Spaced Repetition Boosts Retention

My clinical career ended before it even began.

I graduated from medical school fully intending to practice medicine for the rest of my life.

But just four months later, I was struggling with debilitating anxiety and depression.

I remember one night in particular. My wife and I had a friend over for Indian takeout, but I couldn’t bring myself to eat. I couldn’t engage in the conversation.

I sat there, turned inward, trying to envision a future where I both practiced medicine and wanted to stay alive.

I started to imagine myself in a car crash and felt relief. Those thoughts became more frequent. Then, I began making plans.

I’m alive today thanks to a therapist, a psych NP, and a supportive community.

I made the decision to leave my residency program, not knowing what I would do next, but knowing that staying was too high a risk for me.

It’s been 8 years, and I’m grateful every single day that I made that decision and that I still get to be involved in medicine.

I wish that were the case for all physicians in distress, but unfortunately, it isn't. 

In the US alone, we lose 300-400 physicians to suicide every year.

Physicians Anonymous is a non-profit organization that provides FREE confidential physician-only support groups and coaching for medical students and physicians who are struggling with burnout, moral injury, anxiety, depression, addiction, and suicidality. They are on an ambitious mission to reduce physician suicide by 50% in 5 years.

I recently met with the organization's co-founder, Dr. Dominic Corrigan, who has a personal connection with this issue. He said:

September is Suicide Prevention Month. You can learn more and access resources through the National Alliance on Mental Illness (NAMI) and the ACGME, and can refer students, residents, and physicians to Physicians Anonymous.

A new study, published online ahead of print in Academic Medicine, shows that spaced repetition helps learners retain information longer and apply it in new situations.

What is Spaced Repetition?

Spaced repetition involves strategically re-reviewing material at set intervals over time, leading to better retention compared to cramming or single reviews.

Study Details at a Glance:

• Study Title: The Effect of Spaced Repetition on Learning and Knowledge Transfer in a Large Cohort of Practicing Physicians

• Study Type: Prospective cohort study

• Participants: 26,258 family doctors and residents

• Groups:

  • Control group (no spaced repetition)

  • Five spaced repetition groups with different strategies

• Duration: 15 months, with follow-up 6 months later

• Key Findings:

  • Higher retention: Doctors using spaced repetition remembered more than those who didn’t (58.03% vs 43.20%, P < .001, Cohen d = 0.62).

  • Better knowledge transfer: Doctors using spaced repetition applied knowledge in new clinical situations more effectively (58.33% vs 52.39%, P < .001, Cohen d = 0.26).

  • More reviews, better results: Doctors who repeated the review twice outperformed those who reviewed only once in both retention (62.24% vs 51.83%, P < .001, Cohen d = 0.43) and knowledge transfer (60.08% vs 55.72%, P < .001, Cohen d = 0.20).

👉 Key Takeaways

🗝️ Spaced repetition leads to better retention.

🗝️ Spaced repetition improves knowledge application.

🗝️ Use practice questions to prioritize content for spaced repetition. Focus first on questions answered incorrectly with confidence.

🗝️ Regular, brief reviews significantly enhances memory.

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