Every medical student hits this question: Should I use AnKing (or another pre-made deck) or make my own cards?
The r/medicalschool and r/Anki communities have debated this endlessly. Some swear by AnKing's 28,000+ cards covering everything from First Aid to Pathoma. Others insist that making your own cards is the only way to truly learn. Both sides cite "science" to back their position.
Here's the thing: they're both right, and both wrong. The answer depends on factors most students never consider. Let's break it down.
The Case for Pre-made Decks
Coverage and Quality
Pre-made decks like AnKing represent thousands of hours of collective effort. The cards have been refined through multiple versions, fact-checked against authoritative sources, and tagged by topic for easy customization.
For Step 1 specifically, AnKing is essentially a comprehensive map of testable content. Every First Aid fact, every Pathoma concept, every Sketchy micro-organism — it's all there. You're not going to miss high-yield topics because you got tired or ran out of time.
The coverage argument is real: Making your own cards means you might skip topics, write incomplete cards, or miss connections you didn't realize were important. Pre-made decks eliminate this risk.
Time Efficiency
Let's be honest about the math. Creating a good Anki card takes 2-5 minutes when done well (researching, writing, formatting). AnKing has ~28,000 cards. That's potentially 1,400-2,300 hours of card creation you're skipping.
Those hours could go toward:
- More practice questions
- Research or clinical experience
- Sleep (remember that?)
- Actually studying instead of making study materials
Pre-made decks give you a complete system on day one of M1. You're learning immediately, not spending your first semester building a study infrastructure.
Community and Updates
Popular pre-made decks have communities behind them. AnKing gets regular updates as guidelines change or errors are found. The tagging system lets you sync with your curriculum. Add-ons enhance the experience.
When you make your own cards, you're on your own. An error stays an error until you catch it.
The Case for Making Your Own Cards
The Generation Effect
The strongest argument for making your own cards comes from cognitive science: the generation effect. Research consistently shows that actively generating information produces stronger memory traces than passively receiving it.
When you write a card, you're:
- Reading and processing the source material
- Deciding what's important enough to test
- Reformulating the information in your own words
- Creating the cloze structure that forces future retrieval
This isn't passive. It's active engagement with the material at every step. By the time you review your own card, you've already learned it partially through creation.
Pre-made cards skip all of this. You're doing pure retrieval practice on information you may not have encoded deeply in the first place.
Personal Relevance and Understanding
Your own cards reflect your own gaps. That confusing mechanism from lecture? You can write a card that addresses exactly where you got stuck. That professor's weird emphasis on an obscure detail? You'll capture it because you were there.
Pre-made cards are generic. They cover what's generally important, not what's specifically difficult for you. Your personal confusion points might not have a targeted card.
Deeper Processing
There's a reason experts recommend explaining concepts in your own words. The act of transformation — taking information from one form and expressing it in another — requires understanding, not just recognition.
Writing your own cards forces this transformation. Using pre-made cards lets you skip it. You can technically memorize AnKing without ever deeply understanding the connections.
The Research: What Does Science Actually Say?
Let's look at the evidence honestly.
Studies Supporting Active Generation
Multiple studies demonstrate the generation effect is real and substantial. Slamecka and Graf's foundational 1978 research showed that generating information leads to better recall than reading it. This has been replicated extensively.
For medical education specifically, studies on self-generated vs provided study materials generally favor active creation for understanding and retention.
Studies Supporting Pre-made Materials
However, other research shows that retrieval practice (reviewing cards) produces strong learning regardless of who created them. The testing effect — the benefit of retrieving information — is one of the most robust findings in learning science.
A key finding: spaced retrieval practice works even with materials you didn't create. The act of retrieving is powerful in itself.
The Uncomfortable Truth
Here's what the research actually suggests when you put it all together:
- Creating cards improves initial encoding (generation effect)
- Retrieving cards improves long-term retention (testing effect)
- Both effects are real and significant
- They're not mutually exclusive
The optimal approach likely involves both creation and retrieval. The question is how to get both efficiently.
A Framework for Deciding
Instead of picking a side, use this framework:
Time and Stage
M1/M2 (building foundation):
- More time available
- Still learning how to learn
- Benefit from understanding over volume
- Consider: More self-made cards, supplemented by pre-made for coverage
Dedicated Step 1 Period:
- Less time available
- Need to cover massive content
- Focus shifts to efficiency
- Consider: Primarily pre-made (AnKing), self-made for weak areas
Clerkships and Beyond:
- Time severely limited
- Learning is case-based
- Consider: Quick self-made cards for clinical pearls, minimal formal decks
Subject Type
Conceptual content (physiology, mechanisms):
- Benefits more from self-creation
- Understanding matters more than memorization
- Making cards forces you to articulate the "why"
Fact-heavy content (drug names, lab values, micro-organisms):
- Benefits more from pre-made decks
- There's no deeper understanding to gain — it's pure memorization
- Use the best available cards efficiently
Your Learning Style
Be honest with yourself:
Good candidates for self-made cards:
- You enjoy the creation process
- You're disciplined about quality (not just making cards to make cards)
- You have time and aren't rushing
- You genuinely find it helps you understand better
Good candidates for pre-made cards:
- You find card creation tedious and do it poorly
- You're pressed for time
- You learn well from retrieval practice alone
- You need comprehensive coverage quickly
The Middle Path: Best of Both Worlds
Here's what high-performing medical students actually do:
Hybrid Approach
- Use AnKing as your base layer. Unsuspend cards as you cover topics. This ensures coverage and saves time.
- Make your own cards for:
- Lecture-specific content not in AnKing
- Concepts you genuinely don't understand (forces processing)
- Clinical pearls and real-world applications
- Your personal weak points
- Edit and personalize AnKing cards. Add notes, mnemonics, or extra context to pre-made cards. This adds a generation component without full creation.
AI-Assisted Creation: A New Middle Ground
The traditional debate assumes two choices: hours of manual card creation, or zero creation with pre-made decks.
But what if you could get the benefits of processing your own lecture content — engagement, relevance, capturing what your professor emphasized — without the time cost of manual card creation?
This is where AI tools enter the picture. Uploading your actual lecture slides and generating cards from YOUR content gives you:
- Personal relevance (it's from your lectures)
- Engagement with processing (you're reviewing and editing AI output)
- Time efficiency (not starting from blank)
- Curriculum alignment (matches what your school actually teaches)
You're not just downloading someone else's cards. You're transforming your own course material into spaced repetition format, with AI handling the mechanical work while you handle the quality control and understanding.
This combines the generation effect (engagement with your material) with the efficiency of not manually creating thousands of cards.
Practical Recommendations
For M1s Just Starting
- Start with AnKing, suspended. Unsuspend as you cover topics.
- Make 5-10 personal cards per lecture for confusing concepts.
- Don't stress about the "right" approach — adjust as you learn your style.
For M2s in Organ Blocks
- AnKing for the big picture and board-relevant content.
- Personal cards for pathophysiology mechanisms and clinical correlations.
- Consider AI-assisted card generation from lecture slides for time efficiency.
For Dedicated Step 1
- Primarily AnKing — you need coverage and can't afford gaps.
- Personal cards only for persistent weak points.
- Focus time on practice questions, not card creation.
For Clerkships
- Minimal formal Anki (time constraints are real).
- Quick personal cards for clinical pearls worth remembering.
- Consider IM/Surgery-specific decks if useful for shelf exams.
The Bottom Line
The pre-made vs self-made debate is a false dichotomy. The best approach uses both strategically:
- Pre-made decks for comprehensive coverage and efficiency
- Self-made cards for understanding, relevance, and personal weak points
- AI-assisted tools to get the benefits of personal cards without the time cost
Stop asking "which is better" and start asking "which is better for this specific content, at this stage, given my time constraints?"
That's the framework that actually works.