Studying for the clinical years and the EDN, item by item

The second cycle of medical school in France (DFASM1 to DFASM3, that is 4th, 5th and 6th year) alternates hospital rotations and teaching. Since the second-cycle reform (R2C), the curriculum is split into 367 items, and each item into rank A knowledge, which every doctor must master, and rank B knowledge, more specialized.

• The EDN (épreuves dématérialisées nationales), taken on a tablet, replaced the ECN. They cover rank A and rank B knowledge, and a minimum grade is required on rank A.
• The ECOS (objective structured clinical examinations) then assess clinical skills, with a simulated patient.
• The choice of specialty and residency city takes these exams and your track record into account.

The exact rules (schedule, weightings) are set by official texts and detailed by your university: refer to them.

The EDN mix progressive case files, where a clinical case unfolds question after question, and stand-alone questions. Formats range from multiple-answer questions to single answers and short written answers, including questions where you point at an area of an image.

Scoring of multiple-answer questions is strict: each discrepancy between your answers and the key takes away part of the question's points. Hence the value of practicing with the real scoring, to learn to tick precisely rather than broadly.

The clinical years are lived in the morning at the hospital. Studying happens in the afternoon, in the evening and in the quiet moments of a rotation. This pace calls for short, frequent sessions rather than long days: the day's cards in twenty minutes, a set of MCQs between two patients, one item reviewed in the evening.

The rotation also feeds memory: a patient seen in cardiology brings an item to life. Write down in the evening what struck you and link it to its item.

The ECOS, for their part, are prepared out loud: on rotation, with your supervisors and with other students.

• Work by item, not by book: an item read in the reference textbook, its rank A knowledge first, then the cards and MCQs that go with it.
• Review each item with the J method (J0, J1, J3, J7…), then let spaced repetition take over on the cards.
• Sit MCQs with the EDN scoring every week, by specialty then mixed, and go back over each mistake.
• Track your progress item by item: what you have seen, what is left, at what pace. A forgotten specialty shows up right away.

For how memory works, see our page on spaced repetition; for correcting MCQs, our guide to practicing MCQs.

• The Items tab: the 367 EDN items sorted into their specialties, the reference textbook for each item, a color tag that colors its cards and sessions, and progress statistics, overall and by specialty.
• The J method by item: J0 on the day you learn it, then J1, J3, J7…, placed in the planner.
• MCQs written by you or shared between students: single answer, multiple answers, multiple answers with a set number, short answer, clinical cases with a shared context, figures. Timed exams, scored with the EDN rules, corrected papers and mistakes to go over again; you can sit just part of an exam.
• Spaced repetition cards (FSRS), cloze or image masks, import of Anki (.apkg) and Quizlet (csv, tsv) decks, mixed review and difficult cards.
• Your handouts and textbooks as annotated PDFs, with text recognition for scans.
• On iPhone, on rotation: review your cards, sit an MCQ, see today's J reviews. Everything is prepared on a Mac or iPad and arrives through iCloud.

Everything stays on your device, with no account. Mnemesia does not include a question bank: the MCQs are the ones you write or that your classmates send you.