Never Forget What You Learn: 4 Reasons You Should Be Using Anki in Medical School and Beyond

Even with well-made memory palaces and tricks for stronger images (e.g. I shoot for ≤3 images per locus to minimize congestion and speed recall), fading images are an inevitable problem. When I first experimented with memory palaces in medical school, this frustrated me to no end. What's the point of doing all this work if I'm going to forget my images in a week?! The solution: spaced repetition—a review strategy that spaces out reviews over progressively longer time intervals. For example, you learn the material on Day 1, review on Day 4, review a week later, then a month later, etc.). The good news is that after 2-3 reviews, the images and ideas tend to stick really well. There's good learning science to back up spaced repetition too. One of the learning literature's seminal papers marked "distributed practice" (spaced repetition, essentially) as a high-efficacy learning strategy. The only other strategy to receive that designation was practice testing. An easy way to implement both spaced repetition and practice testing? Anki.

Anki refers to a free, flashcard-based spaced repetition software available here. Spaced repetition is a powerful tool for making things stick long-term, and I can't imagine learning without it—even with the aid of memory palaces. In my mind, spaced repetition plus no memory palaces beats memory palaces without spaced repetition. That said, the combo of spaced repetition supplemented with memory palaces beats both. 

I take just about all of my notes using Anki (for medical school, language learning, etc.). It’s not perfect, but I think it can be a valuable learning asset for anyone when used correctly. Despite its rigid structure, I find that Anki helps de-constrain me in many ways. I do, however, accept that different approaches work for different people. In addition to its automated spaced repetition algorithm, here are the main things I like about Anki:

  1. I like the structure of Anki, since it theoretically optimizes the amount of time needed to get info into long-term memory. I know exactly what I need to do each day, and I feel a sense of completion when I finish. Reviewing for an hour+ each day (when I'm making lots of new cards) isn’t always the most fun thing in the world, but review is unquestionably important for building long-term understanding. Spaced repetition is the most efficient way to do that. In addition, I prioritize info I've missed while doing question banks (using a "missed" tag), so I know I'm hitting the material I've tripped up on. 

  2. Anki capitalizes on the testing effect (i.e. the "practice testing" strategy mentioned above). Research shows that active recall aids long-term memory much more than passive recall like re-reading notes.

  3. I can easily attach my mnemonic images using an extra field. This makes the integration of memory techniques into note-taking quite seamless. The coupling of memory techniques and spaced repetition makes for a synergistic combination.

  4. It's mobile app enables me to knock out reviews no matter where I am. It's $25, pricy for an app but well worth it.

While Anki is helpful for making things stick, it should come as no surprise that it’s not the end-all-be-all of learning. If you’re learning a language, get out and practice with a fluent speaker. If you're learning medicine, you need to test yourself with QBanks like UWorld (or with actual patients on rotations). Even the best-made Anki decks are no substitutes for these. We believe that an optimal learning strategy contains not just book learning/review, not just practical experience, but a mix of the two.

Making effective flashcards is an art itself. I won't get into specific tips here, but for general advice about making effective Anki cards, I've found Alec from Yousmle's and Hacking Chinese's tips to be concise and helpful.