Prevalence of exam anxiety among the undergraduate medical students in Kathmandu, Nepal: a cross-sectional study

Exam anxiety is a significant psychological concern among medical students globally, yet data from Nepal remain limited. This study aimed to determine the prevalence of exam anxiety and its association with academic and study-related factors among undergraduate medical students in Kathmandu, Nepal. A descriptive cross-sectional study was conducted among 384 undergraduate medical students at the Nepalese Army Institute of Health Sciences, Kathmandu, Nepal. Proportionate stratified random sampling was used. Data were collected using a self-administered questionnaire including sociodemographic characteristics and the Westside Test Anxiety Scale. Exam anxiety levels were categorized from comfortably low to extremely high. Chi-square and independent t-tests were used for analysis. The prevalence of high exam anxiety (moderately high to extremely high) was 36.2%. Female students had significantly higher anxiety than males ( p = 0.002). High exam anxiety was significantly associated with failure in the last major examination ( p < 0.001). Students with high anxiety reported fewer study hours ( p = 0.031) and were less likely to revise before exams ( p < 0.001) compared to those with normal anxiety. Exam anxiety was present at moderately high to extremely high levels in more than one-third of medical students in this Nepalese cohort and was associated with poorer recent academic performance, female gender, fewer study hours, and lack of revision.