Why it works, why it doesn’t and strategies to use instead
Anki has a reputation as one of the most popular and, arguably, one of the most effective study tools for med students. That’s a pretty bold statement. But, if you’re in struggling in med school and looking for better ways to study, there’s a good chance a peer, a dean, an advisor, or a learning specialist at your school has recommended it to you. Anki is a free, open-source flashcard program that uses spaced repetition, a technique from cognitive science, for fast, long-lasting memorization.
If Anki works for you, that’s great. There are several reasons why Anki is so effective, including
- Generation: Simply creating Anki requires the learner to break the information into a prompt and an answer, which is more engaging than just reading and re-reading or recopying information by rote.
- Retrieval Practice: Anki requires you to read the prompt, attempt to come up with the answer and then self-check your guess by reading the answer. Retrieval practice is the number one thing we want all learners to do when learning, so this is great.
- Spaced and Interleaved Practice: The Anki software promotes distributing and mixing the questions. To facilitate learning, Anki brings up missed questions more frequently. This inherently makes the studying more spaced by distributing the study experience over time. This strategy also interleaves or mixes topics and concepts instead of trying to “burn” one topic into memory before moving on to the next. This type of studying is called “massed” or “blocked” practice and is something we urge STATMed Learning students to avoid.
- App-Based: The fact that it is an app-based system is a benefit since students can use it on the go, across devices, share other students’ decks, and add to and evolve their decks.
Anki is undoubtedly popular because it can be “prescribed” to struggling students, which is certainly very appealing to advisors and peers when they encounter a struggling student looking for better ways to study.
This all sounds great. But what happens when Anki doesn’t work for you as a med student?
Multiple times per week, someone contacts me looking for better ways to study. They’ll ask something like, “What’s wrong with me? I try Anki, and it just doesn’t work. I feel like a failure, or maybe there’s something wrong with me, or I don’t want to make it work.”
The bottom line is this: Anki does not work for all med students.
Although it may benefit many med students, if it doesn’t work for you, it doesn’t have anything to do with your intelligence, desire, or ability to become a fantastic physician, veterinarian or pharmacist.
Whether Anki works for you depends mainly on how you receive information and build the cognitive structures to hold that information. We call this structural awareness the framework. And the fact is, most med students are adept at building this framework.
Anki is, by its nature, a detail-first and detail-centric approach to learning. Anki will likely work for you if you are adept at learning super-dense information from a detail-centric trajectory. Students who succeed with Anki typically fall into most of the following categories:
- Bottom-Up Learners: They learn from details and subconsciously build the organizational structures to hold details organically behind the scenes.
- High Structure-Builders: They can build mental models that accelerate the learning of dense material. I believe most med students fall under this category.
- Dual Trackers: As they receive dense information, they can sort and build it on two simultaneous tracks: the first track builds the framework or mental model or mental shelving unit, and the second track puts the details where they belong.
- Robust Executive Functioning Skills: Broadly speaking, this is the brain’s control center where we regulate many functions of behavior and learning. Individuals with high executive function will likely be able to learn from the detail-centric nature of Anki.
Anki isn’t always the best option for med students
However, Anki might feel more like a nightmare for the students who can’t learn from a details-first orientation. These students need to find the organizational structure externally and explicitly upfront before encoding all the details. This has nothing to do with their intelligence, aptitude as a physician, or willpower, and it’s more a matter of sequence and strategy. These students usually fall into one or more of these overlapping categories:
- Top-Down Learners: They learn best by consciously building out the structural framework or mental model first, then adding the details.
- Low Structure-Builders: They struggle to organically and subconsciously find and build the organization of a learning event, thus impeding acquisition and mastery of learning in med school in particular.
- Single Trackers: They can only receive information on a single track, and they have to choose to focus on organizational structure or details. Anki concentrates only on details and doesn’t foster the subconscious work necessary to build the mental model to house and organize these details for sustained access and application in the future.
- Impaired Executive Functioning Skills: If learners know they are impaired or weak in this broad category, they may expect to struggle with Anki (although this is not guaranteed); they need external and explicit strategies to offset these issues.
- ADHD or symptoms of ADHD: If you have a diagnosis or aspects of ADHD, that may indicate additional issues with working memory and executive functioning. ADHD may also indicate a top-down learner or show issues with low structure-building. All of this would explain why Anki is not working for you.
The speed-volume-density equation of medical school, where there is so much coming at you so fast, also referred to as drinking from a firehose, must be factored in.
Have you been feeling like you’ve been drinking from the firehose in med school? Find out how we helped two STATMed Students turn the pressure down in Drinking from the Firehose — How Two Students Learned to Overcome Information Overload and Keep Up in Med School
For most students, Anki will work up to a certain amount of speed, volume, and density. So, a student might have used Anki with great success in high school, undergrad, or grad school, only to see that skill fail to provide the yield needed at medical school. Why would this happen? Simply because the firehose of medical school is so ferocious, it can make skills that used to work no longer work.
So if Anki is not working for you, that’s okay! It doesn’t mean you are not “smart enough” or not working hard enough. It might simply not align with how you need to learn and the dense medical information in med school. And as always, this also applied to those in related fields like veterinarian school, pharmacy school, PA programs, and others.
Interested in learning strategies and skills to address your issues with studying in med school? Check out the STATMed Study Skills Class to get the most bang for your buck every time you sit down to study.