Evergreen notes in medicine workflow

Hello there Rem community!

I suppose that some of us are somewhat related to medicine - either studying in med school or already being a doctor. Med school knowledge may be divided into two parts - basic sciences and medical sciences. However these two parts are deeply connected. A lot of med students struggle to develop those deep connections, and I personally think there’s no way to deeply understand medical sciences without knowledge of basic sciences (eg. pharmacology, biochemistry etc.).

My goal is to develop the perfect workflow suitable for med students. The most important features of this workflow would be:

  1. A base of concepts (i.e. diseases, symptoms, drugs)
  2. A possibility to make notes from various sources and connect them to the base of concepts (evergreen notes that include spaced repetition questions)
  3. Possibility to connect notes between each other in context of used concepts

However I stumbled upon some difficulties during developing this workflow. I have no idea how to create the base of concepts - should the concepts be top level rems or just references? Should I make a special slot in my note for references or just use references inside the text of notes and questions?

I’d like to ask for help from You guys. Maybe some of you already did something alike mine workflow?
@Karthikk @mattygrov


I love this initiation, and you posted this at the right time. I have just begun to organise groups based on degrees/ exams that a RemNote user might be learning for. Check out the discord server, for a channel named Workflow Groups, and kindly fill in your details, I should have the groups functional in a few days, where I intend to work closely with all of you to help everyone come up with best practices or powerful workflows based on their niche!

Will be looking forward to seeing you there!


Yeah, this with this thread I intended to start a discussion to be further continued on discord

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Wonderful, please do save it until I have the group organised :slight_smile: let’s explore good workflows soon!

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I’d be wary of importing a note-taking framework in a non-native environment. I know that Zettelkasten or Evergreen notes have been garnering a lot of hype lately but before venturing into such an upkeep heavy note-taking approach, I think one should consider the environment under which an approach emerged in the first place to see whether the environment could be replicated.

As Andy puts it Powerful enabling environments usually arise as a byproduct of projects pursuing their own intrinsically meaningful purposes.

From my understanding, Evergreen notes are essentially nuggets of insights that equate to intermediate outputs in an environment meant to ultimately marshall and synthesize these insights into Research (aka: new incremental knowledge in a very specific domain)

I’m not very familiar with Med School student practices, but I imagine based on the obsession with Anki that it’s about building up knowledge (breadth and depth) in diverse range of complex domains for application… Hence it’s not about projects that end in discovery… it’s about knowledge acquisition, application and retention (ahem: anki)

This doesn’t mean Evergreen notes can’t be applied, but I’d just caution against jumping in based on hype… I’ve known people still tweaking their zettelkasten workflows since Roam came out… which suggest to me that a huge chunk of their time have been invested in building/tooling > learning

One thing that is zettelkasten like though is “Every Page is Page One” which approaches knowledge building from the perspective of a technical writer. You can see the discussion about it here Baker and Me -- Joe Pairman Uncovers Universal Principles • Zettelkasten Method

End of day… I think the best bet is to leverage the principles in Andy’s notes for something (not necessarily Evergreen notes) that can work in your unique environment


Wow, I am very thankful for your in depth reply. It got me into thinking if Zettelkasten or evergreen notes are for real nescessary for my med school worflow

No worries. My rule of thumb is to focus on what the successful practitioners in your field does workflow and tool wise. The idea of zettelkasten came from Luhman who was prolific professor. As you can surmise, being professor required publishing lots of original content meant to drive knowledge (analytic and/or synthetic). That’s way different from a student in a profession or a trade. Which is probably why medschoolers aren’t tripping over it. Another rule of thumb is this idea of “leveling”. It’s almost like a heuristic that whenever an idea spreads like wildfire outside it’s original context, the original sense gets “leveled” or “flattened”… which is why we now see zettelkasten kinda equating to “how one should” build a knowledge base or do note taking…


The upgrading process of pure zettelkasten is meant to make sure only well understood and therefore well connected notes get to mingle with each other (only “evergreen” and entrypoints/indices for them), while the rest stay separate in the literature reference system (literature notes, and by extension annotated pdfs, lectures etc.) or get discarded after getting used to create an evergreen (daily notes/thought queue). While this process is unambiguously the best for writing-related tasks, it is not a replacement for carrying out the non-writing processes described in the notes, nor is there much space for “orphan” flashcards that don’t link to anything.

Not being a medic myself, I would suggest dipping your toes by creating a small web of notes about a topic you feel you need to understand more deeply rather than just recall the names of things. Of course, you can always download and import an Anki deck to keep up with the memorisation workload and as possible jumping off points to evergreens. You can also dump the flashcards in a glossary per topic and link to them in your more elaborate notes.

Happily, with everything being a rem, you can always go back and forth between systems and combine them freely. You may find a list of resources for further reading here.