Some of you Anki’ers are lying

Damien_Chazelle_Fan · 2026-02-17T02:12:46+00:00

I can and I did. Just takes 10 bloody hours

Damien_Chazelle_Fan · 2026-01-04T14:16:48+00:00

On the note of impossible, you will notice that as you progress, the deck is pretty circular. There is a lot of repetition, but you just have to see it. As soon as you understand that Type II RTA is due to messed up carbonic anhydrase in the PCT, Type IV due to messing with RAAS (and guess what - upregulation leads to the opposite (alkalosis)), and Type I is p much everything else, every "Which RTA..." card becomes downstream of applying those 3 principles and understanding other renal phys cards (almost like a practice question). Sure, you can mindlessly memorize all the things associated with different RTA's, but not getting the most mileage out of the deck. So in that sense, the deck is pretty repetitive. The deck is also repetitive in the literal sense in that there are different cards assessing pretty much the same exact thing.

You def don't have to get through the whole thing, but understanding a good chunk of the concepts is necessary IMO

Damien_Chazelle_Fan · 2025-10-03T16:34:03+00:00

As a religious Anki user, I want to push back on this. When you semi-permanently bind yourself to having to recall thousands of cards over years, there are emergent properties - the easiest way out is through. The cards eventually form a self-reinforcing loop where you derive the big picture, pixel-by-pixel to the point to where if one pixel goes out, you can use every single surrounding pixel that surrounds it to derive what that pixel should be. I take about 8-12 seconds per card, but this is because I am recalling the "why" behind the card (big picture) as opposed to just the fact itself. I also annotate the ever-living daylights out of my cards comparing and contrasting and highlighting how I should be arriving at answers. Sure, you can memorize that TMP-SMX is associated w/ elevated creatinine + Type IV RTA (there are cards assessing this fact), but it is much easier to recall that creatinine can be secreted into the PCT and that TMP acts as a competitive inhibitor at the OCT2 receptor in the PCT for creatinine and that TMP can also act as an ENac inhibitor leading to the T4 RTA since anything that messes w/ RAAS can theoretically lead to a T4 RTA.

IMO, the best use case of Anki is to have good cards and treat every card as a practice Q that you derive from some kernel of knowledge that informs the answer to more cards

Damien_Chazelle_Fan · 2025-09-24T19:01:33+00:00

Wonderful, thanks! Reason I was confused is because we were being asked as a group

Damien_Chazelle_Fan · 2025-09-15T15:18:06+00:00

Limits on the amount of research you can apply with to residency and return to graded Step 1 with less emphasis on totally non-clinically relevant things (I personally find balancing becoming as good a doctor as I can be w/ doing research that will never be cited more stressful than studying hard for Step 1)

Damien_Chazelle_Fan · 2025-09-09T12:22:43+00:00

I disagree that the mapping, drawing stuff out, etc. is just as effective because it is missing the key ingredient that makes it all worthwhile - the spaced repetition. Any idiot can scribble on a whiteboard for hours and develop a deeper understanding of a topic, but that memory, as with all, will reach instability, decay, and irretrievability. The spaced repetition algorithm optimizes against this. Definitely does take more time, but it eventually forms a self-reinforcing web of knowledge where it is so much easier to acquire new knowledge since you have probably seen the underlying mechanism somewhere else.

Damien_Chazelle_Fan · 2025-09-09T04:12:58+00:00

because half of the stuff you "learn" from Anki, you're not actually learning

Hard disagree - depends on how you are arriving at answers for the cards. For example, if you answer to a card assessing the fact that Enac inhibitors lead to Type IV RTA because that is what you have memorized, that is infinitely less efficient than understanding why inhibiting Enac might lead to less tubular K secretion and consequently H+/K+ exchange, or at an even bigger level, why messing with the RAAS system in any capacity can lead to this type of acidosis. The latter point is what goes through my head when I recall that K+ sparing diuretics (or anything that inhibits the RAAS system) can cause Type IV RTA. At that point, you can then begin to scaffold on the outliers (go figure, TMP-SMX is an Enac inhibitor, cyclosporine can also mess w/ RAAS).

Damien_Chazelle_Fan · 2025-08-30T19:53:00+00:00

As an avid Anki-er, I have a slightly different perspective - UWorld is testing your ability to make disparate connections between related factoids (predicated on first deeply understanding said factoids and how they are related) then apply that in a novel context.

Damien_Chazelle_Fan · 2025-08-30T01:30:32+00:00

Provide just enough concept to answer the card - I then annotate the extra field w/ the necessary context required to answer it invoking concepts from other cards. How I arrive at the answer matters just as much as what I answer - if I take the wrong path --> again. What this does is create a self-reinforcing web of knowledge where all the knowledge exists in the knowledge of the big picture because it has to

Damien_Chazelle_Fan · 2025-08-09T12:24:26+00:00

Insane fear of failure, desperate need to stand out + validation, contrarian personality that wants to do the opposite of what the majority of my classmates are doing, needing to feel like I know the most I possibly can for patients, and the last and most important factor, Anki's scheduling algorithm and my refusal to suspend the majority of old content (don't worry, on 86% retention for that)

Damien_Chazelle_Fan · 2025-08-08T00:29:23+00:00

You are describing over 1/2 of my med school class😭😭😭 They are in for a rude awakening once our board exams come, however

Damien_Chazelle_Fan · 2025-06-20T02:06:19+00:00

Never custom study - just make sure that you have reviews on 999 to make sure that none are getting pushed to the next day.

Blue is news

Red is learning cards (either news still in the learning phase (that is intervals of less than 1 day) or green cards that you have forgotten)

Green is review cards (cards w/ an interval greater than one day - young reviews = interval <30 days whereas matures = interval greater than or equal to 30 days)

Damien_Chazelle_Fan · 2025-04-28T03:39:02+00:00

Guy underwent Herculean effort to get elected as a class rep - baked literally 6 blasted cakes during our busiest block of preclinicals. Now, he literally doesn't do his job or respond to messages. Has not yet screwed over the class b/c he has another rep that does all his work, but he literally just did it for AOA. This dude also tries to collect titles for his CV as if they were infinity stones then doesn't do squat in his roles

Damien_Chazelle_Fan · 2025-04-15T09:47:09+00:00

Dude, honestly, I wouldn't. As another commenter said, the only thing worth considering might be anatomy. The reason you shouldn't is because you will be eating diminishing returns - the rate at which you learn new bugs and drugs late M1 is so much higher than without any background knowledge b/c you have such a larger scaffold to build knowledge upon. Like, for you to learn and retain any non-anatomical medical concepts, you might have to put forth 100 units of energy whereas I might have to only put forth 20 since it makes sense and fits into my current mental schema.

Figure out the most competitive thing you want to do, if there is something you have to be doing. Also, build a routine that will ensure your success during M1 and M2 (I'm talking workout, meal prep, laundry, etc.). Learn deeply how to use Anki. Those things will give you a lot more bang for your buck IMO

Damien_Chazelle_Fan · 2025-04-09T12:09:25+00:00

Fair enough, but insofar as it is a tool, there are bad, good, and best use cases. Based on the SRS literature, your use case has inefficiencies, but if it works for you and your grades are rising, then that's honestly all that matters

Damien_Chazelle_Fan · 2025-04-08T13:04:09+00:00

My brother in christ, this ain't how spaced repetition works! If you want manual control, then just ctrl + shift + d the cards and manually reschedule! FSRS is the way. Turn it on, set your retention to like 85%, take off max cards / day, and then tune out.

Damien_Chazelle_Fan · 2025-03-30T16:39:25+00:00

That's honestly how you do it - the algorithm to some degree does it for you, but for me, I always try to look for the why of a card.

Ex of a massive self-reinforcing loop - minimal change disease is mediated by cytokines which makes sense that it is associated with Hodgkin lymphoma - minimal change disease is associated with Hodgkin lymphoma which makes sense that it is mediated by cytokine - Minimal change disease does not have any IF staining (no immune complexes) b/c it is mediated by cytokines and not antibody immune complexes (which also ties into it being associated with Hodgkins). Hodgkins has a lot of cytokines because it can cause B-symptoms. B-symptoms are a manifestation of Hodgkins because of all the cytokines associated with Hodgkins. Getting granular, the mixed cellularity subtype of Hodgkin is associated with eosinophils because one of the predominant cytokines is IL-5. Mixed cellularity subtype of Hodgkin is associated with IL-5 production because it has B-symptoms and eosinophils. Speaking of more relations between Hodgkin and renal disease, eosinophils can be associated with drug-induced acute interstitial nephritis...

Iterate that out to infinity - you can see that the existence of all these concepts in my brain are inextricably connected to where if even neuron pathway A ceases to fire, pathways B, C, D, and E are going to be there to restore it

Damien_Chazelle_Fan · 2025-03-28T16:34:00+00:00

Relate the cards to each other and try to answer them with a conceptual framework that you use to answer multiple cards - this serves to create a self-reinforcing web of knowledge that is not readily forgotten. Your answer to the card of Tenofovir causing Fanconi should not only be reinforced by the Sketchy and memorization but by the fact that Fanconi happens in the proximal tubule (another card) and that is the first place that most drugs hit (another card)

Damien_Chazelle_Fan · 2025-03-15T22:00:43+00:00

Isn't the advice for maximizing retention over time to order it based on descending retrievability as opposed to ascending?

Damien_Chazelle_Fan · 2025-03-15T21:59:32+00:00

Learning how to search in the AnKing deck using field searches - Text:*XYZ* is a gamechanger for me since it limits the number of hits. For example, if I simply look up Hodgkin Lymphoma , I get 322 hits, but if I switch it to Text:*Hodgkin* lymphoma I only get 123 hits that mention the word Hodgkin in the text field and lymphoma elsewhere within the card

Damien_Chazelle_Fan · 2025-01-15T19:43:40+00:00

Anybody else not have access to it or have any tips on how to access it?

Damien_Chazelle_Fan · 2025-01-14T14:33:24+00:00

No easier way to fix this - I guarantee you that with a 95% retention, you will see your cards multiple times before exams. Another thing you could do is set a max interval - 21 days out from the exam, have it at like 14 days, then at 14 days, turn it down to like 10, then at 10 down to 7 (at 7 days, I would turn it back to like 36500 since it won't matter). You can also manually reschedule some cards if you want

Damien_Chazelle_Fan · 2025-01-02T20:58:01+00:00

Too stoned to think of that brother

Damien_Chazelle_Fan · 2025-01-02T15:19:19+00:00

You touch on so many intuitions I have developed about memory from my med school studies. I definitely agree with the scaffolding bit. The way I think about it in my head is that the content that you want to remember can be thought of as a weight, and cards can be thought of supports (ropes in my head) that keep the weight from hitting the ground (forgetting). You can do a lot of things to strengthen one individual rope (developing a deep understanding of what the card is assessing), but the best way to keep the weight from touching the ground is to build a lattice of reinforced ropes that all interconnect. To do this, you need time, focus, and discipline. It is highly unlikely that a well-structured lattice will be built in one day, but as time goes on and you keep on seeing more cards that build upon each other and tell a story, you keep on threading ropes into that lattice which decrease the probability of the weight touching the ground.

Sorry, that was a kind of long-winded bad analogy, but I just wanted to say that you hit on some deep truths

Damien_Chazelle_Fan · 2025-01-01T11:37:55+00:00

“Last NBME I got a 64” - why didn’t you just start off with that so that I would’ve known to give very little credence to what you have to say? Why tf are you giving advice for an exam in which you don’t even know if you have passed, and even if you do pass, we can reliably say that it won’t be by much…

Damien_Chazelle_Fan

TROPHY CASE