A PA School Workflow for 100-Slide Clinical Medicine Lectures

A PA student on r/PAstudent asked how anyone keeps up with decks during “lectures with 100 slides+ and potentially ‘paying attention.’” The replies describe split-screen PowerPoint and Anki, screenshots, audio recordings, and placeholder cards holding nothing but a slide number. The original poster’s own line was “I can never get my decks done in time.”

They never get done because card-building and listening want the same attention. Card during class and you attend the lecture twice: once while typing, once while replaying the recording to hear what you typed through. For a lecture you are required to sit in, that is the most expensive way to spend it.

What class is for in a clinical medicine lecture is emphasis, and emphasis is not in the file. Mark the slide where the lecturer says “classic presentation” or “first-line” or “this is the one that gets missed.” Mark the disposition slides, admit versus discharge versus refer, because that is where the exam vignette ends. Write down the aside that is on no slide at all. Everything else is in the PowerPoint, and the PowerPoint is yours after class.

The same r/PAstudent poster who was moving information around added: “After 300 cards I don’t remember what I learned at the start.” Another PA student, on rotations, wrote “I practically rewrite the chart.” The chain those threads describe looks like this: slides to a notes document, notes document to Anki, Anki to a question bank, and back to the notes document when a question is missed. Every arrow is the same fact typed again.

Retyping feels like studying. It is not retrieval, and it is where the evening goes. The step to cut is the middle one: the notes document that exists only so it can be turned into cards. The slide already has the chart. The card is the retrieval unit. A third copy in between adds nothing you can be tested on.

The caution comes from an incoming PA student’s thread on AI notes, where a reply warned that summarising tends to “overcondense my notes” or “skip over high yeild info.” Whatever compresses a 100-slide lecture into something you can review has to keep pointing back to the slide, so the high-yield line you did not card is still one click away. When making cards takes longer than reviewing them, the shuffle is usually why.

A clinical medicine lecture has a repeating shape. For each condition: presentation, the test that confirms it, the focused workup, initial treatment, and disposition or referral. That shape tells you which format each piece belongs in.

A PA student on r/PAstudent had “built up quite the decks” and had not studied “any past material after test day.” A reply: “I just didn’t have enough time in the day for it.” This is didactic review debt. Every card you made for Monday becomes a daily obligation on Tuesday, and the queue does not know the exam is over.

So make one decision after each exam, in one pass, before the next block starts. For each lecture’s cards, sort into two piles.

A December PANCE candidate on r/PAstudent listed “2000 pending uworld questions, 3000 pending rosh questions and 5000 anki flashcards.” Another, given both banks by their programme, found it “unrealistic to attempt to complete both.” A third, a month out, did not know “if what I’m doing will be enough to pass.” A fourth had “tried to cover everything and got overwhelmed.”

In-house didactic exams are not standardised. Your programme writes them from these slides. The PANCE is written by NCCPA from a blueprint, and Rosh and UWorld are built to represent it. So lecture-derived questions rehearse the lecture, for Monday. Rosh and UWorld are the representative practice, for the PANCE and the EORs. Neither counts as the other. Doing Rosh the week of an in-house cardiology exam is not studying for the cardiology exam, and finishing a set of lecture questions is not PANCE progress.

The one thing lecture questions have that the banks do not is an end. A set generated from one lecture is finite. You finish it, you know where the gaps are, and it does not join the 5,000.

Upload the lecture’s PowerPoint directly, .pptx or .ppt. It is converted to PDF on the server, speaker notes are not carried over, and a deck over 100 slides is refused, so split a 130-slide cardiology lecture where the lecturer changed conditions. Set the level selector to PA. That frames the Story and the Practice questions for PA scope: diagnosis, focused workup, initial treatment, disposition. The lecture stays the source of truth.

The Anki deck comes back as a standard .apkg with the source slide image on the back of every card, which is the answer to the overcondensing worry: the high-yield line you did not card is on the back, not gone. The generator is told to prioritise objectives and repeated emphasis and to stay under roughly three cards per content slide. Practice questions are five-option vignettes with an explanation that names the answer first, walks the mechanism, and addresses the most tempting distractor, with the source slide beside it. The Story is for the lecture you sat through and did not follow.

Review the output against the slides before Monday. The generator can omit a detail or state something wrong, and a wrong first-line drug is worse than no card. Check doses and thresholds against the slide and never against a patient. New accounts start with five credits and no card, and Anki plus Practice from one lecture is two credits. PDFs go in the same way if your programme distributes those instead.