Anki Flashcard 13 Best Practices: How to Create Good Cards

If you’re a premed or medical student, you’ve likely heard of Anki. Chances are you fall into one of two camps: you either love it, or you tried it and decided it wasn’t for you. If you’re in the second camp, I’d bet you’re not creating good flashcards.

Spaced-repetition software like Anki is one of the most powerful learning tools available to medical students, but there’s a real gap between using it well and using it badly. When I started using Anki in medical school, some of my cards were good. Most were garbage.

It wasn’t until the end of medical school and into plastic surgery residency that I figured out how to use it well. These are the best practices I’ve found for 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 a large exam.

In medical school, I had a single deck for Step 1 that included everything from my first two years. My Step 2 CK deck included everything from my third year. Within each deck, I tagged cards by organ system (e.g., cardiology or pulmonology) and by other useful 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 excellent for your larger exams, whether that’s the MCAT, 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 review the information regularly.

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 on to 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 on 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 studying efficiently. Focus on the highest-yield information such that on test day, you’ve optimized your chances of scoring well.

Often, students get caught up in low-yield details. Remember that a mental scaffolding and a foundation of basics are essential. Simple models are easier to comprehend and to review quickly. 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, each can be repeated at its 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 as the number of cards increases, the benefit diminishes. 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.
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 using Cloze deletions in a previous video.

If you’re finding it difficult to stick with the minimum information principle, Cloze deletions are a great tool for breaking 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 said, I’d argue that even for more text-based subjects, images are still warranted.

When creating your Anki cards, try to include an image for most of them. It doesn’t always have to be exactly related to the card, either. If the card’s topic 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 to Google Images, search for something relevant, and quickly copy/paste it or take a screenshot in Anki. Knowing your shortcuts will save you loads of time here.

If you have a diagram you want to test yourself on, like the Krebs 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 tags “story” or “mnemonic” on my Anki cards and would craft stories or mnemonics on the back of the cards, underneath the answer. 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, keep two things 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, lean on strong emotional states to make the information stickier. 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 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 to optimize the wording. Focus on the exact information you need. The words before and after that information are less important. Get rid of it.

10 | Attack the Information From Different Angles

Most of us learn information 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 multiple directions.

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 for your cards. This isn’t a hard rule, but it proved useful to me many times in medical school. Certain texts may contradict other texts, and there are times when you need to figure out what the truth is.

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 developing my card-creation skills 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 a more manageable 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 do per day and how many they should review. There are too many factors, so it’s not possible to give a range suitable for everyone.

My recommendation is to stay flexible. There were times, such as when I was ramping up for my sub-internships, when 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 achieve consistent, excellent results that enabled me to match into a hypercompetitive surgical subspecialty.

If you’re studying for the MCAT specifically and don’t want to spend the time building your own deck from scratch, Memm is worth a look. It skips the card-creation process entirely and gives you comprehensive, pre-built flashcards and review sheets designed around the exam, so you get the benefits of spaced repetition without the years of trial and error I went through building mine by hand.