I think this is a great characterization of how various people use Zanki. Here's the problem - there are 21,000 plus cards. I see people who are doing hundreds (some over a thousand) reviews + new cards every day. It's really impossible to do all of that while thinking about each concept in depth and annotating the cards. Let's say you have 500 reviews a day plus 100 new cards or so. So 600 in total. In order to think about each card in depth and think through the concepts, let's say you spend 30 seconds on each card. That's 300 minutes each day. Then let's say you don't recall concepts for 1 in 20 cards and you have to look it up on Wikipedia or First Aid or wherever and annotate the card. That takes you 3-5 minutes. So add on, on average, another 120 minutes. That's 420 minutes, or 7 hours, each day spent on just Anki. I would say that most people don't do this. Even if you assume 20 seconds spent on each card and 2 minutes for looking up and annotating (a really efficient person!) you would spend 260 minutes, or over four hours, on Anki. I know only a few people who do this. Most people memorize the content of the card without really thinking about the bigger picture concepts and how they relate to one another.
Plus, I can think of a hundred better ways to be spending those 4-7 hours of my day (I would spend maybe 1-2 hours max each day on Anki).
I don't think that RR should replace Pathoma for boards review at all. That's not what I'm saying at all. I'm saying that RR is a more comprehensive resource and there's nothing in Pathoma that I haven't already seen in RR. So RR is a great resource if you're learning the material for the first time; Pathoma is great for boards review because you have limited time. I know there are people who score very high using only UFAPS. But they also have had excellent pre-clinical preparation and learned the material well the first time. RR is one resource that I believe is great as a resource during your pre-clinical education.
I really diagree with the entirety of this post.
First of all - when you review one card you cover the concept in depth in your head. Then move onto the next. Thing is thousands of those cards are close variants of each other, so when you get to a card related to that topic youve just covered, it takes you shorter amt of time to go through that concept in your head. You do this over and over again thousands of time, going through the concept in your head takes seconds. Its the initial learning of cards that takes a long time. And yes I know many people who do anki for 3-4 hours daily. That is not a massive amount of time to review information if you’re serious about doing well on step. That’s the whole point of spaced repetition.
High scorers study effectively. They dont take shortcuts like memorizing first aid, memorizing anki, etc. they seek in depth understanding of every concept in first aid and pathoma, and they commit this to long term memory. Zanki is one tool to do this that works very well if used correctly.
As far as pathoma and RR i disagree. RR is such a dense higher level book that you need a foundation to appreciate the connections it will make for you. If you go in blind, you will miss a lot of connections that the book is intended to make, unless you reread the book again during dedicated. Standard advice is to do pathoma first, and then if you are seeking connections that you arent getting from qbanks, do Golijan. Some people do it other way around, but this is not what i recommend and not what i see most ultra high (260+) scorers do. In fact most ultra high scorers I know don’t do RR but instead do a critical mass (5,000+) practice questions prior to hitting dedicated. But if it works for you it works for you and thats great.
I think sometimes, especially on sdn, there is an anti-zanki bias for no real reason - by people who have little experience with the program or regret not trying it earlier.
Going back to OP - If you want to truly master and commit to long term memory the information you need for step, zanki is one tool to do this. There are many other ways too. Key is to talk to upperclassmen, make a plan before entering school, and then adjust the plan as needed.