Introduction:

In the 2nd grade of medical school in the University of Beira Interior, there is a 'heart' exam, the only oral exam of the course. The observation that about 1 out of 5 students failed the exam, propelled an investigation.

Subjects and methods:

We conducted two questionnaires, before and after the exam, that assessed multiple factors. Blood pressure and heart rate were recorded before and after the exam and in a non-stress situation. Two different teachers assessed students. Descriptive statistical tests, t -test, chi-square test and Mann-Whitney test were applied.

Results:

Of a total of 1042 students, between 2005 and 2014, 19.96% failed in the oral exam. In 2015 ( n = 144), there was a 100% response rate to the questionnaires. The male gender is associated with a higher failure rate ( p = 0.04). The parameters 'I was nervous for watching my colleague's exam' ( p = 0.041) and 'The presence of a colleague in the room left me nervous' ( p = 0.014) were associated to failure. The heart rate ( p = 0.028) and diastolic blood pressure ( p = 0.030) after the oral exam were related to failure.

Conclusions:

It is suggested that students wait outside the room during the exam. It is crucial to avoid differences between teachers, so it is suggested, an initial pre-training on the structure and parameters of evaluation.

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