Background: We demonstrate the phenomenon of ‘incompetent and unaware’ in a real world setting. Summary of work: Medical students (193) participated in a self-assessment exercise, requiring predictions of exam grade in 3 domains; knowledge, skills, and behaviours. The exercise was completed 3 times; immediately after January exams, one week after January exams and immediately after May exams. Feedback on assessment ability was given between January and May. Personality type was correlated with self-assessment ability. Students assessed the Conscientiousness Index (CI) scores of themselves and peers. Summary of results: Failing students over predicted their exam performance. Merit students under assessed performance, and pass students ...