Abstract
INTRODUCTION: Medical students face increasing content demands while adapting to condensed preclinical curricula and the transition of USMLE Step 1 to pass/fail. As students seek effective study strategies, tools like Anki, which use spaced repetition and retrieval practice, have gained popularity. However, their impact on in-house performance and wellness remains unclear. METHODS: A cross-sectional study of 176 first-year medical students at Saint Louis University School of Medicine was conducted during the 2024 to 2025 academic year. A structured, anonymized Qualtrics survey assessed study methods, Anki use, study hours, and self-reported wellness using 10-point Likert scales and categorical items. Survey data were linked by a third party to scores from six in-house assessments, including three multiple-choice written exams and two cadaver-based anatomy lab practicals per course. Statistical analyses included ANOVA, Mann-Whitney U tests, and regression modeling. RESULTS: Eighty-two percent of respondents reported using Anki, and 51 percent identified it as their primary study method. Anki use was not associated with improved exam performance. Students who used three or more study methods scored significantly lower on written exams compared to those using two or fewer (p = 0.02). Higher self-reported wellness and sleep of at least seven hours were both associated with better written exam performance (p = 0.01). Study hours and time spent in lab showed no correlation with outcomes. CONCLUSIONS: Success in early medical education appears more closely related to wellness and focused study habits than to any specific study tool. Consistency and self-care may be more effective than time investment alone. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-025-02549-8.