How U.S. Med Students Actually Study: Real Strategies from the Trenches

Introduction: How Do Med Students Study?

If you ask a dozen medical students how they study, you’ll get a dozen different answers. Sure, everyone knows about active recall and spaced repetition – but how do students really put those into practice day-to-day? This article pulls back the curtain on how U.S. med students actually study, grounded in firsthand accounts from Reddit, Student Doctor Network, and other forums. We’ll start with my own study method, then explore a variety of strategies that thrive in both pre-clinical and clinical years. Along the way, we’ll highlight why certain approaches work better for certain learners, and how students pivot as they progress from first year (M1) to fourth year (M4).

My Study Method: Bootcamp + AnKing + Active Reinforcement

This is how I like to study—especially when I want to learn material efficiently and actually retain it. My process centers around combining Med School Bootcamp videos with the AnKing Anki deck. Together, they give me structure, clarity, and a reliable way to reinforce what I learn.

Bootcamp video first: I start by watching a high-yield Bootcamp video on the topic I’m studying. The videos are tight, focused, and concept-heavy—no fluff. As I watch, I annotate Bootcamp’s lecture slides directly. I highlight key points, jot down connections, rephrase complex ideas in my own words, and occasionally sketch out diagrams in the margins. It keeps me actively engaged while giving me a clean, organized reference to return to later.

AnKing flashcards next: Right after I finish the video, I open Anki and unsuspend the cards from the AnKing deck that match the Bootcamp module. Bootcamp and AnKing are built to sync well—Bootcamp teaches, AnKing reinforces. Doing the cards immediately afterward forces me to retrieve what I just learned. That active recall locks in the details before they start to fade.

Targeted card selection: I don’t try to do every card. I’ve gotten good at being selective. The AnKing deck is massive, so I focus on cards I don’t already know or ones that hit high-yield concepts. If something is too detailed or not relevant to how I’m learning the material, I skip it. I’ll often add my own notes or screenshots from the Bootcamp slides to existing cards so the context is crystal clear during reviews. These small tweaks make a big difference in keeping my daily load manageable and focused.

Bootcamp practice questions: Once I’ve finished the cards, I move on to Bootcamp’s board-style practice questions. Each video comes with a set of related questions, plus there’s a full Qbank to draw from. I use these to apply what I just learned in a format that feels like the real thing. If I miss a question—or even if I get it right but wasn’t confident—I dive into the explanation. I might add a flashcard or note if there’s a concept I need to revisit. This gives me a feedback loop that sharpens both recall and understanding.

Why this works for me: This setup hits a perfect balance between learning, reinforcement, and application. Bootcamp gives me the core teaching. AnKing trains my recall. The practice questions push me to apply it all in a test-like setting. It’s efficient, layered, and built for long-term retention. Another student once said it’s super easy to “watch a Bootcamp video and do the subsequent [AnKing] cards”—I completely agree. It’s a clean, frictionless workflow.

Personally, I learn best when I’m doing something—annotating, quizzing, applying—not just passively absorbing. Annotating Bootcamp slides keeps me hands-on with the material. Flashcards make sure I don’t forget it. Questions make me prove I understand it. And thanks to Anki’s spaced repetition, I keep reviewing the material on a timeline that actually works. By the time an exam comes up, I’m not scrambling—I’ve already seen it multiple times, in multiple ways. This is the method I stick to. It works.

Skipping Class and Going All-In on Boards Resources

While I rely heavily on third-party resources like Bootcamp and AnKing, I still like having structure—annotating Bootcamp’s lecture slides as I go, syncing them with flashcards, and using built-in practice questions to test my understanding. But plenty of med students take a different route: they skip lectures entirely and go all-in on board prep materials. It might sound risky at first (“You don’t even go to class?”), but it’s surprisingly common—especially at schools where lecture attendance isn’t required.

The reasoning is simple: boards-focused content is usually more efficient than long, meandering lectures. Students in this camp often find that outside resources are better aligned with how they’ll be tested on Step 1 and Step 2. As one Reddit user put it bluntly:

“I spent my entire second year not attending lecture [and] not watching lecture at home. Boards and Beyond, Sketchy, and Anki. Try it for a week. Once you notice how much time you save, and how much more efficient it is, you will never go back.”

What does “all-in” on boards prep actually look like?

Typically, students following this model build their own “curriculum” using:

• Boards and Beyond (BnB): Core video lectures for physiology, pathology, and basic sciences.

• Pathoma: Concise video/book combo, especially strong for pathology.

• Sketchy Medical: Illustrated mnemonics for micro, pharm, and more.

• Premade Anki decks: Massive decks like AnKing or Zanki, often tagged to First Aid, BnB, Sketchy, and UWorld.

• Question banks early: Many begin UWorld, AMBOSS, or Kaplan Qbanks well before dedicated Step prep.

These students generally follow their school’s topic schedule, but not the actual lectures. If the school is covering nephrology, for example, they’ll study the same topic using Boards & Beyond, Pathoma, and Sketchy, then reinforce with Anki and Qbank questions. They might skim their school’s slides just to check for surprises, but otherwise skip class entirely. One student explained:

“I don't go to class, listen to lecture, or even check our PowerPoints. I just look at the title of the lecture and find corresponding B&B/Pathoma videos and solidify those with Anki/Kaplan Qbank.”

Why some students love this strategy

The appeal is all about efficiency and control. Instead of sitting through a 90-minute lecture that may or may not be high-yield, they spend 30–40 minutes on a focused BnB video, then reinforce the material with flashcards and board-style questions. That’s active learning from the start. Students often report that they learn faster, retain more, and have better clarity on what actually matters for boards. The earlier quote says it best: after trying it for a week, many never go backto lecture-based learning.

The trade-offs

Of course, skipping class isn’t risk-free. Some schools test on hyper-specific material that only shows up in lectures. If that’s the case, you may need to do extra review before exams. Some students accept getting a pass or lower class rank in exchange for stronger Step 1 prep. As one Redditor put it, they were fine “doing mediocre on in-house exams in order to prioritize Step 1.” Back when Step 1 was scored, this was a smart gamble. Now that it’s pass/fail, fewer students feel the pressure to go all in so early—but the high-yield focus still pays off, especially for shelf exams and Step 2 CK.

Whether this works depends on your school’s curriculum and your own preferences. If lectures are genuinely helpful or required, you won’t have this level of freedom. But if your program records everything or doesn’t track attendance, you have options.

A middle-ground approach

If you’re thinking about switching to a board-focused model, test it out for a week. Track your comprehension and your time management. You might find that external resources give you more value per hour. Just be sure to cross-check your performance on school quizzes and exams—adjust if needed. Personally, I don’t attend most lectures, but I do follow my school’s topic flow. I prefer to watch Bootcamp videos, annotate the Bootcamp-provided lecture slides, then unsuspend relevant AnKing cards and finish with Bootcamp’s practice questions. If there’s anything unique on my school’s exam, I’ll catch it by scanning the syllabus or checking with classmates.

Many students strike a similar balance. One described their process this way:

“Most of the time I watched the relevant Boards and Beyond, Sketchy, and/or Pathoma videos for the subjects being covered in lecture that day and unsuspended the related Anki cards. I’d usually glance over the school lecture slides to make sure I was familiar with everything... but only rarely did I ever watch the lecture (anything I am watching is on at least 1.5x speed).”

Final thoughts

Going all-in on boards resources can be a highly efficient and scalable strategy—especially if you’re self-directed and value clarity over class politics. It works best if you’re disciplined and can identify what’s worth your time. For visual learners, Sketchy is often a must. For big-picture thinkers, Boards & Beyond or Bootcamp videos offer strong conceptual anchors. If your school’s lectures feel slow, bloated, or redundant, don’t feel guilty about building your own learning pipeline. You’re not alone—tons of med students are doing the exact same thing, and forums like Reddit are full of their playbooks. The key is to find a method that keeps you learning, engaged, and on track for your goals.

Blending Class with Anki: Annotating Lecture Slides and Using Flashcards

For other students, completely ignoring lectures isn’t ideal. You might have engaging professors, graded in-class quizzes, or simply learn better when you’ve heard the material from your school’s perspective. One popular compromise is attending lecture (or watching it at 2x speed later) but incorporating Anki into the process. In practice, this often means annotating lecture slides during class and later converting those notes into flashcards. It’s a way of bringing active recall into what could otherwise be a passive activity (like re-reading notes).

A common workflow: Imagine you have a one-hour lecture on pharmacology. Students who use this method will follow along with the lecture slides (often on a tablet or laptop) and take notes directly on them – adding clarifications the lecturer says, highlighting key points, maybe marking which slides are most important. Right after the lecture (or later that day), they’ll turn those annotations into study materials. This could mean unsuspending cards in a premade AnKing deck that correspond to the lecture topics, or writing their own flashcards based on the lecture. Often it’s a mix of both: premade decks save time, but if the professor emphasized something oddly specific (say, an experimental drug not in boards decks), the student might quickly make a custom Anki card for it.

One med student described their note-taking to Anki process like this: “Watch lecture + annotate slides (1 hour). Using annotated slides, make Anki cards (2-4 hours) ... I put a lot of effort into making notes appealing, easy to understand (lots of simplifying and rephrasing, adding images, clozes, etc.)... I understand, but it takes TOO LONG and I end up with hardly any free time, and I still forget stuff (not enough time for practicing recall).”. This honest reflection shows both the benefit and the pitfall of heavy lecture-to-Anki workflows. On the plus side, by thoroughly reprocessing the lecture into flashcards, you engage deeply with the material and ensure you comprehend it (“I get a pretty good understanding of what I’m learning during the time”). The act of making the card can itself be learning. But the downside is obvious: it’s extremely time-consuming. Spending 3–4 hours per lecture making cards isn’t sustainable with a full course load, and it can crowd out time for reviewing those cards or doing practice questions (which are crucial for long-term retention).

Strategies to make it efficient: Many students start M1 trying to make meticulous Anki cards from scratch for every lecture, but later adjust to save time. Here are some refinements commonly mentioned in forums:

• Use premade decks as a base. If your school’s content is standard, chances are AnKing or other decks already have cards on it. Instead of making a new card, search the deck for the topic. You can then modify an existing card if needed (add a detail from lecture, etc.). This way you leverage the collective wisdom of AnKing (which is massive) and only spend effort where needed. As one person advised, “Let AnKing + [Boards and Beyond]/Bootcamp decide it for you” – meaning trust the premade deck to cover most info, so you’re not reinventing the wheel.

• Only make cards for truly novel info or things you keep forgetting. If a lecture covers 10 diseases but 8 of them are in First Aid/boards materials you’re already studying, you might skip making cards for those 8 (relying on your other resources or existing cards). Focus on the 2 that are either school-specific or personally challenging for you. In other words, don’t Anki what you already know. One Reddit user following Bootcamp+AnKing emphasized: “Don’t unsuspend stuff you already know, and you don’t always have to do all the cloze deletions for a card… it will decrease your card count a lot.”. The same principle applies to making your own cards – be selective.

• Limit time per lecture for note-to-Anki conversion. Some students set a timer or cap, e.g. “no more than 1 hour making cards per lecture.” This forces you to prioritize the high-yield points. Perfectionists may struggle with this, but it’s important to avoid burnout. Remember that reviewing cards and doing questions is more directly correlated with exam performance than creating the “perfect” flashcard.

• During lecture, identify what’s testable. Many lectures have fluff or background slides. Use cues from the instructor (or upperclassmen intel) to mark which slides are key. Then you can focus your post-lecture Anki work on those high-yield slides. Some students literally put a star next to slide titles that got a “this will be on the exam” mention, and only Anki those points.

For learners who are auditory or learn well from explanation, attending lecture (or watching the recording) and then using Anki gives the best of both worlds. You hear the material in a structured way and engage in active recall after. This method especially suits those who might feel anxious about skipping class – it’s a way to cover everything your school expects and incorporate proven memory techniques. It’s also adaptable: you can attend only the more interactive or harder lectures, and self-study the rest. Or you might start by going to class, and if you notice it’s not adding value, transition to independent study later (many realize in M2 that boards resources cover things better).

One caveat: if you find yourself spending more time making flashcards than reviewing them, step back and reassess. The goal is to learn information, not produce the fanciest Anki deck. As the earlier student admitted, focusing too much on perfect notes meant “more time is spent making notes rather than learning/recalling… [and] hardly any free time”. If that sounds like you, consider using premade cards or other resources to free up time. Remember, there’s no bonus points for original notes – your grades and boards won’t care how you learned it, just that you did.

DIY vs Premade: Custom Cards or Pre-Written Decks?

This is a big debate in the med student community. Some swear that making your own Anki cards is the only way the info really sticks – the process forces you to digest material and put it in your own words. Others point out (rightly) that making cards from scratch is brutally slow and that excellent premade decks already exist for most topics. The consensus from many forums is to aim for a hybrid approach: use premade decks as a foundation, and add custom cards selectively.

When to create your own cards:

• If the content is very school-specific or not covered by standard resources. For example, maybe your professor gave a unique classification schema or there’s a detailed pathway not emphasized in board prep. Making a few cards for those will ensure you don’t neglect them.

• If you learn by writing things out. A subset of students find that the act of writing a flashcard (or even handwriting notes) is what cements the knowledge for them. One student on Reddit mentioned they never used Anki proper, “but I still wrote flashcards (the writing helps with memorizing). I primarily used UWorld and AMBOSS…doing practice questions and reading the explanations for all answer choices.”. For this person, making physical or digital cards themselves was key to learning (and they paired it with heavy question usage). If you’re like that – the type who always rewrote notes in undergrad to study – you might lean more toward making your own concise cards.

• If you have a very particular style or mnemonic that works for you. Sometimes premade cards don’t click because you didn’t create the association. If you think of a funny mnemonic or connection, making a card for it will make it far more memorable to you than someone else’s wording.

When to lean on premade decks:

• When time is of the essence. Premade decks like AnKing are popular for a reason – they cover everything and are ready to go. Especially as you get closer to board exams or have less free time, using premade cards can be a lifesaver. You can always suspend ones you find unnecessary, but you don’t risk missing a key concept entirely.

• When the material is standardized. Things like biochemical pathways, drug mechanisms, classic disease presentations – these are pretty much the same across any curriculum. No need to make your own card for the 12 cranial nerves or the features of nephrotic syndrome; thousands of students before you have made those cards. Save your effort for understanding the concept and maybe annotating an existing card with a memory trick if needed, rather than writing it from scratch.

• If you’re not confident in what’s high-yield. Premade decks often have tags for High Yield, or they’re sourced from resources like First Aid. AnKing, for instance, integrates with Boards&Beyond, Sketchy, etc. One student pointed out that Bootcamp’s Anki tags were sometimes more in-depth than even the video, so they would pre-read the cards and decide which to keep, rather than unsuspending all. Trusting a well-curated deck can guide you to what matters most, whereas making cards on your own, you might overdo the minutiae.

Pro tip: If you use AnKing (or another big deck), learn to use its tagging and filtering system. For example, you can pull up only cards related to your current lecture block or only cards tagged by a certain resource. I would often go to the Bootcamp tag within AnKing for the video I watched and unsuspend those cards first. If something seemed off or overly detailed, I’d skip it or mark it. Some students even customize the deck by marking certain cards with flags (e.g. green for “must know, high yield” and blue for “medium yield”). Over time, this creates a personalized set of cards tailored to your needs, but without the labor of making each one from scratch.

Ultimately, whether you DIY or not comes down to efficiency and learning style. First-year med students often experiment with making their own cards and either fall in love with the method or quickly abandon it when they’re drowning in unfinished decks. By second year, most have found a balance – maybe you make a handful of cards each week for tricky concepts, but rely on a premade deck for the bulk. Or you might start with premade and gradually replace some with your own as you go through class. Find the ratio that maximizes your learning while minimizing redundant work. Remember: the value of Anki is in the review (active recall and spaced repetition), not in the card creation itself – unless making cards is how you learn best. Don’t be afraid to pivot if something isn’t clicking.

Learning by Doing: Question-Bank-Centric Studying

A powerful (and often underrated) way that many med students learn is by diving directly into practice questions – essentially using Q-banks as a primary study tool, not just an assessment tool. This approach flips the script: instead of studying content first and then quizzing yourself, you quiz yourself to learn the content.

How does that work? Think of it this way: a good board-style question has a vignette and then a series of answer explanations that teach you not just why the correct answer is right, but why the others are wrong. If you treat each question as a mini learning experience, a Q-bank like UWorld or AMBOSS becomes a teaching resource. For example, you do a set of 10–20 questions, then spend substantial time reviewing the explanations, looking up facts you didn’t know, and maybe making flashcards or notes on those. One student wrote: “I primarily used UWorld and AMBOSS... doing practice questions and reading the explanations for all answer choices.”. This method ensured they were actively engaged (each question forces thought) and that they identified weak areas immediately. If they missed a question on, say, cardiac tamponade, they’d then go read about it in a review book or watch a video, or flip the card in Anki. In this way, doing questions drives what to study next.

Benefits of a Q-bank-first strategy:

• Active learning from the get-go: Answering questions is active retrieval practice. Even if you haven’t formally studied a topic, you might recall something from prior knowledge or make a reasoned guess. This primes your brain for the explanation, which then fills in the gaps or corrects misconceptions. It’s more engaging than just reading a chapter cold.

• Big picture orientation: Questions train you to think like the exam. They highlight what’s clinically relevant. Many students note that going through UWorld gives them a framework of what the important conditions and concepts are, so they can then allocate study time accordingly. As one med student put it, “practice questions help... Then you can refer back to content and see if you have any gaps once you have an idea of the big picture!”. Starting with questions can reveal your weak spots early.

• Immediate application: Instead of passively reading about diabetes, you might do 5 diabetes questions and realize you keep missing ones about side effects of a drug. That tells you exactly what to go review (targeted studying). It’s a form of diagnostic feedback.

• Efficiency with time: In clinical years especially (more on that soon), you have less pure study time. Jumping into questions maximizes the yield of that time. Even in pre-clinicals, some students just prefer doing Qs over making elaborate notes. If reading textbooks makes your eyes glaze over, doing questions could be a more stimulating way to learn.

That said, a pure Q-bank approach in early med school can be challenging, since you might not have enough base knowledge. Often, students use question banks in conjunction with another resource: e.g. read First Aid or watch Pathoma alongside doing UWorld for that subject. A popular advice for Step 1 prep is to treat UWorld itself as a learning tool, not just a test – meaning you do it slowly and study every explanation. People sometimes even do UWorld twice (though others caution not to start it so early that you burn through it and have to redo it).

If you’re going to incorporate Q-banks early:

• Consider using a beginner-friendly Q-bank like USMLE-Rx or Kaplan Qbank during pre-clinical courses to test knowledge after you’ve studied a topic. Save UWorld (the gold standard) for a bit later when you’ve covered more material, or do it in tutor mode subject-by-subject as you finish each block.

• Always read explanations thoroughly – that’s where learning happens. Don’t just note the correct answer; understand why it’s correct and why the others are wrong. This is where you’ll pick up those “in the weeds” facts and nuances.

• Make Anki cards or notes from questions you missed. Some students unsuspend AnKing cards related to questions they got wrong (AnKing has tags for UWorld topics too). One strategy from Reddit: “Unsuspend AnKing cards as needed for concepts and questions that you miss… [that way] my reviews towards the end of M3 were never more than 200/day.” By only adding cards for missed questions, you target your weak areas and control the Anki load.

• Use question analysis to guide content review. For example, if you do 40 random questions and see a pattern that you’re weak in microbiology, then you might dedicate the next day to watching Sketchy micro videos or doing micro flashcards, then come back to more questions.

Some learners absolutely love this approach because it mirrors how they’ll ultimately be tested. If you’re someone who “learns by doing” or gets impatient with too much passive reading, try incorporating practice questions earlier. It can also keep studying more gameified – you have scores and performance to track, which can motivate improvement. Just be cautious not to let your school exams slip if they ask things differently. Ideally, you’ll balance both: use questions to master the core concepts for boards, and be aware of any specific details your professors expect you to know (which you might glean from lectures or class materials).

Visual Learners and Storytellers: Sketchy, Mind Maps, and Conceptual Linking

Not everyone learns best from text or flashcards. Many med students are visual learners who remember diagrams, pictures, or stories far better than lists of facts. If that’s you, you’re in good company – resources like Sketchy were practically made for you, and plenty of students sketch out their own mind maps or diagrams to connect ideas.

Sketchy: This resource warrants special mention. SketchyMedical provides illustrated story scenes where each element is a mnemonic for a medical fact. For example, a Sketchy scene for a bacterium might show a pirate (representing Proteus mirabilis, since Proteus sounds like “protease” -> pirate, etc.) rowing a boat in urine (since Proteus causes UTIs) with stone crystals in the water (struvite kidney stones), and so on. The scenes are often zany and memorable. Students who are visual/spatial learners find that recalling the silly Sketchy image helps them retrieve details on exams. “Oh, yeah, Proteus – that was the pirate -> urease positive, causes staghorn stones, motile…” – the image triggers those facts.

Many med students (even those who don’t consider themselves primarily visual) use Sketchy at least for microbiology and pharmacology, because the volume of rote memorization in those subjects is high and Sketchy’s method is effective. A common strategy is to watch a Sketchy video for, say, a set of bacteria before or after you cover them in class. One Reddit user shared: “I did Sketchy before/after lectures to get big pictures. They help concepts stick better. Once you have Sketchy foundations, you can build on it with lectures and AnKing.”. This approach echoes what many do: let the visual mnemonic give you a framework (big picture), then layer on the details via lecture notes or flashcards. It’s a great way to make otherwise dry material more engaging and memorable.

Mind maps and concept maps: Some students love to draw concept maps – connecting related ideas in a web or flowchart. For example, if you’re studying anemias, a concept map might branch out different types of anemia, their causes, lab findings, treatments, etc., all in one diagram. Creating these maps can be an active way to process and organize information. One student on Reddit said, “I do make concept maps. It helps in terms of organization of the material for me. Sometimes when I'm making a concept map, it helps me zero in on a concept and I notice something I didn’t during lecture.”. This highlights a big benefit: by drawing connections yourself, you might catch details or relationships you overlooked when you first learned it. It’s a form of elaboration – relating new info to what you already know.

However, not everyone finds mind-mapping efficient. Some find it takes too long or that the benefit is already achieved mentally without drawing it out. One could argue that Anki’s concept linking (tags, hierarchical decks) is a kind of digital mind map. But if you’re the artistic or big-picture type, making a quick sketch or flowchart after learning a topic might solidify it for you. It doesn’t have to be fancy; even a quick whiteboard sketch linking the clotting cascade steps or the nephron’s transporters can imprint an image in your mind to recall later.

Other visual or auditory tools:

• Videos like Osmosis or YouTube explainers: Some students will watch YouTube med educators for tough topics (channels like Dirty Medicine, Armando Hasudungan’s drawings, etc.). These often include visuals or metaphors that stick.

• Charts and tables: Creating comparison tables (e.g. all the glycogen storage diseases side by side) is another form of visual organization. It’s not a story, but the spatial arrangement helps some people recall (“that enzyme deficiency was in the second column of my table, which was Cori disease…”).

• Mnemonics and silly phrases: These are auditory or conceptual hooks. Med students collectively have created thousands of mnemonics (like “Virchow’s node is in the left supraclavicular fossa, think stomach cancer – Left for Lunch (gastric)”). Using or making these can be a lifesaver for random factoids.

The key insight here is know your learning style. If you find that after reading pages of notes you still can’t remember a process, try drawing it out or finding a video that illustrates it. If flashcards bore you to tears but you can remember every detail of a Sketchy scene, then lean into that strength (and consider doing Sketchy’s newer courses for pathology or immunology as well). Many top students use a combination: for instance, watch a Sketchy video, then test themselves with Anki cards about that video’s content. The Sketchy visual provides the memory palace, and the Anki ensures recall.

Also, be mindful of time – Sketchy vids and doodling can be fun, but ensure you’re still practicing retrieval (maybe by reciting what each symbol in the Sketchy stands for, or quizzing yourself using a fan-made “Sketchy flashcard” deck). If you’re in a time crunch, you might reserve mind-mapping for topics you really struggle with or for reviewing at the end of a block to see the connections.

Relying on the In-House Curriculum (Minimal Outside Resources)

Thus far we’ve focused on leveraging external resources, but it’s worth noting that some students stick almost entirely to what their medical school provides – and they succeed doing so. This often happens at institutions with robust curricula or among students who prefer a more straightforward approach (or who feel overwhelmed by the plethora of outside resources). If your school’s lectures, syllabi, small groups, and practice exams are high quality, you might find you don’t need much else.

In fact, there are anecdotes of students at top medical schools who barely know about resources like BnB or Anki because their in-house material and study groups carried them. One student shared a story: “Some of my med school friends from other institutions attend top 20 schools, where their average STEP scores are phenomenal. Yet, when I mentioned B&B/Pathoma/Lightyear/Zanki, they had no idea what I was talking about. They said they just study class material and don't know about any of the outside STEP resources.”. These peers weren’t even thinking about boards during classes; they focused on their curriculum, did well, and then hit dedicated study period for Step 1 later. This exemplifies that there’s no single mandatory way to succeed. A strong curriculum will naturally cover a lot of what Step 1/Step 2 tests. Some schools explicitly integrate board-style questions into their exams or use NBME subject exams for finals, which aligns the in-house and boards prep even more.

If you choose the in-house-heavy route, a few tips:

• Use your school’s materials actively. Just because you’re not using outside resources doesn’t mean you shouldn’t use active learning. Turn your lectures or notes into questions for yourself. Some students create their own quiz bowl with classmates using lecture objectives. Others still use Anki, but populate it only with content from their school’s notes.

• Supplement lightly as needed. Maybe you rely on school for everything, but Pathology slides confuse you – so you watch Pathoma for clarification. Or you do a few UWorld questions after you’ve studied a unit to gauge your understanding. Using school resources doesn’t mean you must shun all others; it’s about primary focus. One can still dip into First Aid or Boards & Beyond if a particular topic wasn’t clear in class.

• Be mindful of boards timeline. The one risk of ignoring outside resources is you might miss some ultra high-yield tidbits that never came up in class (phosphofructokinase-2 regulation, for example, or certain biostats concepts). To mitigate this, at least during dedicated boards prep, cross-check a comprehensive source like First Aid or do a Q-bank to catch those blind spots. Many who rely on in-house do a pass of First Aid or boards Qs starting mid-M2 year, just to ensure nothing crucial was missed.

• Leverage faculty and mentors. If you’re sticking to school content, take advantage of review sessions, ask questions to clarify confusing topics, and use any study guides the school provides. Some schools hand out learning objectives or key concepts – use those as your checklist.

This strategy can work well for students who like structure and want to minimize juggling resources. It can reduce the stress of FOMO (fear of missing out) on Resource X that your classmate swears by. Instead, you invest fully in one set of materials. It’s also sometimes a necessity if your school has graded exams that pull heavily from lecture-only material – you can’t ignore that without consequences. The downside is you might not be as explicitly board-focused early on, but as long as you perform well in classes and do some targeted prep for Step 1/Step 2, you’ll likely be fine. Remember, plenty of physicians trained before things like Anki or Sketchy existed and they survived by hitting the books their school gave them!

In reality, even those who rely mostly on in-house stuff will often use at least one or two outside aids (e.g. maybe everyone uses Sketchy for micro, or everyone uses a question bank before the final). The difference is they’re not building their entire study plan around third-party resources. If you’re a student who feels overwhelmed by the smorgasbord of resource options out there, it’s perfectly reasonable to stick to what your professors provide and only augment where you personally feel needed.

Pivoting in Clinical Years: Adapting Study Strategies on Rotations

No discussion of med school study strategies is complete without addressing how things change in the clinical years (M3 and M4). The transition from pre-clinical to clinical is huge: your schedule is now dominated by hospital rotations, hours are long and unpredictable, and your brain is juggling real patient care tasks along with exam prep. Study time is at a premium. Strategies that worked in the pre-clinical classroom may not translate perfectly to the wards.

Here are some ways students successfully adapt their studying in the clinical phase:

1. “Questions First” becomes even more important: During third year, you’ll face shelf exams (mini boards exams for each core rotation) and eventually Step 2 CK. The content is vast, but doing well relies heavily on being able to apply knowledge in clinical scenarios. Almost every high-scorer will tell you that UWorld (Step 2 CK Q-bank) is the backbone of shelf studying. A common strategy: determine how many UWorld questions exist for the rotation (e.g. ~1400 for internal medicine, fewer for others) and divide them by the weeks you have, aiming to finish the Q-bank a week or so before the shelf exam. One successful student shared: “Divide the UWorld questions for each rotation in a way that allows you to finish a week before the shelf. Some rotations will be fewer per day (like Psych), others much more (IM). Unsuspend AnKing cards as needed for concepts and questions that you miss... In the week before the shelf, purchase every NBME shelf practice exam and review them thoroughly.”. They also emphasized keeping up with daily Anki reviews throughout third year, so by Step 2 time their foundation was solid. Another student replied that they did the same and got great results, noting “consistency is key” on every rotation.

In essence, during clinicals: UWorld is king, and practice NBME shelf exams (if available) are extremely useful. Question practice not only teaches you, it also acclimates you to the style and timing of shelf exams, which can be tougher than Step 1 in some ways (long vignettes, less straightforward clues). Many students also use AMBOSS Q-bank either to supplement UWorld or after finishing it, since AMBOSS has nice explanations and some more nitty-gritty details (plus an integrated encyclopedia if you need to read more on a topic).

2. Targeted Anki and maintaining what you know: If you were an Anki user in pre-clinical, one big question is “Do I keep doing Anki during rotations?” The answer for many is yes, but with adjustments. You probably won’t have time to do 500 new cards a day on rotations. Instead, some strategies are:

• Keep reviewing old cards (from Step 1 deck) to prevent forgetting the basics, just at a slower pace. This pays dividends for Step 2.

• Use a Step 2 deck (like AnKing Step 2 or Dorian deck) selectively. For example, unsuspend cards for topics as they come up during rotation or for things you missed on questions. One approach mentioned earlier was to unsuspend cards only for missed UWorld questions (kind of a “missed question” deck).

• Set a cap like “do max 100-200 reviews a day” so that Anki is supplementing, not consuming all your free time. One Reddit user mentioned not mass-unsuspending an entire rotation’s cards at once, but targeting to keep daily reviews manageable (<=200).

• If you weren’t an Anki person before, clinical year might not be the time to start heavy Anki, but you can still use it for select memorization (like diagnostic criteria, risk stratification tools, etc., which are fodder for flashcards).

Some students do drop Anki altogether in clinicals due to time constraints, choosing to focus purely on questions and maybe reading. That can work too, especially if you retain a lot from first two years. It really depends on how much time you have after coming home from the hospital and personal preference.

3. One primary resource per rotation: In addition to question banks, students often choose one main study resource for each clerkship:

• For Internal Medicine, many use the textbook Step-Up to Medicine or online Med U cases/Docs, or OnlineMedEd (OME) video lectures. (Though Step-Up is long; some skip it or just read certain chapters due to time).

• For Surgery, a popular combo is Dr. Pestana’s Surgery Notes (short high-yield book) plus maybe OME videos.

• For Pediatrics, PreTest question book or Laughing Your Way can be helpful, or Case Files.

• For OB/Gyn, UWorld + Case Files or a review book like Blueprints (though Blueprints series are more detailed than needed sometimes).

• For Psych, honestly just UWorld and maybe First Aid for Psych or OME is enough for many.

• For Family Med, there’s an ambulatory section in Step-Up or specific FM Qbanks (also many overlap with IM).

The point is, most students pick one resource to read or watch in addition to doing questions, rather than trying to use too many sources. One structured guide from an excellent student (“Duke’s Strategy to Excelling in M3”) explicitly said: “The base of your studying for every clerkship should be UWorld and flashcards… Next, limit yourself to one additional resource per clerkship. ... Dense textbook-like or outline-style books like BRS or Blueprints are horrible [for this purpose]. Your additional resource should ideally be case-based or contain additional practice questions.”. They then listed examples: Case Files for OB, PreTest for Peds, etc., and emphasized scheduling NBME practice exams in the final week. This resonates with many students’ experiences – the time simply isn’t there to read multiple books, so choose wisely.

4. Experiential learning and on-the-fly studying: In clinical years, a lot of learning happens on the wards. Reading about your patients’ conditions as you encounter them can be very high-yield (and helps you shine on rounds). Many students use apps like UpToDate or Pocket Medicine to quickly lookup topics during downtime. While this isn’t “studying for an exam” per se, it reinforces key concepts in a memorable way (you’ll definitely remember the management of diabetic ketoacidosis after you’ve helped treat a patient with it). Some even keep a notebook of things they saw that day to review later. Balancing this with exam prep is tricky, but ideally you integrate the two: if you saw a patient with lupus nephritis, that night you might do some UWorld questions on lupus or read the nephrology chapter relevant to SLE, etc. Clinical year is about application and context, so it’s okay if your studying is less about brute force memorization and more about understanding workups, interpreting labs, and so on.

5. Less time, more efficiency: You might only have 1-2 hours on a weekday to study during a tough rotation (and sometimes zero if you’re on call or exhausted). So you become a master of efficiency:

• Listen to audio resources on your commute (e.g. the Divine Intervention podcasts, which many recommend for shelf exams – one student claimed “with Divine [Intervention] and UWorld alone, you will destroy your shelves”).

• Study in short bursts, e.g. do 5-10 UWorld questions on a lunch break or between cases.

• Use weekends strategically for longer review or full practice tests.

• Accept that you can’t do it all – focus on high-yield. Perhaps you only annotate First Aid for Step 2 with the most salient points from questions, rather than reading an entire 600-page text.

By M4, after you’ve finished core rotations and taken Step 2, studying tends to dial down for most (aside from any specific rotations like sub-internships or if you’re pursuing a competitive specialty needing strong Step 2). Many students in M4 focus more on applications, research, etc., and just keep their knowledge fresh via light reading or teaching junior students. But the early part of M4 (before residency applications) might involve studying for any remaining shelf exams or a Step 2 CK if you delayed it – in which case the strategies are similar to M3: question banks, targeted review, and catching up on any weak areas from M3.

Conclusion: Find What Works and Be Ready to Pivot

If there’s one takeaway from all these firsthand study stories, it’s that there is no one-size-fits-all method in med school. Successful students each craft a system that fits their learning style, leverages their strengths, and addresses their weaknesses. It often involves stacking multiple resources – lecture notes + Bootcamp/Boards videos + Anki + Qbanks + maybe a dash of Sketchy or a trusted textbook. It might sound overwhelming, but over time you’ll identify which components actually help you learn versus which just give FOMO.

Some general advice for pre-meds or new med students reading this:

• Experiment early on. Try a few different study techniques in your first block. Do a week where you attend all lectures and make flashcards, then a week where you skip lecture and use outside resources. See which yields better understanding/grades for you. By second year you should have a solid routine, but don’t worry if it takes a semester to figure it out.

• Be intentional with time. There is always more to study in med school. A key skill is prioritizing. Short, focused study sessions (e.g. 45 min of Anki, or doing 10 questions with thorough review) often beat hours of unfocused reading. Use active methods as much as possible – they give more bang for your buck.

• Tailor to your learning style, but don’t neglect any modality entirely. For instance, even if you’re a visual learner, still practice doing questions (for test-taking skill). If you’re an Anki fanatic, great – but also ensure you sometimes synthesize info broadly (maybe via a mind map or summary sheet) so you don’t get lost in details. Balance is key.

• Stay flexible and adapt. The method that aced Step 1 might not be how you ace Step 2 – be ready to adjust. One student noted how their mindset and strategies evolved: initially cramming and passive study gave way to deliberate practice and active learning, yielding huge improvements. Always reflect on what’s working and what isn’t. If you’re struggling in a course, seek out how upperclassmen studied for it – you might need a different tactic for that subject.

Finally, don’t forget the basics: get sleep, take care of your health, and maintain some balance. A study method that isn’t sustainable for your mental health will backfire. It’s better to be 85% efficient consistently than 110% efficient for two weeks followed by burnout. Many students in forums emphasize finding a schedule that allows downtime so you can actually absorb what you learn. Quality beats quantity.

Real-world reassurance: No matter which approach you choose – Bootcamp+Anki integration, boards-only independent study, lecture-focused with custom notes, Qbank-heavy, Sketchy visual, or any hybrid – there are students who have succeeded with it. Throughout med school, you’ll likely borrow elements from all these strategies to create your personal study “recipe.” And if you ever feel lost, remember there’s a whole online community of fellow students who have been there, tried that, and are willing to share their experiences (often with brutal honesty and humor). Hopefully, this tour through their strategies gives you some inspiration and insight into crafting your own path through the firehose. Good luck, and happy studying!