How I Use Anki in Medical School

I’d say that one of the best things I’ve done in my 2 years of medical school is using Anki. I’ve been using it since my first year of medical school with great success. Anki has allowed me to spend less time on studying, and yet I’ve been retaining and learning better compared to my pre-Anki times.

It has totally revolutionised my study technique, helped me memorised tons and tons of details that I usually would’ve forgotten on a whim, decreased my stress levels throughout medical school especially and has allowed me to go through medical school on my own terms, where I’m able to travel, join lots of extracurricular activities, run for student council, jog regularly, and do things I love. It has also eliminated that feeling of dread I used to feel whenever an exam lurks nearby.

What is Anki?

Anki is an app created by Damien Elmes that helps you in learning and memorising facts. It has an algorithm build into it that allows you to implement Spaced Repetition into your learning. In simple terms, this means you’ll do a card today, then tomorrow, then 3 days after that, then 5 days, etc.

By showing you flashcards right before you are theoretically about to forget them, this method is both effective and efficient. Spaced repetition is a study technique that mitigates the forgetting curve of memory. Using Anki helps you as it incorporates the two most important techniques for effective learning: Active Recall and Spaced Repetition

4 Reasons Why You Need to Use Anki

1. You won’t have to cram during exams.
2. You’ll save hours and hours on learning and can spend that time elsewhere.
3. You’ll retain what you have learnt over the long term better.
4. You’ll do better in tests, especially in medical school.

How To Get Started with Anki

I’d like to start with a bit of warning: Anki has a steep learning curve, therefore it might take some time for you to get comfortable with it. Since Anki utilises spaced repetition, keep in mind that it’s for long term learning, and not cramming. If you only have a week or two before your exam, I’d recommend you to use this method by Ali Abdaal instead.

First, Download Anki. It’s available on Mac, Windows and Linux.

I’d recommend getting the latest version, which as of time of writing is 2.1.26.

Anki also has a mobile app on both Android and iOS, but I don’t recommend starting with the mobile app as the mobile apps are quite limited in what they can do and were meant to be a companion to the laptop app. The price is a bit steep for the iOS version, but if you find Anki useful, do consider buying the app to support Anki’s developers. Buying the Anki app has probably been the best purchase I made in medical school. You can also access it on your phone via AnkiWeb if you choose not to pay for the iOS app.

After downloading, I’d recommend installing some addons, especially the Hierarchical Tags addons. To do so, go over to the top of your screen, click View → Addons, and click Add Addons. Type in the addon number which can be found on the addon page. The only addons which you need for this guide is Hierarchical tags. There are other addons, but I’ll save that for another post.

I’d also recommend that you read the official Anki Manual.

Navigating through Anki/The Basics of Anki

Download some decks

Next, download some pre-made decks. Head over to r/medicalschoolanki and download the decks. The gold standard for pre-clinicals and Step 1 is Anking Step 1 v7.2 while there’s AnKing Step 2 v2 for clinical students and for those taking Step 2. There are many decks available on r/medicalschoolanki for your use. After downloading it, it should come up as an .apkg file. Double click it and the deck should be exported.

Recommended Anki Settings

Next, configure some of your deck settings. There are various recommended settings out there, but I’d say to stick to the ones I’ve shown in this post for now. I’ll say that there’s no setting that fits all, and the settings really depend on what you are trying to achieve. I’ll work on a post explaining settings soon, but for now, just use the ones that I have listed. I’ll make another post on the other settings and what are the differences between them later.

Click the gear bar next to the deck, and click options. For the Default settings, you’d want to use the ones as shown below:

Next, configure your preferences. Go over to Tools → Preferences (Ctrl+P)

How to Use Pre-Made Decks

There are some people that recommend making your own cards, but for medical school at least, based on my personal experience, it’s always better to use pre-made cards. 3 reasons being:

1. You can save time, it takes tons of time to make your own cards, and I wished I could regain the time I lost making cards.
2. The pre-made cards that are out there are usually are of very high quality and helps simplify information in a very good manner.
3. If your lecture materials cover more than what the pre-made cards cover, what you can do is just do what’s pre-made first, then add on with your class material later.

The AnKing deck that I’ve stated is that its the most extensively tagged decks out there. That means that you can easily find whatever material/topic you want just through its tags. At the start, click (Ctrl/cmd+A) on all of your cards, and toggle suspend it (Ctrl/cmd+J). Suspended cards will show up as yellow. Suspending means that the card won’t show up when you review it. Whenever you want to study a topic, what you can do is go to the left side of the bar, click the tags according to the topic you want, and un-suspend the cards that are related to the topic.

You could also make decks for each topic that you wish, and move them to the decks, which is what I did for my case as shown in the picture below.

How To Use Pre-Made decks alongside your lectures

The search bar in the Anki browser utilises Boolean search.
If you want to find cards with a specific term eg; heart failure, type in “heart failure”. If you were to search for heart failure instead, it’d show cards containing the term heart OR failure. What you can do is, look for the learning objectives of your lecture for terms regarding the topic, and search in the browser using the OR function.

I would then suggest that you add in screenshots from your lectures into the pre-made cards for context learning.

Anki Workflow

1. Understand. Before you do any Anki Cards, make sure that you have gotten a first-pass through the material that you are learning. You need to understand the big picture of a topic before doing Anki.
2. Memorise. Do the Anki cards based on the topics you just learnt.
3. Apply. Try doing some question banks, or questions regarding the topic that you just learned. Learning how to apply it, even with MCQ books can help solidify it.
4. I usually do this at the start of each block, and I try to finish all of the premade cards for a specific topic to gain a basic foundation, a big picture of how the whole block is. Once that’s done, I’ll proceed with making cards for my lectures. I find that having a big picture view of a block helps me in learning lecture materials as I find lectures a bit too detailed most of the time.

Some tips on how to use Anki

• If there’s one rule to Anki, it is that you must complete ALL your due review cards for each day.
• You must do your due cards every single day for the best results. You need to trust the spa
• Study in Pomodoro sessions. Reviewing your cards can be dull. Studying via the Pomodoro method can help you stay energised and interested throughout.
• The recommended number of new cards you should do every day that is sustainable at least would be 100 cards, 6 days per week. The number will vary according to what you have in mind, but 100 is a reasonable amount since you gotta remember that you need to do reviews too! try 100 a day, for 6 days of the week first. If you find it too hard or too easy, adjust accordingly. Another way of finding how many cards you need to do in a day is to simply count how many days till you want to get a certain deck done, and just divide the number of cards with the number of days you have left.
• If you have a lot of cards to do, try doing 10 cards first/use filtered decks. Sure, you lose out on the interleaving side of Anki, but the motivation you get from achieving small steps is more worth it IMO. The most important step in making a habit is to make it easy.
• An issue that arises when studying with Anki is that you tend to think of the information as discrete, intangible and separate facts. Therefore, you need to get a big picture of the topic first before memorising with Anki. You could achieve the connections between each fact by constantly asking yourself 2 questions as you go along doing your cards. Why is the answer as such? Where does this piece of information fit into the overall big picture? You could also connect the dots by doing question banks and mind maps.
• Speak the answer out loud. It can help you in memorising and ensures that you are actively learning the material.

What if I’m not taking USMLE? Are the pre-made decks still relevant for me?

Yes. Absolutely. I’d say to use pre-made cards, even if you’re not taking Step, for the sole reason being that step covers the basic medical knowledge adequately. For my case, I’d say step pre-made decks covers about 70-80% of my syllabi. If you find the stuff in the pre-made decks insufficient, you can always make your own cards anyway.
The adage goes such that you should make your own cards, but IMHO I’d go with pre-made cards. They’re of better quality and probably cover 80% of your syllabus anyway. (it depends on your school, my school materials are around 70-80% on pre-made cards). The problem with medical school is such that there’s just too much info to take in at once, and you only have 24 hours a day. Using pre-made cards can save tons of time. If you decide to make your own cards, you’re still saving time by effective learning anyway.

Why not Quizlet?

Quizlet’s spaced repetition algorithm requires a paid subscription, and Anki is free bar the iOS app. Plus, the amount of community support and addons Anki has is just incredible. I can’t believe that there’s a huge community of people willing to share their knowledge freely.

Important Note: Use Anki as a supplement to your studying.

Don’t substitute it for understanding, and do not just simply memorise the facts via brute force.

A good way to help to understand would be to ask yourself why? whenever you see the answer to a card.

If you don’t fully get it, it’s like a tree in your head with no trunk – and without a trunk, when you learn something new about the topic – a new branch or leaf of the tree – there’s nothing for it to hang onto, so it just falls away. By [developing understanding], I build a tree trunk in my head, and from then on, all new information can hold on, which makes that topic forever more interesting and productive to learn about

– Tim Urban

Still Don’t Buy It?

• Read this, this and this
• Just try it for one week and to see what a difference it makes compared to note-taking/highlighting/re-reading.

Further Reading

• How to Make Good Anki Cards
• Ali Abdaal’s Skillshare class
• MedShamim
• r/Anki and r/medicalschoolanki
• MedSchoolAnki site
• The AnKing YouTube channel
• Prerak Juthani
• Official Anki manual

If you have any questions, feel free to contact me.

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