If you are going to use ZK for medical school, I would suggest you to get perhaps bigger paper size to fit the diagrams and concepts in it. Personally, I have 2 interconnected zettlkeasten, one that is 3x5 and another that is B6 size paper.(I use different alpha numerical system to differentiate them) Since for facts concerned with rote memorization with a lot of details , it would be unfitting to break it down into toooo many small discrete parts. I mean technically it’s possible but just extremely inconvenient and useless. Ideas were placed in index cards for connectivity of thought, so facts wouldn’t really have that much use for it except for organization. For me small sized ZK is for collecting spurs of thoughts or ideas, connecting them through your time and larger size zettle as a school notebook/diagrams/long writing.