In medical school, I heard stories of students who could recite entire chapters from BAJA, the renowned surgical textbook. Some could read textbooks cover to cover, not just once, but multiple times. Their ability astonished me.
My approach to studying has always been different. I read a chapter, absorb what I can, and move on. Later, I return, reread, and pick up details I missed or forgot. It’s a cycle of refining my understanding over time. I believe that’s how most of us learn. It's a type of spaced repetition.
In essence, we all use spaced repetition—it’s just not always intentional or efficient. That’s why I recommend Anki—a tool that helps you make the most of it.
THE FORGETTING CURVE
Hermann Ebbinghaus. Does that name mean anything to you? No? It meant nothing to me—until I started looking into how we learn and forget.
Ebbinghaus was a German psychologist in the late 19th century. He discovered that we forget nearly 50% of what we learn within an hour and up to 80% within a few days—unless we reinforce it. (I’m sure we’ve all experienced this firsthand.)
However, every time we actively recall information, we slow down the forgetting process, making it easier to retain over time.
This is where spaced repetition comes in. Instead of reviewing material randomly or cramming everything in one sitting, spaced repetition ensures you revisit information at the optimal intervals—right before you're about to forget it.
Optimal intervals. That’s the key.
Traditional rote memorization relies on passive review—re-reading notes, highlighting, or copying information over and over. While this might feel like learning, it doesn’t engage active recall or effectively combat the forgetting curve.
Spaced repetition, on the other hand, is an active learning technique. Strategically reinforcing knowledge at increasing intervals strengthens neural connections, making recall easier and more reliable.
Students who use spaced repetition don’t just memorize for exams—they retain knowledge for the long haul, in both academics and clinical practice.
WHAT IS ANKI?
Traditional flashcards, whether physical or digital, require self-scheduling, meaning you must decide when to review each card. This often leads to inefficient study patterns, either through over-reviewing well-known material or under-reviewing difficult content.
Anki is an advanced flashcard-based learning software that leverages spaced repetition to enhance memory retention and recall.
Unlike traditional flashcards, which rely on random or manual review, Anki uses an algorithm to optimize when and how often you review each card.
When you study with Anki, every flashcard you review is assigned a difficulty rating based on how well you recall it. This rating determines when the card will reappear in your study queue.
Here's how it works:
- Difficult cards (those you struggle with) will reappear frequently.
- Moderately familiar cards will return after a few days.
- Well-known cards will be pushed further into the future—sometimes weeks or months later.
Each time you successfully recall a fact, the interval before you see it again increases exponentially (e.g., 1 day → 3 days → 7 days → 14 days → 1 month → 3 months, and so on).
This is inspired by something called the Leitner System. It ensures that you focus more on weak areas while reinforcing strong ones at just the right time.
This leads to stronger recall, better exam performance, and knowledge that actually sticks—long after medical school.
WHAT'S THE LEITNER SYSTEM
The Leitner System works by organizing flashcards into different groups or "boxes" based on how well you remember them.
- You start with all your flashcards in the first box.
- When you review a card and get it right, it moves to the next box, where you’ll see it less frequently.
- If you get a card wrong, it stays in the first box (or moves back to an earlier one), meaning you’ll review it more often.
- The better you remember a card, the further it moves along the system, increasing the time before you see it again.
WHERE TO GET THE CARD DECKS
You have two options: create your own or use pre-made decks.
Creating Your Own Decks
There are plenty of YouTube tutorials that walk you through the process, and making your own cards can actually reinforce your learning, but I'm not going to recommend that.
Using Pre-Made Decks
One of the biggest advantages of Anki is the vast collection of high-quality, shared decks created by medical students and professionals. Some of the most popular ones include:
- Zanki – A comprehensive, high-yield deck covering nearly all of medical school.
- AnKing – An improved version of Zanki, integrating additional resources like First Aid and Boards & Beyond.
- Lightyear – A structured deck that follows the Boards & Beyond curriculum, ideal for students who prefer an organized study path.
These pre-made decks contain thousands of meticulously crafted flashcards aligned with medical curricula, saving you countless hours of card creation.
Instead of spending time building your own deck, you can dive straight into active learning and review, making your study sessions far more efficient.
Here’s the best part: You’re not locked into these decks. You can:
- Delete cards that aren’t useful to you.
- Add cards for concepts you want to reinforce.
- Edit existing cards to reflect the latest medical knowledge—because, after all, medicine is always evolving.
By adapting these decks to fit your personal learning style, you get the best of both worlds: the efficiency of pre-made resources and the flexibility to tailor them to your needs.
A WORD OF CAUTION: Understand Before Memorizing
While pre-made decks are incredibly useful, they should not be used as a replacement for true comprehension.
Memorizing isolated facts without understanding the underlying concepts can lead to superficial learning, making it difficult to apply knowledge in clinical settings or during exams that require critical thinking.
To avoid this pitfall:
- Use Anki alongside primary learning resources (e.g., lectures, textbooks, videos).
- Ensure conceptual understanding before memorizing—don’t just rote-learn facts without context.
- Actively engage with the material by thinking through mechanisms, forming connections, and applying knowledge to practice questions.
HOW TO GET STARTED
If you’re ready to make Anki an essential part of your medical school study routine, here’s a step-by-step guide to getting started.
1. Download and Install Anki
Anki is a free, open-source software available on multiple platforms:
- Desktop (Windows, macOS, Linux) – The most powerful version with full features.
- Mobile (iOS, Android) – Ideal for reviewing cards on the go (note: the iOS version is paid).
Download Anki here: https://apps.ankiweb.net/
2. Syncing Across Devices
To keep your progress updated across devices:
- Create an AnkiWeb account (free).
- Enable syncing in the Anki desktop app (File → Sync).
- Sign in on your mobile app to access your flashcards anywhere.
NOTE: I have found only having Anki on my laptop to be most effective. Our phones contain too many distractions.
3. Develop a Consistent Routine
Set a Daily Goal
- Aim for 100–200 cards per day, depending on your workload.
- Newer users should start slow (e.g., 50–100 cards) to avoid burnout.
4. Consistency > Volume
- Anki works best when used daily—even 15-30 minutes a day is better than cramming.
- Skipping multiple days leads to a backlog of due cards, making it harder to catch up.
- Avoiding Overload and Burnout: Limit daily new cards (~20-50 per day for beginners).
- Use the ‘Easy’ button wisely—don’t overuse it, or you’ll push cards too far into the future.
- If overwhelmed, suspend non-essential cards and focus on high-yield topics.
FINAL THOUGHTS
Starting with Anki may feel overwhelming at first, but once you develop a routine, it becomes one of the most efficient ways to retain vast amounts of medical knowledge. Keep your cards simple, stay consistent, and trust the process—your future self (and exam scores) will thank you.
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