Update: Per reader requests, we’ve made direct links to the pictures in this article now, so they should show up full screen with only one click now

If you have an iPad, iAnnotate PDF is almost a must have application for healthcare professionals and students. I’ll explain the almost part later.

No matter where you are in your career in medicine, you’re reading PDF files constantly – it’s what keeps your evidence based clinical skills up to date. And as we all know, PDF files aren’t exactly optimized for the iPhone or other mobile devices. Rather, the two column appearance that dominates journal layouts is displayed horribly on mobile devices.

When the iPad was first released, I was looking forward to a host of medical applications, but unfortunately, most developers have been slow to convert their medical apps to the iPad format. I’ve documented the show transition in prior posts. But PDF viewing apps such as Papers, GoodReader, and now iAnnotate have not disappointed – and were quickly released with the iPad in mind.

With the iPad’s larger real estate, I knew viewing PDF files would be significantly easier, but I didn’t know how much I could do with them until I tried iAnnotate PDF. This app allows you to annotate in ways you couldn’t even do if you had a paper version of literature with pens and highlighters. However, it does have some flaws that we’ll get into later in the review. 

Annotation functionality:

I was going to list the different types of annotation you can do with this app, but you almost have to ask yourself what this application can’t do. All the annotating is done with your fingers and keyboard, and in true Apple form, the capacitive touch screen is extremely accurate and is a huge asset for this application.

Key annotation features [Picture is shown for each feature]:

*Highlighting: This is done with ease by dragging your finger across text.  I was pleasantly surprised by how smooth this feature is.

*Hand Writing: As you can see by the writing skills showcased, you probably want to use a Pogo stick – stylus for the iPad – if you really want to use this feature.  Handwriting on the iPad’s screen is fun, but using your fingers to write a short note is difficult and too cumbersome without a stylus like accessory.



*Comments: This feature is done extremely well. You can put a comment box anywhere on the PDF, and once you’re done, you can collapse the comment box, or you can choose to leave it open.  The collapsing feature prevents clutter within your PDF, while also giving you the ability to recall key notes.



*Lines: You can use the ruler tab to form straight lines. This can be useful to highlight key tables, graphs, or paragraphs.  Or for making random boxes just for fun, as I’ve shown below.



*Underlining and Crossing out: There isn’t really a need for the crossing out feature if you’re reviewing literature, but the underlying feature is definitely useful. Again, I got the same reaction with this feature as I did with highlighting – it’s extremely easy and smooth to do.  Just drag your finger across the text you want to underline [below picture is in portrait mode]



There are other things this app can do as well, but these are the main features I found useful when reading medical literature on this app. If you want to see other features explained in more detail view the video we have attached at the end of this post.

Transferring Files onto and from your iPad:

The achilles heel of this application is clearly transferring files. The developers offer a program you can download onto your computer that enables you to sync to your iPad with your computer via your Wi-Fi connection. But, if you have a hospital issued laptop with extra layers of security, the application might not work – it didn’t for me. If you don’t have the extra layers of security, you should be able to get your PDF files into the application with ease. I had to use another laptop to do this, but even then, there were a few PDF files that the iAnnotate PDF app wasn’t able to upload [almost all the files were uploaded easily].



The developers actually have a pretty robust forums section on their website that is useful in guiding you with file transferring issues. However, you shouldn’t have to spend half an hour or more trying to figure out how to get PDF files onto your iPad – you could have read a few clinical guideline PDFs in that time.  Another way to get files into the app is to view them in safari or your mail, where an option to view the file in iAnnotate pops up.



We e-mailed the developers about the connectivity issues we were having, and they have assured us that better file transfer options are coming very soon.

What I liked:

*Extremely powerful annotation features: Highlighting, Underlining, Crossing out, Comments, and more.  Each of these features is done really well, and is fun to use.
*Ability to have more than one PDF file opened at a time, the “tab” feature – similar to using a web browser. This feature is great if you’re trying to read multiple PDF files at the same time or are referencing information in multiple files simultaneously.
*You can customize how the toolbar is displayed, and the toolbar is displayed in both portrait and landscape mode.

What I didn’t like:

*Transferring files can be an issue – as mentioned above.
*No clear method on how to move annotated files back onto your computer.  We’ve been told updates will resolve this.


Once the developers of iAnnotate PDF figure out alternate methods to upload PDF files into the app, this will become a must have application for medical professionals. The type of annotating you can do with this app is actually fun – and makes reading medical literature that can sometimes be bland a bit more exciting. Per the iTunes description, the app is currently on sale for a limited time at $6.99, and at this price, the iMedicalApps team definitely recommends it – even with the issues that can arise for some users.

Links: iAnnotate PDF website, iAnnotate on iTunes

Note: We’ll be reviewing other PDF viewers (Papers and Goodreader) for the iPad soon, so stay tuned.

Video of the App in action[developers video]: