2021 Guide to Creating High-Yield Flashcard Decks on UWorld

Did you know that flashcards have been around since at least the 1800’s when paper became widely available to the average student? Certainly, the use of flashcards to aid in the memorization of facts is no foreign concept to any of us; in fact, I think most people remember making flashcards throughout their educational career (Or do they? Perhaps I am showing my age!) to memorize things like foreign languages and history facts. Over the last 30-40 years however, researchers have begun taking a closer look at the effectiveness of flashcards and other learning techniques. Through this research, the important concepts of “active learning” and “spaced repetition” were born. 

As you may have guessed, especially in medical school while studying for the USMLE exams, utilizing flashcards as an avenue for active learning and spaced repetition are major contributing factors to studying success. Creating your own personalized flashcards provides a custom study resource tailored to your specific knowledge base and needs, and, when leveraged appropriately, flashcards can become your most valuable review resource that puts the icing on your hard earned USMLE study cake! As luck may have it, the popular USMLE qbank UWorld offers the ability to make flashcards right on their platform which is what we will be exploring in this post. So, grab a fork and let’s talk UWorld flashcards!

Why Flashcards Work for the USMLE Exams

To start, active learning, for those who may not be familiar, refers to any learning activity in which the student participates or interacts with the learning process (as opposed to passively taking in information). This is the first key part of why taking the time to create personalized flashcards on UWorld or elsewhere is so important. Making your own flashcards instead of simply using a premade deck creates a learning activity that causes you to interact with the material you are trying to memorize and increases your retention rate. 

The second reason making flashcards is so important deals with the concept of spaced repetition which relies on reviewing flashcards at increasing intervals based on the difficulty of the card. This concept of spaced repetition has overtaken medical education as the best way to retain all that information needed to do well on the USMLE Step Exams. Essentially, taking the time to repetitively review flashcards over the course of a period of time lifts the “forgetting curve” so that students actually remember the information they have reviewed. 

Flashcards Meet Medical School

Medical students worldwide have become hooked on spaced repetition flashcards, facilitated by the release of the Anki app in 2006 (Anki is the Japanese word for “memorization”). which over the past decade has swept through medical schools as one of the best methods of implementing spaced repetition. Anki’s popularity has largely been attributed to the fact that it is free to use and there are many high-quality flashcard decks available specifically for USMLE Step 1 and Step 2. Students have the flexibility to create their own cards and decks by importing pictures and charts as necessary.

Anki is often used in tandem with First Aid and the UWorld question bank (QBank) to make flashcard sets based on the material being reviewed in each resource. However, UWorld, the QBank leader for USMLE Step 1 and Step 2 CK test preparation, recently launched its own Flashcards feature. Since then, many students have opted to stay within the UWorld platform to create and review their flashcards.

UWorld’s Flashcards Features

UWorld flashcards have several unique features that make them particularly well suited to USMLE Step 1 and Step 2 prep. First and foremost, the flashcard feature utilizes spaced repetition systems, which again has been proven as the most effective way to recall and retain information. Secondly, the flashcard feature is completely integrated with the UWorld question bank which makes creating flashcards very simple and less time consuming than having to switch between platforms. Take the following example:

Whenever you come across a classic presentation, a high-yield concept, or an exceptionally delicious bite of knowledge, you can just click the Flashcards pop-up window and add that content to a new or existing card in your deck. Of course, you can also copy and paste any written or visual content onto your card!

For students who use flashcards primarily to reinforce material from incorrect answers (detailed explanations), the UWorld Flashcards feature allows you to add proprietary UWorld images, tables, and charts featured in UWorld explanations to your flashcards. Given the high-quality images, tables, and charts featured within the UWorld explanations, directly incorporating that content into flashcards is beneficial.

As seen in the above screen captures, students can easily create flashcards incorporating helpful images as mentioned above. Sometimes tables can be worth 1000 words and having the ability to drop one into a flashcard and not worry about finding it later can be very helpful! Thirdly, UWorld flashcards are very user friendly (significantly more so than the somewhat cumbersome html software found on Anki). Having the ability to quickly and easily browse, organize, and study flashcards is a huge timesaver when studying for the USMLE Step 1 and Step 2 CK exams (and can save students many a headache when trying to merge or organize Anki decks… particularly if students are new to the app and haven’t learned all of its quirks). The newest features of UWorld’s flashcard function include “browse” and “enhanced filtering” to help organize and edit your decks by subject/organ, ect. This functionality will help to: keep you organized, identify which subjects you may be struggling with most and identify themes to guide your review, pair down your deck by eliminating subjects you’ve mastered, and easily group and review related organ systems for multi system integration critical for higher level understanding!

Integrated Spaced Repetition

Speaking of reviewing your flashcards, a favorite benefit of using the UWorld flashcard making feature is its integrated spaced repetition feature. If for example you’re reviewing your cards and you feel like you always get a specific card correct or always mix up that one fact, you can use the integrated space repetition feature to increase or decrease the frequency that you see that card. For cards you feel like you’ve nailed, I actually recommend students “retire” that card by decreasing the frequency to 0. On the flipside, you can also increase a card’s frequency that you are struggling to remember. While pairing down your deck can sometimes feel difficult, remember this is your study experience and your deck should include the most high yield facts for you! On this point, I also recommend that in order to maximize your study efficiency, you create custom study sessions. Choose how many cards, order, and frequency for spaced repetition. Then, after you’re done reviewing for the day, remember to check out your metrics to assess progress!

With all these benefits, the best way to use the UWorld flashcard feature is undoubtedly as a way to memorize and retain content from UWorld questions. Granted, making your own flashcards is time-consuming. However, the benefits of making your own cards tailored to material you got wrong are astronomical, particularly if you start making cards early, during your first pass of UWorld in your first or second year of medical school. As a great active learning strategy, consistently using the flashcards through spaced repetition will facilitate the acquisition and retention of all those high-yield USMLE facts, and make sure that you are not overwhelmed with struggling to remember details on test day. In addition, if Anki is still a go-to for you, there is nothing wrong with using Anki in tandem with UWorld as a spaced repetition platform for other material (such as their pre-made decks, reinforcement from other qbanks, material from First Aid, or other board-review content such as Boards and Beyond)! 

Reaping the Benefits

Overall, combining the power of a daily flashcard review with the power of UWorld as the gold standard qbank resource for medical students creates a highly effective combo students should absolutely take advantage of while studying for their USMLE exams. Regardless of what flashcard platform students use, the important thing to remember is that spaced repetition only works if you are dedicated to it, and keep up with your cards. Unfortunately, our memory doesn’t take a “vacation”, so while it’s possible to catch up after taking a day or two off from flashcards, if you take a whole week off (or, *gasp*, a month!), you will be digging yourself out of that hole for a long, long time. The good news is that you don’t have to dedicate hours each day to flashcards. Most students find that they can get through their deck during downtime throughout the day, whether they are commuting, on break between clinical duties, or stepping away from learning content through doing questions or video resources. Likewise, it takes time to get really good at making effective flashcards. So the earlier you start, the better!

[Originally guest published on the UWorld Blog]