SD,
First, i'd not bother too much w/ PhRing at this time. I actually think you probably already know it well enuff.
I'd make it a point to listen to Self Esteem Supercharger once daily. Do it at different times too. Morning, midmorning, afternoon, night, before bed. I'll not go into explanations here. Once a day at different times. Maybe a few days in the morning before you get out of bed. Then a few days around lunch time. Like that.
Next, write down your goals...all of them. Just layer them and take your time. If it takes you 5 days to get them written down and worded positively, then so be it. A goal has these specific qualities: It has to be worthwhile to you. It needs to be valuable to you. It must be measurable and testable. It has to be achievable. It must be stated postively.
Start thinking about all the good and worthwhile things you have accomplished. I mean ALL of them. It'd be good for you to list them. You might surprise yourself. What nice thing did you do for someone today? It all counts when you are building self esteem. Your whole being needs to know how much you mean to yourself, your family and to society...in a real and vital and knowing manner.
If you miss 4 out of 10 questions, you must focus first on the 4 you got right and tell yourself you'll build on that. Never look at anything in your life as a deficiency. You are layering and building on success. So, you have to acknowledge ALL of your successes. Don't downgrade any success no matter how small.
Be honest w/ yourself by using the indirect method 
of rating yourself 1---10. If you rate yourself as a 2 in something, then if you can just get to 3 or 4 in the near future, then this is to be considered a success to build on. This also automatically implies not comparing yourself w/ others. In the medical field there a plenty of egoistical people. It comes w/ the territory.
Go to level if you can to do this. Level means, relax your physical being and mental being. Listen to a paraliminal like 10 minute SC and turn it off before he starts to count back up. Create a quiet scene(s) for yourself. This should be a place you can always feel safe in. A place where you can make changes mentally for your success. I have now come to the conclusion that one basic quiet scene is fine, but from there we can then go to others. Like for you, once you have your quiet scene down and anchored, you can then go to the scene of the test and just program how you will act and do there. Then go back to the original quiet scene and count back up.
Well, this is enough for now. As you can see, i think your problem areas are in solid self esteem. You don't build true self esteem w/ good grades only. True self esteem comes from self approval and self love. When you approve and love yourself, it just naturally flows into your patients and others. Self esteem allows us to feel safe and capable anywhere and under any circumstances. It says: I may not know how to do this, but i'm sure i'll either figure it out later or get help here. I'll go to level and program getting the help i need. Every thing i need to know will be revealed to me. Everything i need comes to me. All is well in my life.
Then after a couple months of this regimen, check out PhRing and activating. 
If you have any questions please ask. I don't think it's in your best interests to tell you to read this or that book. But, if you want references then ask.
[This message has been edited by Margaret (edited June 13, 2002).]
