistently provide excellent service and  

deliver stellar results. That's the Med School  Insiders difference. Learn more about why our  

customers love us at MedSchoolInsiders.com. Thank you all so much for watching! If you  

enjoyed this video, make sure you check out my  video going over 5 things I Wish I knew About the  

MCAT or the Regrets of a 99.9th Percentile MCAT  Score. Much love and I'll see you guys there.