Spaced repetition and other key factors influencing medical school entrance exam success: insights from a French survey
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Abstract
BACKGROUND: First-year medical candidates encounter steep learning demands when transitioning from high school to university. Spaced repetition– a method of distributing review sessions over time– improves long-term memory retention. This study assessed its effectiveness alongside lifestyle and academic factors in students preparing for the medical school entrance examination. METHODS: In 2023, all 618 candidates at the University of Rouen were invited to complete a post-exam, self-administered questionnaire; 523 responded (84.6%). We collected data on revision methods (e.g., spaced repetition, reviewing archives of previous exams), participation in private preparatory classes and summer courses, lifestyle behaviors (e.g., sleep duration, physical activity or smoking), and secondary-school grades. Predictors of success were identified through univariate analyses. A multivariate logistic regression was then conducted to determine independent predictors of success. RESULTS: Of 523 respondents, 134 (25.6%) passed the entrance exam. In univariate analysis, successful candidates significantly more often used spaced repetition (44.8% vs. 20.3%; p < 0.001), reviewed archives of previous exams, attended private preparatory classes or summer courses, and had higher secondary-school grades. In multivariate logistic regression, independent predictors of success included spaced repetition (aOR 2.09; 95% CI, 1.16–3.48), secondary-school grades (aOR 3.19; 95% CI, 2.33–4.37), private preparatory class attendance (aOR 2.02; 95% CI, 1.11–3.66), sleep duration (aOR 1.49; 95% CI, 1.12–1.99), and regular sport practice (aOR 1.81; 95% CI, 1.13–2.93). CONCLUSIONS: Admission success in the medical school entrance examination appeared to be influenced by multiple factors: while spaced repetition significantly enhanced performance, academic background, private preparatory classes, and healthy lifestyle habits also contributed. These findings support integrating validated study techniques and wellness strategies into university support programs for entrance examinations.
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Researchers utilized high-impact standardized assessments, such as the USMLE Step 1 and institutional final exams, to measure long-term knowledge retention.
“Researchers utilized high-impact standardized assessments, such as the USMLE Step 1 and institutional final exams, to measure long-term knowledge retention (Azim et al., 2025;Burel et al., 2025;Chang & Wimmers, 2017;Gilbert et al., 2023;Ward & Vengrin, 2024).”
From Systematic Review of the Effectiveness of Neurodidactic Spaced Learning Strategies in Long-Term Memory (2026) · cites this paper as Burel et al., 2025
The Methods (Design and setting; no page given) describe end-of-year medical-school entrance examinations at the University of Rouen, and the Methods (Statistical analysis; no page given) use exam success as the outcome. The paper does not use USMLE Step 1 or measure long-term knowledge retention; the Discussion (no page given) calls for future research on outcomes beyond entrance examinations. (LLM, conf=0.88)
Experimental — accuracy not yet measuredInferential statistics, including ANOVA, t-tests, and multivariate regression, were systematically applied to establish the significance of time intervals and identify predictors of academic success.
“Regarding data analysis and reliability, inferential statistics, including ANOVA, ttests, and multivariate regression, were systematically applied to establish the significance of time intervals and identify predictors of academic success (Burel et al., 2025;Khalafi et al., 2024;Simmons, 2012).”
From Systematic Review of the Effectiveness of Neurodidactic Spaced Learning Strategies in Long-Term Memory (2026) · cites this paper as Burel et al., 2025
The Methods (Statistical analysis; page not provided) report Welch’s t-tests and multivariate logistic regression, and the Results (Multivariate analysis; page not provided) identify predictors of exam success. The paper does not report ANOVA or test the significance of specific time intervals; the Discussion says students were not asked to specify their study schedules. (LLM, conf=0.90)
Experimental — accuracy not yet measuredNeurodidactic strategies based on spaced learning are frequently associated with better long-term memory consolidation outcomes compared to massed practice, particularly in academic contexts and under controlled conditions.
“The reviewed evidence suggests that neurodidactic strategies based on spaced learning are frequently associated with better outcomes in long-term memory consolidation compared to massed practice, particularly in academic contexts and under controlled conditions”
From Systematic Review of the Effectiveness of Neurodidactic Spaced Learning Strategies in Long-Term Memory (2026) · cites this paper as Burel et al., 2025
The Background says spaced repetition appears to produce better long-term retention than massed practice, and the Discussion links the spacing effect to long-term consolidation. The paper concerns an academic setting, but its Discussion describes a retrospective survey, not a controlled study, and calls for future research on long-term outcomes. It therefore does not substantiate the claim’s qualification about controlled conditions. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMedical school applicants who successfully passed entrance exams used spaced repetition strategies much more frequently than non-admitted candidates (44.8% vs. 20.3%).
“Extending these findings to pre-academic contexts, Burel et al. (2025) reported that medical school applicants who successfully passed entrance exams used spaced repetition strategies much more frequently than non-admitted candidates (44.8% vs. 20.3%).”
From Systematic Review of the Effectiveness of Neurodidactic Spaced Learning Strategies in Long-Term Memory (2026) · cites this paper as Burel et al. (2025)
Strategies including peer tutoring and qualitative student reflections allowed learners to self-regulate their progress and perceive a higher degree of readiness for high-stakes examinations.
“Additionally, strategies including peer tutoring and qualitative student reflections allowed learners to self-regulate their progress and perceive a higher degree of readiness for high-stakes examinations (Azim et al., 2025;Burel et al., 2025;Ward & Vengrin, 2024).”
From Systematic Review of the Effectiveness of Neurodidactic Spaced Learning Strategies in Long-Term Memory (2026) · cites this paper as Burel et al., 2025
The Discussion describes private preparatory classes with small study groups and regular assessments, and the Methods describe a post-exam questionnaire. Neither passage addresses peer tutoring or qualitative student reflections, or reports that these strategies improved self-regulation or perceived exam readiness. Searches for those terms found no supporting passage in our copy. (LLM, conf=0.76)
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Cited by
Sorted by citations
Silva Sánchez, M., Lainez Quinde, G. A., & Zambrano Vélez, W. A. (2026) · Education Sciences · doi:10.3390/educsci16060962
“Researchers utilized high-impact standardized assessments, such as the USMLE Step 1 and institutional final exams, to measure long-term knowledge retention (Azim et al., 2025; Burel et al., 2025; Chang & Wimmers, 2017; Gilbert et al., 2023; Ward & Vengrin, 2024).”
Influential
- Authors
- Burel, J., Trost, O., Demeyere, M., Rives, N., Estour, F., Ladner, J., Crampon, F., Deneuve, S., & Maquet, C.
- Affiliations
- Centre Hospitalier Universitaire de Rouen (FR)
- Inserm (FR)
- Centre National de la Recherche Scientifique (FR)
- Laboratoire d'Informatique, du Traitement de l'Information et des Systèmes (FR)
- Université de Rouen Normandie (FR)
- Corresponding author
- Burel, Julien
- ORCID
- Venue
- BMC Medical Education
- Published
- 2025-07-11
- Volume
- 25
- Issue
- 1
- Pages
- 1036-1036
- ISSN
- 1472-6920 (ISSN-L)
- PMC
- PMC12255137
- OpenAlex
- W4412195572
- Cited by
- 3
- References
- 9
- Citations by year
- 2026: 1 · 2025: 2
- FWCI
- 2.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Medical Education (publishedVersion, cc-by-nc-nd)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- HAL (submittedVersion, cc-by-nc-nd)
- HAL (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Medical Education and Admissions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Social Sciences › Education › Educational Outcomes and Influences
- Keywords
- spaced repetition, medical entrance examination, exam preparation, predictors of exam success, high school grades, sleep duration, physical activity, lifestyle factors, study skills, medical school admissions
- MeSH terms
- Educational Measurement, Female, France, Humans, Life Style, Male, Surveys and Questionnaires, School Admission Criteria, Schools, Medical, Students, Medical
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