When medical school should still use Anki
Anki is the gold standard for USMLE prep, but it is not always the best tool for this week's lecture. Here is when to keep Anki and when to switch.
If you are a medical student, you have likely been told that Anki is mandatory. For the USMLE Step 1 and Step 2, that advice is mostly correct because of one word: AnKing. If your goal is to master the massive, community-vetted decks that have been refined over a decade, you should stay in Anki.
However, if you are trying to keep up with this week's specific school-curriculum lecture slides, Anki is often the bottleneck rather than the solution.
A little about me: my name is Daniel. I am a third year engineering science student at UofT. I work on Nebulearn, so I have a clear conflict of interest here. I spent my internship years at IBM and Intel thinking about how to move data faster, and I realized that the hardest part of flashcards is not the "studying" but the "making."
The AnKing exception
Anki is less of a "software app" and more of a "delivery vehicle for AnKing." The medical school community has spent thousands of hours tagging and refining these cards. If you are using these premade sets, you are benefiting from a massive amount of free labor.
The trade-off is the interface. Anki can feel like using a spreadsheet from 2004. You have to manage add-ons, sync issues, and a steep learning curve for card types. If you already have 10,000 cards in your queue and you are preparing for boards, do not switch. The time you would spend migrating is time you should spend reviewing.
When the bottleneck is your own school curriculum
The problem with medical school is the split between "Board Prep" and "In-House Exams." While AnKing covers the high-yield board material, your specific professors will test you on the niche details in their own slides.
This is where the Anki workflow breaks down for most students. Making cards in Anki involves a lot of tabbing back and forth between a PDF and the "Add" window. You have to manually snip images, type out fields, and organize tags. If you have four lectures to get through by Friday, you will spend five hours making cards and only one hour actually learning them.
| Study Goal | Best Tool | Why |
|---|---|---|
| USMLE / Step 1 Prep | Anki | Access to AnKing and community decks. |
| Weekly Lecture Slides | Nebulearn | PDF side-by-side and AI creation speed. |
| Friday Cramming | Quizlet | Best for session-based "mastery" before a quiz. |
| Linked Medical Notes | RemNote | Better for connecting complex systems. |
I wrote more about these trade-offs in my guide on whether Anki is still worth it in 2026.
The cost of staying organized
Anki is technically free on desktop and Android. If you want the official iOS app, AnkiMobile is about $25 one-time. For most students, that is a bargain.
The real cost is the "setup tax." To make Anki efficient, you usually need a suite of add-ons: Image Occlusion Enhanced, Review Heatmap, and specialized cloze templates. If you enjoy tinkering with software, this is a feature. If you are exhausted and just want to finish your cards so you can sleep, it is a chore.
When I built Nebulearn, I wanted to skip the setup tax. We put FSRS spaced repetition in by default so you do not have to configure complex intervals. We also built a Chrome extension that lets you highlight a sentence in your digital textbook and turn it into a card without leaving the page.
Why you might need both
Most medical students I talk to end up using a hybrid system. They use Anki for the long-term, high-yield board prep because those decks are already made. They use a faster tool for their specific, in-house classes where they have to make their own cards from scratch.
If you are currently making your own cards for a microbiology or anatomy class, you should evaluate how much time you spend in the "Add" window. If you are spending more time formatting cards than seeing them, you are losing the efficiency that spaced repetition was supposed to give you.
You can read more about the difference between premade decks and making your own to see which fits your current block.
Making the choice
If you are happy with Anki, keep using it. Consistency is the only thing that actually makes spaced repetition work.
But if you find yourself falling behind on your "due" list because it takes too long to get your lecture notes into the app, that is a tool problem. I work on Nebulearn to solve that specific bottleneck: the gap between a 40-slide PDF and a real study queue. Our free tier gives you 1,000 saved questions and 40 weekly AI credits, which is usually enough to handle a full semester of in-house lectures.
We also have a built-in importer if you want to bring over your existing sets, though you should check our Anki vs Nebulearn comparison first to see if the trade-offs make sense for your workflow.