Purpose
To date, there are no studies quantifying medical students’ fear of failure (FoF) in the United States, nor how FoF may differ between lived experiences. Understanding students’ mentality regarding learning and failure proves paramount to improving medical education; attitudes towards failure affect a student’s self-efficacy, future performance, and feelings of imposter syndrome. With the high stakes medical students face in pre-clinical examinations, instructors’ ability to understand their students’ fears could enhance student-instructor relationships.

Methods
The validated Performance Failure Appraisal Inventory (PFAI) contains control data (n=440) assessing FoF quantitatively from -2 to 2. The PFAI breaks down FoF into five categories: (a) fear of experiencing shame and embarrassment (FSE), (b) fear of devaluing one’s self-esteem (FDSE), (c) fear of having an uncertain future (FUF), (d) fear of important others losing interest (FIOLI), and (e) fear of upsetting important others (FUIO). Data was collected through an anonymous, de-identified survey sent to the MS1 and MS2 classes.

Results
Of the 68 responses received, there was a significant difference between the students surveyed and the control regarding fear of an uncertain future (p < .05). All other categories were not statistically significant. Modifiers such as race, first-gen student status, and previous exam failure did not produce any significant differences, although some categories lacked normal distribution.

Conclusion
Medical students are traditionally known for being afraid of failing, however this study proves otherwise. As medical education shifts to pass/fail curriculum, taking into consideration attitudes surrounding failure and failure’s impact on the ability to learn increases in importance. If students believe failure puts their future in jeopardy, will they be motivated to work hard, or too terrified to face exams? Moreover, we must examine the work we do as educators to give or take away fear’s power.