One remaining question, once one acknowledges the importance of making cards, is when in one’s studies is it the best time to start making cards? Furthermore, the time required to make Anki cards is not as much as one might expect-with practice, many students end up spending 5 minutes or fewer per card. Active learning is critical for the USMLE, when the demands on your memory are extremely high, and you will be required to retain and recall a very large body of fairly esoteric facts, particularly for Step 1. Manipulating information in the way that is required when you make cards sets you up to retain as much as 95% of this information after 2 weeks, compared to only 5% information retention at 2 weeks when you learn passively by listening to a lecture or reading a textbook (like First Aid!). Making cards-which requires you to critically think about what information is important, and to understand the information well enough in order to essentially teach it to yourself-is one of the most active ways you can learn. Although it’s important to review your cards and take advantage of spaced repetition, the process of making cards is just as useful for information retention. Many students acknowledge the downside of pre-made decks such as Brosencephalon and Zanki, but question the value of the process of making one’s own cards. But how do we identify those gaps in our knowledge in order to craft a personalized set of Anki cards? More importantly, these pre-made decks to not target your personal knowledge gaps, and reviewing these decks will force you to waste countless hours reviewing material you already have a sufficient grasp of from the perspective of answering USMLE questions correctly. I, for example, during my short stint with trying to use Brosencephalon, often ran into cards that I thought were obvious or redundant. With that said, using large Anki decks like Brosencephalon and Zanki, not only contain and unmanageable amount of cards, thus not allowing the maximal benefit of space-repetition, but also not personalized to address your weaknesses. As the sheer amount of content you need to master for the USMLE can be overwhelming, you may find yourself with over 10,000 cards unless you get in the habit of thinking critically about what deserves to be made into a flash cards. Accordingly, it is very important to make cards very selectively and cards that address specific gaps in your knowledge. In studying for your USMLE exams, primarily the Step 1 exam, you will get the most out of Anki by using it as a very targeted tool-one that targets your personal weaknesses.
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