Anki deck strategy for MRCEM Primary

Last updated: 30 May 2026 · Reading time: ~12 minutes

TL;DR — if you only read this:

1. Best free starting point: Gandolfi Emergency Medicine FRCEM/MRCEM Revision on AnkiWeb (~1,500 cards, updated May 2026). Good for pharmacology, physiology, microbiology, evidence-based medicine. Weak on anatomy.
2. Best free anatomy supplement: ACEM Primary Exam (Written) — Anatomy (~1,500 cloze cards with 678 images). Built for the Australasian equivalent but maps almost 1:1 onto the RCEM anatomy curriculum.
3. Best paid option if you want hand-holding: Dr Behzad Rashid’s MRCEM Primary Anki deck (Patreon, ~£65/$80), explicitly written to the current MRCEM syllabus, with a study schedule and a Telegram community.

Recommended setup: Anki desktop + AnkiMobile/AnkiDroid, FSRS scheduler on, 25–30 new cards/day, 9999 reviews/day, image occlusion add-on for anatomy. Pair Anki with a question bank (MRCEM Success or RCEMexamprep) — flashcards are not a substitute for SBA practice. Start 12–16 weeks out, not 4. See also our guide to how to revise physiology for MRCEM Primary.

Should you even bother with Anki for MRCEM Primary?

Short answer: yes, if you are sitting in three months or more and you can stomach 45–90 minutes of reviews a day. The Primary is a 180-question SBA covering anatomy (60), physiology (60), pharmacology (24), microbiology (17), pathology (9), evidence-based medicine and safeguarding/end-of-life (10). It rewards recognition of small, isolated facts — brachial plexus branches, half-lives, ECG intervals, ATLS thresholds. That is exactly what spaced-repetition flashcards are designed for. See also our guide to active recall and spaced repetition for SBA prep.

What Anki will not do for you: teach you to read a stem, eliminate distractors, or sit in a 4-hour exam without melting. That is what your question bank is for. The two tools are complementary; using Anki alone is the most common mistake we see in failed first attempts. See also our guide to how many hours per week MRCEM Primary really needs.

Premade deck or build your own?

If you have ever asked this question in r/doctorsUK you have seen the answer: premade for breadth, hand-built for the topics you keep getting wrong. Building 1,500 anatomy cards from scratch will burn 60–100 hours before you have studied anything. Use that time on reviews.

The honest split most successful candidates use:

• Premade deck as the spine of revision — loaded on day one, unsuspended in chunks as you cover topics.
• Personal “leech” deck of 100–300 hand-made cards for facts you fail in the qbank or that don’t feature in the premade deck (RCEM-specific cut-offs, NICE updates, paediatric drug doses you keep forgetting).

Pure DIY decks suit one type of candidate: people who already passed Primary once, failed by a handful of marks, and know exactly which 200 facts let them down. For everyone else, start with someone else’s work.

Which premade Anki decks are people actually using?

Here are the decks named most often in UK and Irish trainee forums, Facebook MRCEM groups, and the r/MRCEM subreddit as of May 2026.

Why no anatomy deck built around Aclands? Because Aclands isn’t a deck — it’s a video atlas. The pattern that comes up repeatedly on r/doctorsUK (e.g. the “How to revise/learn anatomy for MRCEM Primary” thread, post 1s847rj) is “Aclands + Anki recommended repeatedly”: watch the relevant Aclands clip, then make 5–10 image-occlusion cards from screenshots while it’s fresh. Combine that with the ACEM anatomy deck above and you have your anatomy spine.

How should you actually configure Anki for a 12-week sprint?

Default Anki settings are not built for exam cramming. They’re built for indefinite long-term retention. Three months is short. Tune accordingly.

Scheduler

• Turn on FSRS (Tools > Preferences > Scheduling). It is the default in Anki 24.x and noticeably better than the legacy SM-2 algorithm for short timeframes.
• Set desired retention to 0.90 for Primary. Higher (0.95) doubles your review load for marginal gain. Lower (0.85) saves time but you’ll feel it in micro-detail anatomy.

Daily limits (deck options)

• New cards/day: 25–30 if you start 12 weeks out. 40–50 if you start 16 weeks out. Above 60 and your reviews will balloon to 90+ minutes/day by week 4.
• Maximum reviews/day: 9999. You want Anki to show you everything that’s due, not arbitrarily cap it.
• Learning steps: 15m 1d. The 1-minute default is fine for med school but wastes time on a tight timeline.
• New/review order: Show after reviews. Reviews are the priority — don’t add new cards if you’re behind.

Last-fortnight settings

Two weeks before the exam, stop adding new cards. Set new cards/day to 0. Increase desired retention to 0.93 and run a filtered deck (Tools > Create Filtered Deck) of cards you’ve answered “Again” in the last 30 days. That’s your leech list and that is where marks live.

Add-ons worth installing

• Image Occlusion Enhanced — non-negotiable for anatomy. Lets you hide labels on a diagram and review them like flashcards.
• Review Heatmap — visual accountability. Helps you spot the weekend you skipped before it becomes a fortnight.
• Pop-up Dictionary — hover-translates drug names and microbiology terms without breaking flow.

What does a realistic week look like?

Assuming a working ED rota with a mix of long days and nights, this is the load most successful first-time pass candidates report on Facebook MRCEM groups and r/MRCEM:

• Mon–Fri: 45–60 minutes Anki (split: 20 min on the commute, 25–40 min in the evening). 20 fresh SBAs from your question bank in one sitting, with full read-through of explanations.
• Saturday: 90-minute “catch-up” review block, then a 3-hour topic deep-dive (a textbook chapter or a Zero-To-Finals video on the week’s weak spot).
• Sunday: Reviews only. Rest your brain.
• Night shifts: Do reviews on the AnkiMobile/AnkiDroid app between patients. Do not add new cards on nights — retention will be terrible.

Total weekly load: 7–10 hours active study. Less than that and 12 weeks isn’t enough; more than that and you’ll burn out by week 8.

Common mistakes that tank your Anki strategy

• Starting too late. Six weeks isn’t enough to learn 1,500 new cards and review them. The deck only pays off if you give it three intervals.
• Adding the whole deck at once and unsuspending everything. 4,000 reviews on day 14. You’ll quit. Unsuspend by topic, in step with your reading.
• Ignoring leeches. Anki tags cards you keep failing as “leeches” and suspends them by default after 8 lapses. Don’t let it. Edit those cards — the wording is usually the problem — and reset.
• Treating Anki as a replacement for SBAs. The Primary tests reasoning under time pressure, not isolated recall. You need 1,500–3,000 practice SBAs minimum.
• Trying two decks in parallel. Pick one spine deck. Use the other as a reference if you fail a topic.

Where do non-Anki resources fit?

A typical successful stack looks like:

• Spine deck (Gandolfi or Behzad Rashid) — daily.
• Anatomy supplement (ACEM anatomy deck + Aclands clips + image occlusion cards from Last’s Anatomy diagrams) — weekly anatomy sessions.
• Question bank — MRCEM Success or RCEMexamprep, ~2,500–3,000 SBAs done at least once, weak topics done twice.
• Reference textbook — Oxford Handbook of Emergency Medicine for quick lookups; Boron & Boulpaep or Ganong for physiology depth where the deck card doesn’t make sense.
• RCEMLearning — free, official, and surprisingly under-used for the curriculum coverage it gives you.

Frequently asked questions

Is there an “AnKing” equivalent for MRCEM Primary?

No. AnKing is a US medical-school deck built around USMLE Step 1/2 and Pathoma/Sketchy. There is no single curated, regularly maintained, community-blessed MRCEM Primary equivalent. The closest in spirit is Dr Behzad Rashid’s paid deck, but it is one author, not a maintained community fork.

Can I just use AnKing/Anking lite for MRCEM Primary?

Partially. The pharmacology and physiology overlap with USMLE Step 1 is real and AnKing’s cards are excellent. But you’ll waste hours on US-specific drug names, immigration-relevant microbiology, and abdominal anatomy depth you don’t need. Net: probably not worth it as a spine. Useful as a pharmacology top-up.

How many cards a day is realistic on a clinical rota?

Most candidates settle at 25–30 new cards/day and 150–250 reviews/day at peak load. That works out at 45–75 minutes daily. If reviews push past 300/day you’re either too far behind or you added too many new cards at the start — cut new cards to 15/day until reviews drop.

FSRS or SM-2?

FSRS. It’s the new Anki default, validated on large user data, and produces noticeably fewer reviews for the same retention target. The one exception: if you’re mid-revision and FSRS hasn’t optimised against your review history yet (it needs ~1,000 reviews), let it run for two weeks then run Compute optimal retention.

Do I really need the desktop app, or can I just use the phone?

You need desktop for: importing shared decks, installing add-ons (image occlusion, heatmap), tuning FSRS, editing cards in bulk. Use the phone for: reviewing between patients, night shifts, train journeys. Both, not one.

How do I handle Anki on a 12-hour ED shift?

Reviews only, never new cards. Aim for two 10-minute bursts: one mid-shift, one before the drive home. If your shift is overrunning, skip the evening session entirely — tomorrow’s reviews will absorb today’s missed cards within 48 hours under FSRS.

Is image occlusion worth setting up if I’ve never used it?

Yes — budget 30 minutes once to install the add-on and learn the workflow. Anatomy retention triples once you stop reading labelled diagrams and start covering them up. The Aclands + image occlusion combination is the single highest-yield change you can make.

What if I’m re-sitting and only have 4 weeks?

Don’t start a new deck. Take your previous Anki database, run a filtered deck of cards you’ve answered “Again” in the last 90 days, and a second filtered deck of cards tagged with whichever curriculum domain you scored worst on. Pair with 30 SBAs/day. Stop adding new cards entirely.

Should I make my own cards from MRCEM Success rationales?

Yes for the ones you fail. No for the ones you got right by luck. A reasonable rule: if you marked it “guess” or your second-choice answer was right, make a card. Otherwise re-read the explanation and move on.

Are paid decks (Behzad Rashid, courses) actually worth it over free ones?

It depends on your structure. If you’re self-disciplined and used Anki in med school, the free Gandolfi + ACEM combination plus a question bank is enough — people pass on that every diet. If you need the scaffolding of a schedule and a community, the paid option earns its keep. Either way the question bank is the bigger investment.

Will Anki work without spending money on a qbank?

You will probably fail. The Primary’s pass mark sits around 60% in most diets and the standard-set questions test SBA reasoning, not pure recall. There is no shortcut around 2,000+ practice questions. RCEMLearning gives some free coverage; pay for one full qbank.

Anki vs Brainscape vs Quizlet?

Anki for flexibility, add-ons, image occlusion and FSRS — the de facto standard in medical revision. Brainscape if you prefer a polished, paid interface and don’t want to fiddle with settings. Quizlet for collaborative class decks but the spaced-repetition algorithm is weaker. For MRCEM Primary specifically: Anki, every time.

Next steps

Pick your spine deck this week, install Anki desktop, enable FSRS and image occlusion, and unsuspend your first 25 cards tonight. Pair that with a structured SBA bank and a 12-week plan. If you want curriculum-mapped MRCEM Primary practice questions and topic guides written for UK trainees, browse the resources at EM Final Exams.

Facts last verified 30 May 2026. Deck card counts, update dates, and pricing change — check the linked AnkiWeb and Patreon pages before committing.

Ready to build your plan? EMF Premium gives you all 40,000 questions and 20 mocks for £59 — one payment, six months' access.