iatroX's Q-Bank is not a single tool — it is three tools in one, and using the right mode at the right time is the difference between efficient preparation and undirected practice. The three modes — Adaptive, Spaced Repetition, and Standard — are each built on different learning science principles, and they serve different purposes at different stages of your revision.
This guide explains what each mode does, when to use it, and how to combine all three into a study plan that works for any major medical exam.
The Three Modes Explained
Adaptive Mode
What it does. Adaptive Mode uses an algorithm that adjusts question difficulty and topic selection based on your performance in real time. As you answer questions, the system identifies your weak areas and progressively increases the proportion of questions from those domains. It simultaneously reduces questions from areas where you are already strong.
The learning science. Adaptive learning implements the principle of "desirable difficulty" — the evidence that learning is most effective when the material is challenging enough to require effort but not so difficult that it produces failure without learning. By continuously calibrating to your performance level, Adaptive Mode keeps you in the optimal learning zone.
When to use it. Adaptive Mode is your discovery and weakness-finding tool. Use it in the early and middle phases of your revision when you need to map your knowledge landscape — finding out where your gaps are, not just confirming what you already know.
Practical use. Select your exam (UKMLA, MRCGP AKT, MRCP, USMLE, MCCQE, AMC, PANE), choose Adaptive Mode, and begin. You do not need to select topics or difficulty levels — the algorithm handles this. Sessions of 20-30 questions are ideal. After each session, review your performance dashboard to see which domains the algorithm is targeting most heavily. Those are your weak areas.
What it feels like. Adaptive Mode can feel harder than Standard Mode because the algorithm deliberately focuses on your weaknesses. This is intentional and desirable. If the questions feel comfortable, the algorithm is not doing its job.
Spaced Repetition Mode
What it does. Spaced Repetition Mode resurfaces questions you previously answered incorrectly at algorithmically determined intervals. Questions you got wrong recently appear sooner; questions you got wrong a while ago and then answered correctly appear later. The spacing intervals expand over time as your recall strengthens.
The learning science. Spaced repetition is the most evidence-based method for building durable long-term memory. The Ebbinghaus forgetting curve shows that memory decays exponentially after initial learning — but each successful retrieval at the point of near-forgetting strengthens the memory trace and extends the interval before the next review is needed. This is how information moves from short-term to permanent knowledge.
When to use it. Spaced Repetition Mode is your retention and consolidation tool. Use it throughout your revision, but especially in the middle and late phases, to ensure that knowledge you acquired early in your study plan is still accessible on exam day.
Practical use. Spaced Repetition Mode works best as a daily habit. Open the app, start a Spaced Repetition session, and work through the questions the algorithm has queued for you. Sessions may be short (10-15 questions) or longer depending on how many items are due. The key is consistency — daily sessions, even brief ones, are far more effective than occasional long sessions.
What it feels like. Spaced Repetition sessions often feel like a mix of familiar and forgotten material. You will encounter questions you answered correctly weeks ago (the algorithm is checking whether you still remember), questions you got wrong recently (the algorithm is reinforcing the correction), and questions that have cycled through multiple review intervals. The variety is intentional.
Standard Mode
What it does. Standard Mode delivers questions in a traditional, untimed or timed format. You select the topic, the number of questions, and the difficulty level (if available). The algorithm does not adapt — it delivers a fixed set based on your selections.
The learning science. Standard Mode implements retrieval practice — the evidence that testing yourself is a more effective learning event than passive reading. Each question is an opportunity to retrieve knowledge from memory, apply it to a clinical scenario, and receive feedback on your performance.
When to use it. Standard Mode is your exam simulation and topic-focused review tool. Use it in the late phase of your revision to simulate exam conditions, and at any stage when you want to focus on a specific topic area deliberately.
Practical use. For exam simulation, select a full-length set (matching your exam's format — 160 questions for AKT, for example), enable the timer, and work through the set under exam conditions. For topic-focused review, select a specific domain (cardiology, dermatology, evidence-based practice) and work through a targeted block. Review every answer, including the ones you got right.
What it feels like. Standard Mode feels the most like a traditional Q-bank. It is straightforward, predictable, and gives you full control over what you practise. It lacks the automated efficiency of Adaptive and Spaced Repetition modes, but it provides the exam-simulation experience that the other modes do not.
The Optimal Sequence: How to Combine All Three
The three modes are most powerful when used in sequence across your study timeline.
Phase 1: Discovery (Weeks 1-3 of an 8-week plan)
Primary mode: Adaptive. Use Adaptive Mode for 20-30 questions daily. The algorithm is mapping your knowledge, finding your gaps, and building the data that will power your Spaced Repetition queue.
Secondary mode: Standard. Use Standard Mode for one full-length practice exam at the start to establish a baseline score. This gives you a reference point for measuring progress.
Spaced Repetition: Starting to queue automatically. As you get questions wrong in Adaptive and Standard modes, they enter the Spaced Repetition system. You do not need to do anything — the queue builds itself.
Phase 2: Targeted Strengthening (Weeks 3-6)
Primary mode: Adaptive + Spaced Repetition in parallel. Continue Adaptive Mode for 15-20 questions daily, now increasingly focused on your identified weak areas. Add daily Spaced Repetition sessions (10-15 questions) to consolidate what you have already learned.
Secondary mode: Standard. Use Standard Mode for topic-focused blocks when you have identified a specific area that needs concentrated work. If your Adaptive dashboard shows cardiovascular medicine or evidence-based practice as persistent weaknesses, do dedicated Standard blocks on those topics, then let the errors feed back into Spaced Repetition.
Phase 3: Consolidation and Simulation (Weeks 6-8)
Primary mode: Spaced Repetition. This is now your most important daily habit. The queue contains all your errors from the previous weeks, spaced at optimal intervals. Working through it daily ensures that your accumulated knowledge is still accessible under exam conditions.
Secondary mode: Standard. Full-length, timed practice exams under exam conditions. Do two to three of these in the final fortnight. Score them by domain and compare with your Phase 1 baseline.
Adaptive Mode: Scale back to short sessions (10-15 questions) as a check — is the algorithm still finding new weak areas, or has your performance plateaued? If it is finding new weaknesses, address them. If not, your preparation is on track.
Integrating iatroX Q-Bank with Your Primary Q-Bank
Most candidates preparing for major exams use a primary Q-bank (Pastest, Passmedicine, UWorld, AMBOSS) alongside iatroX. The integration is straightforward.
Use your primary Q-bank for volume and exam-style simulation. These platforms have larger question banks and longer track records of matching exam format and difficulty.
Use iatroX for adaptive targeting and spaced repetition. After completing a block in your primary Q-bank, note your weak domains. Then use iatroX Adaptive Mode to drill those specific areas. Your primary Q-bank errors should also inform which domains you focus on in iatroX.
Use iatroX's integrated ecosystem for immediate clarification. When you get a question wrong in any mode, Ask iatroX is one click away. You can immediately look up the guideline, understand why your answer was incorrect, and reinforce the correct reasoning. This instant feedback loop — question, error, guideline clarification, return to practice — is more efficient than switching between separate tools.
The Knowledge Centre provides structured topic review when you need to read around a subject rather than just answer questions about it. And the Brainstorm tool helps you work through complex clinical reasoning for the kind of multi-step questions that appear in higher-difficulty exam items.
Tips for Getting the Most from Each Mode
Adaptive Mode. Trust the algorithm. It will feel uncomfortable because it targets your weaknesses. That discomfort is the learning signal. Do not override the topic selection to practise areas where you are already strong — that feels productive but is not.
Spaced Repetition. Never skip a day. The algorithm is precisely timed. A missed day creates a backlog that compounds. Even five minutes of Spaced Repetition is better than zero. Consistency beats intensity.
Standard Mode. Use the timer for exam simulation but not for learning sessions. When you are doing topic-focused review, give yourself time to think through each question carefully. When you are simulating the exam, enforce the time limit strictly.
All modes. Review every answer, including correct ones. The explanation and the linked guideline are where the deep learning happens — not in the act of selecting the right option.
Logging Your Learning
iatroX's CPD module allows you to log your Q-Bank sessions as professional development activities, map them to curriculum domains, and generate reflective entries. This is particularly useful for GP trainees maintaining an ePortfolio and for any clinician who needs CPD evidence for revalidation. Your daily revision becomes documented professional development without any additional administrative work.
Conclusion
The three modes of iatroX's Q-Bank — Adaptive, Spaced Repetition, and Standard — are designed to work together across the arc of your exam preparation. Adaptive discovers your weaknesses. Spaced Repetition consolidates your corrections. Standard simulates the exam.
Use them in sequence. Use them consistently. And use the integrated ecosystem — Ask iatroX, the Knowledge Centre, and Brainstorm — to turn every error into a learning moment.
The Q-Bank is free, mapped to your exam curriculum, and built on the learning science that decades of research shows produces the best results. The only requirement is that you use it. Start today, build the daily habit, and let the algorithms do the heavy lifting of scheduling your revision. Your job is to show up and answer the questions. The system handles the rest.