If you’re a pre-med or medical student, you’ve likely heard of Anki. Chances are that you fall into one of two camps – you either love it, or you’ve tried it and decided that it wasn’t for you. If you fall into the latter, I’m willing to bet that you’re not creating good flashcards. These are the best principles to make Anki easy and effective.
If you haven’t already, be sure to first check out part one on how to improve your memory.
Spaced repetition software, like Anki, is one of the most powerful learning tools available for medical students. But as a tool, there are those who use it well, and those who misuse it. When I first started using Anki as a medical student, some of my cards were good, but most were garbage. It wasn’t until the end of medical school and while I was in plastic surgery residency that I began using it most effectively. These are the best practices in creating effective flashcards.
1 | Keep Your Decks Simple
Do NOT have a sub-deck for each week in a class. This fragmentation simply complicates the task of reviewing the necessary information. My general recommendation is to create a single deck for large exam.
In medical school, I had a single deck for Step 1 that included everything from my first two years. My Step 2CK deck included everything from my third year. Within each deck, I tagged cards by organ system, like cardiology or pulmonology, and also by other useful pieces of information, such as whether they included a mnemonic or other memory device.
Structuring your deck in this manner serves two main purposes. First, you’ll waste less time organizing and structuring your deck. Sometimes simple is better.
Second, and more importantly, you’ll be in the habit of reviewing the entire deck, which is very good for your larger exams, whether that’s the MCAT or USMLE Step 1 or COMLEX. With a fragmented deck, this just doesn’t happen. Remember, for spaced repetition software like Anki to work properly, you must regularly review information. Many students are concerned that they’ll be wasting precious time reviewing older information at the expense of newer information. But therein lies the beauty of spaced repetition. By the time you’ve moved onto the next class, the intervals for your previous subject are much longer, meaning it takes far less time to maintain the already-consolidated information. And when the big exam comes around, you still remember most everything.
2 | First Understand, Then Memorize
A surprising number of students succumb to the mistake of trying to memorize something that they don’t comprehend. There is little utility in memorizing a string of information if you are not able to adequately conceptualize and place it within a mental scaffolding.
If you don’t first understand the information, you’re much less likely to remember and recall it. Equally important, you’re also less likely to adequately apply the information come test day. Remember, performing well on a test isn’t just a matter of knowing the information, but also understanding its context and how to apply it.
You will drastically reduce the time it takes to learn and memorize if you’re able to slot each individual piece into a coherent structure. Memorizing loosely related facts is of little utility.
3 | Lay the Foundations First
This tip is based on the Pareto Principle, also known as the 80/20 rule, which states that 80% of the effects come from the 20% of causes. Applied to Anki flashcards, this means being efficient with how you study – focus on the highest yield information such that on test day, you’ve optimized your chances of scoring well.
Often times, students get caught up in smaller details which are low-yield. Remember that a mental scaffolding and foundation of basics is essential. Simple models, after all, are easier to comprehend and quickly review. From there, you can fill in the details as you progress.
4 | Follow the Minimum Information Principle
The Minimum Information Principle reminds us that simple is easy, and that simple cards are easier to review and schedule. Consider this. If a single card has two sub-items, you need to keep repeating the card to keep the more difficult item in your memory. However, if you split this single card into two separate cards, each can be repeated at their own pace, ultimately saving you time in the long term.
This is arguably the biggest offense of most students when they first begin using Anki. Most students make very complex cards that could be broken down into a dozen or more sub-items. I was guilty of doing this for much of medical school.
Some may argue that since the number of cards increases, it’s ultimately less beneficial. You must keep in mind that the total number of repetitions will decrease over time. By sticking with a complex card with multiple sub-items, you’re more likely to (1) forget the more difficult sub-item repeatedly, (2) repeat the card in excessively short intervals, or (3) remember only a part of the complex card.
5 | Cloze Deletions Are Your Best Friend
I used Anki for several months before learning about Cloze deletions. Once I did, they quickly became my favorite type of card. Cloze deletions are essentially fill-in-the-blank questions. You can make the blank as short or long as you want. I go over the shortcuts, formatting, and details on how to use Cloze deletions in a previous video.
If you’re finding it difficult to stick with the minimum information principle, then Cloze deletions are a great tool to break your bad habits. They’re also incredibly efficient to create, as you can copy text from your powerpoint or notes and create Cloze cards in just seconds.
6 | Use Images, Photos, & Figures
Your memory is much more efficient at retaining visual than text based information. It makes sense – we’ve evolved over millions of years and only had written language for a small percentage of our existence. Images are particularly beneficial for certain subjects, like anatomy or chemistry. That being said, I’d argue that even for more text-based subjects, images are still warranted.
When creating your Anki cards, try to find an image for most of your cards. It doesn’t always have to be exactly related to the card, either. If the topic of the card makes you think of something unrelated, find an image of it. While this may take upfront time and investment, over the long term it greatly reduces your learning time. Be generous with inserting images into Anki. Go on Google images, search for something relevant, and quickly copy/paste it or screenshot into Anki. Knowing your shortcuts will save you loads of time here.
If you have a diagram you want to test yourself on, like the Kreb’s cycle, you can block certain segments of the image and create cards that way. The best way to do this is the Image Occlusion Enhanced plugin for Anki. I go over how to install and use it in a previous video.
7 | Mnemonic Techniques
In a previous video, I went over the importance of various mnemonic devices and the method of loci. Combining these mnemonic devices with spaced repetition in the form of Anki flashcards is one of the best ways to supercharge your memorization abilities.
I personally used the tag “story” or “mnemonic” on my Anki cards and would craft stories or mnemonic devices underneath the answer on the back side of the card. Unfortunately, I can’t share too many of mine as most are rather risqué. Remember, the more vulgar, obscene, or ridiculous, the better, as long as it makes sense to you.
When crafting your own mnemonic devices, there are two additional considerations to keep in mind. First, the Self-Reference Effect means you are more likely to remember pieces of information that relate to you, so think of personal and relatable examples. Second, take advantage of strong emotional states to help make the information more sticky. This ties back in with making more vulgar, obscene, and ridiculous memory devices.
8 | Avoid Sets and Enumerations
Sets are collections of objects. For example, what are all the branches of the external carotid artery? Just listing them without direction is actually quite challenging. Instead, convert this to an ordered list, which is called an enumeration. By reciting the branches in order from proximal to distal, you’re much more likely to remember the information.
Some Anatomists Like F-ing, Others Prefer S&M
S: superior thyroid artery
A: ascending pharyngeal artery
L: lingual artery
F: facial artery
O: occipital artery
P: posterior auricular artery
S: superficial temporal artery
M: maxillary artery
Why is that? Whenever you complete a repetition of the information you want to learn, it’s important to reinforce it the same way each time. Enumerations are good in that they are ordered, forcing you to recite the information in the same order each time, thus reinforcing the same learning pathway. However, they are are not simple and should not be used too frequently.
If you’re having difficulty during each repetition of an enumeration, you can use overlapping cloze deletions. For example, have the first three branches of superior thyroid artery, ascending pharyngeal artery, and lingual artery as one cloze, then the next one as lingual artery, facial artery, and occipital artery, and so on and so forth.
9 | Be Concise
Brevity is your friend. When you’re reviewing hundreds of cards per day, a superfluous word here or there quickly adds up. For that reason, it’s key that you optimize wording. Focus on the exact information you need. The words before and after that information is less important. Get rid of it.
10 | Redundancy – Attack the Information From Different Angles
Most of us practice the information we need to learn in only one direction. Come test time, that can lead to problems. For this reason, I recommend you practice redundancy with your Anki cards. Learn to practice the information from more than one direction.
Let’s go back to the branches of the external carotid artery. Rather than just reciting the branches in order, you can test yourself on a single artery and trace the path from the heart. For example, what is the path from proximal to distal of the left facial artery?
Ascending aorta → common carotid → external carotid → facial artery
11 | Provide Sources
Provide sources to your cards. This isn’t a hard rule, but this proved useful to me on many occasions in medical school. Certain texts may contradict other texts, and there are times when you need to figure out what is the truth. Listing the source from where you got the card will make the process much simpler when this inevitably arises. Remember, this is just for your own purposes so you know where you got the information in case you need to reference it again. Don’t worry about doing MLA bibliography format or anything like that.
12 | Don’t Be Afraid to Edit or Delete
As you prepare for any large exam, your Anki deck should be constantly evolving. And over time, your Anki card creation skills will improve. My earliest cards were far too complicated, and the process of developing my card creation skill was gradual. Don’t be afraid to go back and edit, improve, or even delete cards as needed.
13 | Set a Daily Threshold for New Cards
You will have days where you create lots of cards, and other days where you don’t create any at all. To maintain a more even learning schedule and review burden, I recommend setting a daily threshold for new cards. I usually left my review card number uncapped to let Anki’s algorithm work its magic, and only capped new cards.
Lots of students ask me how many new cards they should be doing per day and how many cards they should be reviewing. There are too many factors and it’s therefore not possible to give a range that’s suitable for everyone. My recommendation is to stay flexible. There were times, such as when I was ramping up for my sub-internships, where I was cranking through up to 100 new cards per day. However, once I felt comfortable with my knowledge and had a large review queue, I reduced the new card limit to 25-50 per day, depending on how busy my rotation was. Play around with the limits and figure out what works best for you.
Creating Anki cards and optimizing your learning in medical school is no easy task. It took me years of experimentation and tweaking to finally get consistent and excellent results that allowed me to match into a hypercompetitive surgical subspecialty. If you aren’t getting the results you want in university or medical school, our tutors at MedSchoolInsiders.com can help. Whether it’s the MCAT, USMLE Step 1, or any other pre-med or medical school test, we can help. Our tutors scored in the top percentiles and can help you do the same. If you regularly watch our YouTube videos, chances are you know how heavily we emphasize the importance of systems in generating desirable results. Our tutoring is no different. We’ve painstakingly taken months crafting the systems in place to provide the best quality tutoring. We examine your test taking strategies, study methods, road blocks and sticking points, and customize a tailored plan to optimize your performance on test day.