The specific challenge of PASS, LAS, and EDN
In PASS, students must memorize thousands of MCQ-level facts across 8 to 10 teaching units: anatomy, biochemistry, physiology, histology, pharmacology, immunology, biophysics, and mathematics. Admission rates usually sit around 20 to 30% depending on faculty. The students who succeed are not always the 'most gifted'; they are usually the ones who install an efficient review system early and maintain it consistently throughout the year.
For EDN (formerly ECN), stakes are even sharper because ranking determines specialty access. Memorizing pharmacology, reference scores, normal ranges, and management steps with high precision -- and keeping them active over months -- is exactly where spaced repetition performs best.
The difficulty in PASS is not understanding the content: most students grasp concepts in lectures. The difficulty is retaining everything simultaneously at exam time, weeks or months after first encountering it. Spaced repetition solves precisely this problem: instead of passively rereading, you actively test each fact at the exact moment your brain is about to forget it -- the maximum-efficiency review window. This is why students using SRS-based workflows report being more confident at PASS exams while spending less cumulative time on revision: the algorithm replaces the guesswork of 'what should I review today?' with a precise, evidence-based schedule.
Students using rigorous SRS workflows for PASS consistently report less total revision time than with traditional methods (rereading, paper notes), while maintaining a broader active knowledge base at exam time. The advantage compounds: by November, a student who started SRS in September holds 2,000 to 3,000 facts reliably, while a student relying on periodic rereading holds far fewer.
How to structure PASS decks
The structure of your decks determines the quality of your tracking throughout the year. Poor initial organization creates blind spots on certain units and makes it difficult to identify where you are falling behind.
One deck per teaching unit, not one mega deck
Create one separate deck per teaching unit: UE1 (chemistry/biochemistry), UE2 (cell biology), UE3 (biophysics), UE4 (medical assessment), UE5 (anatomy), and so on. This separation lets you track subject-level progress, identify units where you are accumulating a backlog, and adapt effort to each unit's exam weighting at your faculty.
Some transversal units (pharmacology, semiology) can be organized into sub-decks by system: cardiovascular, pulmonology, neurology, etc. This subdivision facilitates intensive pre-exam revision on a specific system without needing to filter a large unified deck. For anatomy specifically, consider organizing by region (thorax, abdomen, limbs, head and neck) rather than by structure type -- region-based organization mirrors how MCQs and clinical cases are presented.
Card structure adapted to MCQ exams
PASS MCQs require precise answers and exact wording. Cards should mirror that: short direct prompt, precise unambiguous answer. Avoid over-synthetic cards that bundle multiple concepts -- they do not test recall of a specific fact and produce hesitation during review.
Examples of well-formed cards: 'Normal fasting blood glucose range?' -- '0.7 to 1.1 g/L (3.9 to 6.1 mmol/L)'. 'Klinefelter syndrome karyotype?' -- '47, XXY'. 'Mechanism of ACE inhibitors?' -- 'Inhibit the conversion of angiotensin I to angiotensin II by blocking ACE'. Each card tests exactly one retrievable fact. If a card feels ambiguous to answer during review, that ambiguity is the signal to split it into two or three separate cards.
The most useful card types in medicine
Definition cards: 'Definition of membranous glomerulonephritis'. Numeric-value cards: 'Diagnostic threshold for diabetes on OGTT?' Mechanism cards: 'Mechanism of proton-pump inhibitors?' Association cards: 'Turner syndrome: karyotype, phenotype, complications?' -- one card per element (karyotype: one card; phenotype: one card; complications: one card).
For EDN specifically, add clinical management cards ('Management of suspected massive pulmonary embolism?') and score cards ('Wells score for PE: criteria and interpretation?'). These cards are directly applicable to the progressive clinical case format used in EDN.
How many cards to create?
Target 15 to 30 new cards per day in normal periods, 5 to 10 in pre-exam lockdown (reviews take priority). Over a full PASS year at steady pace, a student creates between 3,000 and 6,000 cards. That is a large number -- but it reflects the actual volume of examinable facts.
Never create cards on concepts you have not understood. A card built on a poorly understood concept becomes a poorly formulated card with an ambiguous answer during review. Understand first, formulate afterwards. If you do not understand the concept well enough to write a clear question and a precise answer, go back to the lecture before creating the card. This principle is especially important in pharmacology and mechanism-heavy subjects: a poorly understood mechanism card will be memorized incorrectly and may cause active harm on MCQs that test discriminative reasoning.
A PASS routine that holds all year
Consistency is the number-one success factor in spaced repetition. A student who does 20 minutes per day 7 days a week gets better results than a student who does 3 hours on the weekend and nothing during the week. The algorithm needs daily signals to calibrate intervals accurately.
Morning (20 to 30 min): due reviews first
Clear all due cards before adding new ones. This discipline is non-negotiable -- it is what prevents backlog drift. If you have 80 due cards and respond to 50 while adding 20 new ones, your backlog grows by 20 per day. Within a week, it is insurmountable.
If due cards exceed 100 in a normal week (outside lockdown), it is a signal: either you created too many new cards too quickly, or you missed several days. Temporarily reduce new cards to zero until the backlog clears. Do not add new cards on top of an existing backlog -- the math works against you. One missed day adds roughly 30 to 40 extra due cards the following morning; three missed days can create a backlog that takes a week to clear at normal pace.
After class (15 to 20 min): create new cards
Create new cards from the day's lecture or tutorial while the content is still fresh. Stay around 30 to 40 new cards per session maximum -- beyond that, card quality drops and you will be overloaded the next morning.
Use AI generation (available in Memia) to quickly convert a lecture excerpt into a set of cards, then review and correct each card before adding it to your deck. Automated generation accelerates creation but does not replace your verification step. The AI-generated formulation is a starting point, not a finished product. A practical workflow: generate 20 cards from a lecture excerpt, then spend 5 minutes reviewing them -- delete cards that duplicate existing ones, split cards that test multiple facts, and rephrase cards whose answers are ambiguous.
Weekend: MCQ training and catch-up
Clear due cards, run MCQ training sessions (2 to 3 sessions of 30 minutes), and avoid mass new-card creation if you are already behind on reviews. The weekend is also the right time to review cards you failed during the week and reformulate any that are consistently causing problems.
Pre-exam (3 to 4 weeks before): lockdown mode
Switch to lockdown mode: zero new cards, only due reviews. Complement with past papers and full MCQ mock exams. Spaced repetition will have done its work upstream -- the weeks before the exam are for verifying existing knowledge, not acquiring new content.
The most frequent mistakes medical students make
Mistake 1: creating too many cards at once
Mass card creation at the start of the year generates an insurmountable backlog by November. Consistency with moderate volume beats sprint-and-drop cycles every time. If you have fallen behind, it is better to suspend new card creation for 2 weeks and clear the backlog than to keep creating while the queue grows.
Mistake 2: using shared decks without verification
Community decks (e.g., shared Anki decks on medical forums) can contain errors, outdated phrasing, or details specific to another faculty. Use them as raw material, not as absolute truth. Systematically verify every fact against your own lecture notes before incorporating it into your active deck.
Mistake 3: marking hard cards as easy for convenience
Honest self-rating is the engine of the algorithm. A card marked too easy when recall was actually hesitant will be rescheduled too far ahead -- and you will have forgotten it by exam day. Conversely, marking all cards as hard overloads the system. Be precise: easy = immediate and certain recall; medium = slight doubt; hard = partial forgetting. A useful calibration rule: if you needed more than 3 seconds of active search to retrieve the answer, rate it medium at best. If you had to guess or reconstruct the answer, rate it hard.
Mistake 4: memorizing without understanding
Spaced repetition amplifies what you put into your cards. A card built on a misunderstood concept will consolidate an error. Take the time to understand each concept before converting it into a card -- otherwise you are reinforcing inaccurate knowledge at the exact retrieval moments the algorithm chooses.
If you are spending more time creating cards than reviewing them, that is an alarm signal. The goal is a balanced create-to-review ratio. When in doubt, suspend new card creation for a week and focus exclusively on due reviews. Creation catches up quickly once the backlog clears.
Anki or Memia for PASS and EDN?
Both tools use a rigorous spaced repetition algorithm (Memia uses FSRS, the same algorithm as recent Anki versions). The choice depends on your primary use case.
- Anki: very rich ecosystem, extensive shared decks from the international medical community (AnKing, specialty decks), plugin ecosystem, free on desktop. Steeper learning curve, less modern interface.
- Memia: integrated AI generation (convert a lecture excerpt into flashcards in seconds), modern interface, rapid card creation. Fewer pre-existing community decks for French medical content specifically.
- Practical recommendation: if you are starting out and want to move fast, Memia will save you time on card creation. If you want access to the large shared decks from the international medical community, complement with Anki or import those decks into Memia.
Many students use Memia to create their daily lecture cards (via AI generation) and complement with shared Anki decks for specialties. What matters is consistency, not the specific tool. Any SRS tool used daily outperforms the best tool used irregularly.
Flashcards and MCQ training: two complementary tools
Spaced repetition anchors facts and concepts in long-term memory. MCQ training tests the application of these concepts in a context of discrimination and clinical reasoning. These two work modes do not do the same thing -- they are complementary, not interchangeable.
A common mistake is believing flashcards can replace past papers. They cannot: flashcards guarantee you know the base facts; past papers train you to mobilize them in the specific format of the exam under time pressure and with discriminative distractors. The right balance in a normal period: flashcards daily (20 to 30 min), MCQ sessions 2 to 3 times per week (30 to 45 min per session). When you get an MCQ wrong, always create a card for the correct answer and the reasoning that distinguishes it from the distractors -- this closes the loop between past paper training and spaced repetition.
For EDN specifically, progressive clinical case files require reasoning over a clinical scenario while mobilizing multiple concepts simultaneously. Spaced repetition ensures each fact is available; case-file work ensures you know how to combine them. Start progressive case files in the second half of D2/D3, not only in the weeks before EDN. Students who wait until the final 6 weeks to start case files consistently report that they 'know the facts but cannot apply them' -- this gap is a training deficit, not a memory deficit, and flashcards alone cannot close it.
EDN-specific preparation
The EDN (Examens Dematerialises Nationaux) replaced the ECN in 2024. The format includes MCQs, open-answer questions (QROC), and progressive clinical cases. Precise factual memory remains fundamental: normal values, diagnostic thresholds, reference dosages, classification criteria.
The highest-value cards for EDN
Numerical reference values (diagnostic thresholds, normal ranges, reference dosages). Clinical scores (Glasgow, Wells, Child-Pugh, SOFA...) with their interpretations and action thresholds. Classification criteria (AHA/ACC for cardiology, GOLD for COPD, Rome IV for functional GI disorders). Emergency management steps (massive PE, shock, acute stroke) with the exact sequence the EDN expects.
These card categories are the most directly testable in both the MCQ and clinical case formats. Building complete decks on these categories early in D2 is an investment that pays compounding returns through D3 and right up to EDN. A practical approach: after each hospital rotation or clerkship, create cards on every clinical score, normal range, or management algorithm you encountered during that rotation -- these are precisely the facts that recur in EDN clinical cases.
Planning across D2 and D3
D2: build your decks system by system as lectures progress. Target 10 to 20 new cards per day. Run module MCQs at end of each semester to test integration. Focus especially on the high-weighting systems: cardiology, pulmonology, neurology, infectious disease.
D3 / pre-EDN: switch to intensive review mode 4 months before the EDN. Reduce new card creation to 5 to 10 per day maximum (only critical gaps discovered via case files), increase progressive case file sessions to daily. Revisit the decks for the highest-weighted systems first: cardiology, pulmonology, neurology, infectious disease, and emergency medicine consistently carry high weighting in EDN scoring. In the final 4 weeks: zero new cards, full reviews only, alternating with timed past papers under real exam conditions -- same screen, same time limits, same self-grading rigor.
How to start if you have no deck yet
If you are at the start of PASS and beginning from zero, here is the most effective sequence to get going without overwhelming yourself. The single most important rule: do not try to create an exhaustive deck from day one. Start small, build the habit, and let volume grow naturally as the semester progresses.
- Create your Memia account and set up one deck per teaching unit (8 to 10 decks total).
- From your first lecture, convert 15 to 20 key facts into cards the same evening.
- The next morning, clear all due cards (there will only be a few at first).
- Continue every day. Resist the temptation to create 100 cards at once -- consistency matters more than volume.
- By end of week 1: 80 to 140 cards. By end of month 1: 400 to 600. By end of semester: 1,500 to 2,500 active cards.
- Complement with MCQ training 2 times per week from the third week onward.
FSRS (Free Spaced Repetition Scheduler) is the algorithm used by Memia and recent Anki versions. It calculates precisely when each card should be reviewed based on your response history for that specific card -- not too early (wasteful), not too late (forgotten). This precision is why 20 minutes of daily spaced repetition consistently outperforms 3 hours of passive rereading.
Frequently asked questions
Anki or Memia for PASS?
Anki is the historically dominant tool among medical students worldwide, with a rich community of shared decks (AnKing, specialty decks). Memia offers equivalent algorithmic rigor (FSRS) with a more modern UX and integrated AI generation -- useful for quickly creating cards from your lectures. If you are starting from scratch, Memia offers faster onboarding and a shallower learning curve. If you specifically want access to the international medical community's shared decks (particularly AnKing for international medical content), Anki remains a strong option. Both are complementary and many students use Memia for daily course-based card creation while complementing with Anki shared decks for specialist content.
Can spaced repetition replace MCQ training?
No -- both approaches are complementary and target different cognitive skills. Flashcards anchor facts and concepts in long-term memory through active retrieval. MCQ training practices applying those concepts in a discrimination and clinical reasoning context -- under time pressure and with plausible distractors. Best outcomes come from combining both: flashcards for daily memory maintenance (15-20 minutes), MCQs 2 to 3 times per week to test integration and reasoning under discriminative pressure (30-45 minutes). When you miss an MCQ, create a card for the correct reasoning rather than just the correct answer.
How many new cards per day in PASS?
15 to 30 new cards per day in normal periods. Do not exceed 40 in a single session -- beyond that, card quality drops and review overload the following day compounds. In pre-exam lockdown (3 to 4 weeks before the exam), reduce to zero new cards and focus exclusively on due reviews and past papers. The cards you have already built will do the work -- what you add in the final weeks contributes little compared to consolidating what you already know. If you are behind on volume, prioritize depth (thorough review of fewer cards) over breadth (superficial exposure to more cards).
Are shared medical decks on forums reliable?
Partially. Large decks like AnKing are high quality but may not correspond exactly to your faculty's programme. Decks shared by individual students can contain errors or outdated information. Use them as a starting framework and systematically verify each fact against your own lecture notes before memorizing it. The verification step feels slow but prevents learning and consolidating errors.
Can you start using spaced repetition for EDN after several years without it?
Yes, absolutely -- but the transition takes 2 to 3 weeks of adjustment. Start with a low volume (5 to 10 new cards per day) to get comfortable with the tool and self-rating calibration, then increase progressively. If you have multiple years of content to cover, prioritize the highest-weighted EDN systems rather than trying to cover everything at once. A targeted approach on high-yield content outperforms exhaustive coverage of low-yield material. One effective approach: create a separate deck for each prior academic year, working backwards from the most recent content. This keeps the review queue manageable while progressively expanding coverage.
How do you manage the backlog during exam periods?
During pre-exam lockdown, suspend new card creation and process only due cards. If the backlog is too large for the available time, postpone non-urgent cards using deck suspension or interval adjustment features. The goal during lockdown is consolidating existing knowledge, not acquiring new content. A smaller set of well-reviewed facts is more valuable on exam day than a large set of poorly reviewed ones. Practical priority rule during lockdown: review the decks for subjects with the highest exam weighting first each session, and suspend the least-weighted decks entirely if time pressure is extreme.
Is Memia AI generation adapted to medical content?
Yes -- Memia AI generation can convert a lecture excerpt (paragraph from a handout, lecture notes) into a set of flashcards in seconds. The output must be verified and corrected before use: automatic formulation is not always optimal for the specific MCQ format of PASS, particularly for mechanism cards and association cards that require precise clinical wording. Use generation as a creation accelerator, not a replacement for your own formulation judgment. The cards you review and edit are better encoded than cards you accept without reading -- the act of reading and approving each card is itself a first review that contributes to initial encoding.