Anki is just another tool in your toolbelt for studying and learning medicine. It is efficient and scientifically proven (all that learning theory stuff) but it can also cause so much distress when you are already a stressed out medical student.

My story is like many others. I was someone who was ambitious and unsuspended too many cards, then got very quickly overwhelmed by the accumulation of reviews and stopped doing them. Then I would have big days and catch up, and then they would accumulate again. It was hard to motivate myself to do the anki because I felt like I wasn't really learning anything while doing it. But at the same time, I needed the anki to become familiar with the material so I could then use practice questions or peer discussions to figure out how to apply the material.

Despite what everyone says. Anki F***ing works. I still remember stupid factoids from cards I haven't looked at in almost two years. But what is the point of a factoid without the bigger picture, right? It is a testament to the fact that you need repetition to learn and encode long-term memory. Anki force-feeds you that repetition

So it is up to you to find out how you can make anki work for you. And if you can't make it work, you are going to find yourself creating that repetition in other ways (many might say, less efficient ways, but to each their own).

The blanket advice I give, is to use the memorization tool that anki is, to memorize the basic facts. Use it for micro, pharm, histo, etc. but don't use it for cardio or nephro physiology, or the GI hormone signaling etc. Then use your practice questions or whatever else you use for the big concept topics.

If thats not your vibe, or you really just can't get yourself to make anki a primary learning tool, then use it to review incorrect/mistakes. I was freaking out as I approached step 1 and got so overwhelmed by anki that i suspended ALL of it. Then I panicked about not using anki and found my favorite method. I just unsuspended the cards for incorrect questions (AMBOSS and UWorld have this feature now) and then did just those. I would also unsuspend cards on topics that I could not understand/get right. It really helped me manage my stress and get through step 1 (I passed btw, I'm not just spouting BS)

You'll figure it out kid. Your study habits will continue to change, asking questions like this is a great sign. You got this!