I use the Brosencephalon deck and search for relevant cards and add them to my current test deck. Then I also have a review deck I do as well.
Basically the way I do it is...
1. Watch lecture on 2x speed and take notes onto slides in one note.
2. Read through the slides and basically search any key words, or search for things I would want to make a card for, if I think the lecturer will test on something not in the deck I will make a card myself. But don't have to do this too much. I used to search cards during lecture (by pausing often), but now I just focus on listening and taking notes on the slides and then I will go back and do cards. Sometimes immediately after the lecture and sometimes a day or two after. Really doesn't take that long, and considering we have to learn the material, it is the quickest thing for me.
3. I'll also go back and take fairly concise handwritten notes through the lectures, usually a few days after or a few days before the test. Mainly just to pick up things I might have missed or the little details that professors tend to test on. I get lazy with this intermittently, but this is the difference between scoring at the average and well above the average for me.
I've been doing this method all 2nd year and I like it. Definitely good for long term studying for Step. Also the Bro's cards are generally better than anything I would make myself (and saves alot of time). You get alot of FA/Pathoma stuff that your lecturer might not cover but you need to know for boards as well. You do miss some of the benefit of actually making the cards, but it all evens out. I started Anki 2nd half of 1st year and made all the cards myself, and my grades definitely improved just doing that alone. I wish I had done it this way then though because its much easier to stick with these ones long term.
Also doing cards is often a pain, especially the review cards and the pace of 2nd year leads to annoyingly long sessions but you do what you have to do.
