Spaced repetition is a study technique that schedules review sessions at increasing intervals over time, based on how well you know each piece of information. Instead of cramming all your review into one session, you spread it out so that you revisit material just as you are about to forget it. This approach is one of the most well-supported learning strategies in cognitive science, and it is particularly valuable for pre-health students who must retain enormous volumes of information across multiple semesters, standardized exams, and clinical training. This page explains how spaced repetition works, how to use it effectively with digital tools like Anki, and how to integrate it into your pre-health study routine.
The Science Behind Spaced Repetition
The psychological principle underlying spaced repetition is the spacing effect, first described by Hermann Ebbinghaus in the 1880s. Ebbinghaus demonstrated that information is forgotten along a predictable curve (the “forgetting curve”) and that strategically timed reviews can flatten this curve, dramatically extending how long you retain information. Each time you successfully recall something at the moment you are about to forget it, the memory becomes stronger, and the interval before the next review can be extended.
Modern research has confirmed and expanded upon these findings. A major review in Psychological Science in the Public Interest rated spaced practice as one of the two most effective learning strategies (alongside retrieval practice). The combination of spaced practice with retrieval practice (testing yourself at spaced intervals rather than rereading at spaced intervals) is particularly powerful and forms the basis of how digital spaced-repetition tools work.
How Spaced Repetition Works in Practice
The basic idea is straightforward. When you first learn a new concept, you review it the next day. If you recall it successfully, you review it again in 3 days. If you recall it again, the next review is in 7 days, then 14 days, then a month, then several months. If you fail to recall it at any point, the interval resets to a shorter period. Over time, well-known material requires very infrequent review, freeing up your study time for new or more difficult content. This system is far more efficient than traditional review methods because you review only the material your brain is about to forget.
Using Anki for Spaced Repetition
Anki is a free, open-source flashcard application that implements a spaced-repetition algorithm. It is by far the most popular spaced-repetition tool among medical, dental, PA, and other health professions students. Anki is available for Windows, Mac, Linux, and Android (free), and iOS (paid). The web version (AnkiWeb) is also free and syncs across devices.
Getting Started: Download Anki from apps.ankiweb.net. Create a free AnkiWeb account to sync your progress. Either create your own cards or download a pre-made deck. For pre-med students, popular decks include MileDown and Jacksparrow2048 for the MCAT®, and the AnKing deck for medical school. For dental, PA, nursing, and other programs, search the AnkiWeb shared decks page for program-specific decks.
Creating Effective Cards: Keep each card focused on a single concept (one question, one answer). Use clear, specific questions rather than vague prompts. Include context that helps you understand why the information matters. Use images, diagrams, and mnemonics when they aid recall. Avoid “trivia” cards that test isolated facts without connecting them to a broader framework.
Daily Reviews: The most important rule of Anki is consistency. Do your reviews every day without exception. The algorithm only works if you follow the schedule. If you skip days, cards pile up, reviews become overwhelming, and the system loses effectiveness. Most students spend 20 to 45 minutes on daily reviews. Start with 10 to 20 new cards per day and adjust based on your capacity.
Common Mistakes with Spaced Repetition
Adding Too Many New Cards: Each new card creates ongoing review obligations. If you add 50 new cards per day, you will quickly accumulate hundreds of daily reviews and burn out. Start with 10 to 20 new cards per day and increase only if you can handle the review volume comfortably.
Using It Without Understanding: Flashcards are most effective when you already understand the material conceptually. If you are memorizing a card you do not understand, you are building fragile knowledge that will not transfer to exam questions. Use spaced repetition to reinforce material you have already learned through active study (see our active learning guide). Learn first, then retain.
Rating Cards Dishonestly: When reviewing a card, rate your recall honestly. If you hesitated or reconstructed the answer, do not rate it as “easy.” Under-rating your recall is better than over-rating, because a card reviewed one extra time does less damage than a card you think you know but actually do not.
Abandoning the System Early: Benefits of spaced repetition are back-loaded. The first few weeks feel like a lot of work for little reward. The payoff comes weeks to months later when you realize you still remember material from the beginning of the semester without cramming. Trust the process and maintain consistency.
Integrating Spaced Repetition into Your Pre-Health Routine
During Coursework: Make or add Anki cards as you learn new material in your courses. Reviewing daily means that by exam time, you have already reviewed the material multiple times at optimal intervals. Pre-exam study then becomes refinement rather than cramming.
During Exam Prep: For standardized exams like the MCAT®, DAT®, or USMLE®, download a comprehensive pre-made deck and work through it daily alongside question-bank practice. The combination of spaced repetition (for retention) and practice questions (for application) is the most effective dual-strategy approach available.
Long-Term Maintenance: If you start Anki in your undergraduate years and maintain it through medical, dental, or PA school, you build a cumulative knowledge base that grows stronger over time. Students who use Anki consistently report that foundational knowledge from years ago remains accessible during clinical rotations and licensing exams.
For related strategies, see our guides on active learning, time management, and test-taking strategies.
Other Spaced Repetition Tools: While Anki is the most popular option, other tools implement similar algorithms. Quizlet has introduced spaced repetition features, and apps like RemNote and Mochi combine note-taking with spaced repetition. The specific tool matters less than the consistency of your practice. Choose the platform that you will actually use every day, because the best spaced repetition system is the one you maintain.
Spacing for Different Content Types: Spaced repetition works best for discrete facts, terminology, and straightforward associations. For complex reasoning, problem-solving, and clinical decision-making, combine spaced repetition with other active learning techniques like practice questions and case-based reasoning. Use flashcards to remember the facts (drug names, mechanisms, lab values) and use practice questions to develop the ability to apply those facts to clinical scenarios.
Troubleshooting Common Problems: If your daily reviews are taking longer than 45 minutes, you probably have too many active cards. Suspend or delete low-priority cards to reduce the load. If you find yourself hitting “Again” on the same cards repeatedly, the card may be poorly written (too vague, testing multiple concepts at once, or testing something you do not actually understand). Rewrite the card or go back to your source material to build understanding before trying to memorize. If you lose your streak and cards pile up, do not try to clear the entire backlog in one session. Set a daily cap and work through the backlog gradually over a week while adding no new cards until you are caught up.
References
Dunlosky, J., et al. “Improving Students’ Learning With Effective Learning Techniques.” Psychological Science in the Public Interest, 14(1), 4-58, 2013. https://doi.org/10.1177/1529100612453266. Accessed March 2026.
Cepeda, N.J., et al. “Distributed practice in verbal recall tasks.” Psychological Bulletin, 132(3), 354-380, 2006. https://doi.org/10.1037/0033-2909.132.3.354. Accessed March 2026.
Anki. “Powerful, Intelligent Flashcards.” 2025. https://apps.ankiweb.net/. Accessed March 2026.