There's often a fair amount of info in lecture material that's fair game for exams that lecturers don't emphasize or discuss during lecture (obviously this doesn't apply to every lecturer, but it happens often enough). Reviewing PPTs/notes/summaries/review books (Skinny Linda, Pathoma, etc.) can be active - by your 2nd or 3rd pass don't just read, mentally talk through what comes next in the notes and why without looking at your notes. For example, while reviewing MSK path: get to osteopetrosis --> mentally go through the pathophysiology in your head, how that relates to the signs, symptoms, and other clinical features, what labs would show and why, and what the Tx it is and why. After that quickly go through your notes to see if you missed anything or your thought process was off. With each pass it takes less and less time. Another method would be to make a 1-2 page summary of each lecture and then just re-writing the summary from your head and checking it with your notes or initial summary to see what you missed (I tried this after ditching Anki but still found it a bit too time consuming for most lectures [not nearly as bad as Anki], a number of my classmates and those in the class above me liked this method though).
My beef with Anki is that it is horribly inefficient and time consuming. I used Anki for the first part of 1st year and hated it. When I dropped Anki and switched to just annotating review books with additional info that was only covered in lecture and using the method(s) above there was a significant decrease in the amount of time I spent studying and a significant increase in my performance on exams. My other issue with Anki is that its basically just memorization and not a good tool for learning to think conceptually (the only topics I can see it being useful for are anatomy, immunology, and some biochem topics, but again its still a huge time sink). During 1st and 2nd year we had weekly group quizzes in TBL, it droves me nuts when there was uncertainty about an answer amongst most of the group but one person was adamant about a given answer. When asked to explain his/her reasoning, a disproportionate amount of the time that person responded with, "I don't know. I just know I saw (insert random word here) on my card related to X." Or another time where there was a third order question regarding 2nd messenger systems and our group couldn't come to a consensus. The answer several of us were arguing for was PKC (this turned out to be the correct answer), however 3 people in the group were adamant that was incorrect - their only argument was that they didn't have any cards on PKC in their Anki decks so there was no way that could be the answer. By 2nd year only a handful of people in my class still used Anki and they were part of a small group that took turn making decks for lectures because of what a time sink it was. The problem with this was relying on other to make decent cards, which seemed to be a perpetual issue amongst that group which led to a lot of passive aggressive complaining to other classmates.
During 2nd year I tutored 1st years that were at risk for being dismissed due to block failures. A common theme was that most relied primarily on Anki for studying. Nearly all of the students who adopted the methods I described above, some other ones I didn't go into detail about, or a combo of them along with lots of practice problems had significant improvements on block exams and no longer needed tutoring. I realize different strokes for different folks, but based on what I observed in the class above me, my class, and the class below me Anki only tends to be truly effective for a small fraction of students. And don't bother making the "Anki works if you know how to properly use it" argument, I heavily researched and experimented with Anki prior to and during med school and knew how to use it.
TL;DR - Different strokes for different folks - Anki may work for some, but in my personal experience with it and what I observed among classmates, other study methods tend to be more effective and efficient. Don't start first year with an Anki or bust attitude.