Medical students and Anki have developed a complicated relationship. On one hand, the AnKing deck is genuinely impressive. Over 30,000 cards, maintained by a community of students, mapped to First Aid, Pathoma, Sketchy, and Boards and Beyond. For many students, it becomes the backbone of their Step 1 prep. On the other hand, the AnKing deck is enormous, Anki's interface is showing its age, and the customization required to actually use it effectively represents a significant time investment that many students do not have.
The barrier is not getting started. Downloading Anki and importing the AnKing deck takes about 20 minutes. The barrier is everything after that. Anki's settings are arcane. The difference between new cards, learning steps, and interval modifiers is not obvious, and getting them wrong means either drowning in reviews or not retaining enough. Students regularly spend two hours configuring Anki before ever reviewing a single card. That time is not nothing during dedicated Step prep.
Alternatives like Osmosis and AMBOSS integrate spaced repetition into broader question banks and video content, which changes the review experience entirely. Gridually takes a different approach with spatial memory, which can help with the kind of classification-heavy content that dominates preclinical medicine. The question is not whether Anki is good. It is whether it is the best use of your limited study time given the alternatives that now exist.
The AnKing deck is the most comprehensive free flashcard resource in medicine. That statement is not marketing. It is just accurate. But it comes with real downsides that are worth naming honestly. The deck is built for Step 1 specifically. If you are in a clinical rotation, the card format often does not match how you actually encounter clinical information. Cards built around memorizing buzzword associations work for multiple choice tests but can feel disconnected from bedside reasoning. AMBOSS handles this better by tying flashcard content directly to clinical case questions. If you are post-Step and preparing for shelf exams or clinical rotations, AnKing may be less relevant than it was during dedicated prep.
Anki's algorithm is designed to show you cards at the last possible moment before you would forget them. That is efficient for long-term retention but it creates a specific problem during Step prep: you have a fixed exam date, not an open-ended learning horizon. The algorithm does not know about your exam schedule. Students routinely hit their exam date with thousands of cards still in a backlog because the review load scaled faster than they could manage. Apps like Gridually and Osmosis have features specifically designed around exam-date countdown review, which is a fundamentally different approach. For students who feel their review pile is out of control, that difference is worth taking seriously.
Aphantasic medical students achieve comparable or higher grades (Taylor & Laming, 2025). Spatial encoding provides an alternative memorization pathway for anatomy, pharmacology, and case law. This is relevant beyond aphantasia: any learner studying structured professional material benefits from spatial organization that mirrors how the subject is actually structured.
Anki with the AnKing deck is still the most cost-effective way to cover Step 1 content if you have the setup time and the discipline to manage your review load. But if you are hitting burnout from the card mountain or you want your flashcard review integrated with question bank practice, AMBOSS or Osmosis are worth the cost. Gridually works well for classification-heavy subjects like pharmacology and microbiology where spatial grouping adds something over card-by-card review. Gridually's spatial encoding is based on memory research from the University of Chicago, University of Bonn, and Macquarie University.
Anki is used by roughly 70% of medical students, mainly because of the AnKing deck that covers entire preclinical curricula. For students who struggle with Anki's interface or want a different approach, Gridually offers spatial memory which helps with anatomy and systems-based content. Osmosis and AMBOSS provide integrated learning platforms with built-in flashcards.
Gridually offers spatial memory flashcards that work particularly well for anatomy and visual medical content. You can import your existing Anki decks. The spatial grid approach helps with organ system relationships and topographical anatomy. However, if you already have a working Anki system with AnKing, switching mid-curriculum may not be worth it.
Yes. Gridually imports .apkg files. Your AnKing cards become spatially positioned grid items. The spatial layout is particularly useful for anatomy and systems-based content where physical relationships between concepts matter.