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Space it out, do not cram
The spacing effect is one of the most reliable findings in cognitive psychology. Reviews that are spread out produce much stronger long term retention than the same amount of massed study. Meta-analyses and large studies confirm this across topics and timescales. [Cepeda et al., 2006; Cepeda et al., 2008]. Match the gap to your goal
There is a useful rule of thumb: the optimal gap before your review is a small fraction of how far away the exam is. In a large field study, the best gap was about 20 to 40 percent of a 1 week target, shrinking to roughly 5 to 10 percent of a 1 year target. In practice, that means short gaps for near tests and longer gaps for far tests. [Cepeda et al., 2008]. Test yourself, do not just re read
Retrieval practice beats restudy for durable learning. Once you can recall an item, additional testing grows memory far more than additional reading. This is true for university level material and is one reason flashcards and practice questions work so well. [Karpicke and Roediger, 2008; Dunlosky et al., 2013]. Make it a little hard on purpose
Conditions that feel a bit effortful produce stronger, more flexible learning. Space your reviews, interleave related topics, vary contexts, and embrace mistakes as information. These are called desirable difficulties. [Bjork and Bjork, 2011]. Interleave problems, do not block by chapter
For skills like ECG interpretation, acid base, or radiology patterns, mix question types. Interleaving improves your ability to choose the right approach when problems look similar. [Rohrer and Taylor, 2014; Rohrer, 2015]. Sleep is part of the study session
Sleep actively consolidates new memories via slow oscillations, spindles, and hippocampal ripples. Learning just before sleep improves recall, and even 60 to 90 minute naps that include NREM stages can boost certain types of learning. [Rasch and Born, 2013; Gais et al., 2006; Mednick et al., 2003; Klinzing, Niethard and Born, 2019]. Expanding vs equal spacing
Early work proposed expanding intervals. Newer findings suggest that when your final test is far away, uniform spacing can match or outperform expanding schedules. The takeaway is to keep spacing, monitor recall, and do not fear equal-interval schedules. [Storm et al., 2010]. Use an algorithm so you can think about medicine, not math
Modern SRS schedulers implement proven algorithms. RemNote supports SM 2 and FSRS, both of which adapt intervals from your feedback, so your time goes to weak items first. [RemNote Docs on SM 2 and FSRS; Anki background].
One fact, one card. For differentials or criteria, use multi line cards with clear sub bullets and cloze deletions for each key element.Prefer cloze deletions for definitions, triads, and lists. Use image occlusion for anatomy, radiology, dermatology.Avoid making automatic reverse cards unless the relationship is truly bidirectional. This reduces noise and interference.Add a brief “why” or clinical cue on cards to link knowledge to cases.
Morning: 20 to 40 minutes of reviews when alert. Retrieval is strongest with fresh prefrontal control.Pre sleep top up: 10 to 20 minutes of difficult cards. This leverages sleep consolidation without overwhelming your evening wind down. Evidence shows studying near sleep supports recall. Strategic naps on heavy days: if you are drilling procedures or visual tasks, a 60 to 90 minute nap can help. Keep it occasional.
Scheduler: enable FSRS for more adaptive intervals, or stick to SM 2 if you prefer simplicity. RemNote lets you choose per document or globally. Priorities: set your current block or exam documents to High so those cards surface first. Use Maintaining or Paused for background decks. Exam mode: before a test, configure an Exam in RemNote so those cards are automatically prioritized without wrecking your long term spacing.
3 new concepts per day per major course. Keep new inflow modest so reviews stay sustainable.2 mixed sets of practice questions most days. Pull cases from past papers or QBanks and convert misses into cards immediately. Retrieval plus interleaving is powerful. 1 consolidation block in the evening where you clean up leech cards, re write poor prompts, and tag tricky items.
Path triad cloze: “Nephrotic syndrome features: {{c1::proteinuria}}, {{c2::hypoalbuminaemia}}, {{c3::oedema}}.”Drug mechanism: “How do thiazides reduce calcium excretion? → {{c1::Increase distal tubular calcium reabsorption via volume depletion mediated proximal sodium and water reabsorption}}.”Vignette to diagnosis: 3 to 4 line stem, single line answer, plus a tag for the system and a link to the image or guideline.Criteria lists: one cloze per criterion to avoid all or nothing failures.
Build a “mixed deck” tag that pulls ECG, electrolytes, ABG, heart murmurs into one daily set.In skill heavy weeks, rotate topics inside a single session: ECG → ABG → CXR → ECG again. This forces discrimination and reduces pattern matching by chapter.
If a card fails 3 times in a week, rewrite it. Make the prompt shorter, add a cue, split into two cards, or add an image.Use tags like clinics, rounds, vivas to surface cards just before real world use. Retrieval in varied contexts is a desirable difficulty.
For a test 4 weeks away, aim for first review 2 to 3 days after learning, then 1 week, then 2 weeks. For finals 6 months away, first review at 3 to 10 days, then 3 to 5 weeks, then 2 to 3 months. This follows the “optimal gap as a fraction of target” idea. Adjust based on your recall rate.
Keep a consistent sleep schedule, get morning light, and dim screens at night.Slot your hardest reviews before sleep on heavy days, then let your brain’s spindles and slow waves do their job.
Day 1: Create 40 to 60 high quality cards from one lecture. Turn on FSRS. Set priorities for current modules.Days 2 to 6: Review 20 to 40 minutes in the morning, 10 to 20 minutes pre sleep. Add 15 to 25 new cards daily. Do one mixed interleaving set after lunch.Day 7: Light review only. Rewrite leeches, tidy tags, preview the next week’s topics.
Bjork EL, Bjork RA. Creating desirable difficulties to enhance learning. 2011. Cepeda NJ, Pashler H, Vul E, Wixted JT, Rohrer D. Distributed practice and spacing effects. 2006, 2008. Dunlosky J, Rawson KA, Marsh EJ, Nathan MJ, Willingham DT. Improving Students’ Learning With Effective Learning Techniques. 2013. Klinzing JG, Niethard N, Born J. Mechanisms of systems memory consolidation during sleep. 2019. Mednick SC, Nakayama K, Stickgold R. Sleep dependent learning: a nap is as good as a night. 2003. Rohrer D, Taylor K. Interleaving practice improves mathematics learning. 2014; and related summaries. Storm BC, Bjork RA, Storm JC. When and why expanding retrieval practice enhances long term retention. 2010. RemNote Help Docs. FSRS and SM 2 schedulers, priorities, exam mode.
Spaced Repitition
Script Overview: Spaced Repetition & Active Recall
Introduction:
Hey everyone, today we're diving into the concept of spaced repetition and why active recall is such a game changer for learning. If you’ve ever wondered why just reading something once doesn’t make it stick, this is the episode for you.
Deeper Dive:
So let’s break it down. The key idea behind spaced repetition is that you want to revisit information at intervals, not cram it all at once. There's a famous concept called the Ebbinghaus forgetting curve, which shows that after you first learn something, you start to forget it pretty quickly if you don’t review it. But every time you review that info, the curve resets and you remember it for longer. Over time, you end up needing fewer reviews to keep that knowledge fresh.
Practical Application:
Now, the trick is to make your brain work a little. When you actively try to recall something rather than just rereading it, you're basically telling your brain: hey, this is important, let’s store it a bit deeper. That’s where active recall comes in. Instead of passively reviewing, you test yourself, you ask questions, you try to pull the info from memory, and that’s what really cements it.
Tools & Resources:
There are some great tools out there like Anki and Quizlet, but I personally love using RemNote. It’s got all the spaced repetition algorithms built in, plus it looks nicer and lets you add emojis, images, and structure your notes easily. And yes, it’s got a mobile app, so you can review a few flashcards anywhere—even if you’re just waiting in line.
Extra Details:
Let’s also add a couple of YouTube links that explain active recall and spaced repetition in more depth, and we can include a diagram of the Ebbinghaus curve for visual learners. The main takeaway is that this technique helps you move info from short-term to long-term memory much more effectively.
Bringing in Mind Palacing:
Now, one cool twist I like to add is layering spaced repetition on top of a mind palace technique. For me, that means using emojis in my RemNote cards as little visual cues. These emojis help me create characters or places in my mind palace, so it’s not just words I’m memorizing—it's a whole visual story.
How I Build My Flashcards:
In practice, I started out making these flashcards from my lecture materials back in third year. But now, I’ve got a custom GPT that helps convert verified sources—like AMBOSS—into RemNote-style flashcards just the way I like them. Each card is broken down into neat sections: general info, pathophysiology, symptoms, clinical signs, diagnostics, treatment, complications, and so on. Then I just drop them into RemNote and start using spaced repetition on those.
Final Tip:
By combining this structured flashcard system with mind palacing and even a bit of podcast learning (which we’ll chat about next time), you get a really robust way to lock information into your long-term memory. And that’s how I make it all work together.
ChatGPT
Spaced repetition is a powerful learning technique that involves spacing out your study sessions over time, rather than trying to cram all of the information into one session. This method has been shown to be highly effective for improving memory retention and recall, as it allows your brain time to process and integrate the information you are learning. By spacing out your study sessions, you can help solidify the information in your long-term memory and reduce the need for last-minute cramming. Other benefits of spaced repetition include increased focus and productivity, as well as reduced stress and anxiety. To get started with spaced repetition, simply schedule your study sessions at regular intervals over a longer period of time, rather than trying to fit everything in at once. This simple yet powerful technique can help you learn and retain more information, and ultimately improve your performance.
How to Use Spaced Repetition to Actually Remember What You Study 🧠⏳
If med school sometimes feels like trying to drink from a firehose, you are not alone. What finally changed the game for me was pairing two things: retrieval practice and spacing. Retrieval is simply testing yourself. Spacing is doing those tests again later, at smartly increasing intervals. Together they turn studying from a cycle of re-reading and forgetting into a steady climb toward long term mastery. And because memory consolidates while you sleep, the way you schedule reviews around sleep can quietly double your returns.
Below is a simple, science-backed playbook focused on university students in medicine, with RemNote as the default tool. I will start with the principles, then show exactly how I apply them day to day.
Principles 🔑
Practicals 🛠️
These are the exact steps I use as a med student who studies in RemNote. Steal anything that helps.
1) Build high quality, atomic cards
2) Daily review rhythm that respects sleep
3) RemNote settings that make a difference
4) The 3 2 1 cadence for medicine
5) Card templates I actually use
6) Interleave on purpose
7) Tame leeches and friction
8) Plan your spacing with the exam in mind
9) Guard sleep so your SRS pays compounding interest
10) A one week starter plan
References 📚
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