No PDF sent by e-mail. The student buys the year on the shop and gets access to their notes, their questions and their progress. That's it.
Shopify store, one product per year (Year 1 to Year 6), in each country's language. Apple Pay, card, PayPal.
Right after payment: an e-mail with the access link. The login is the e-mail used at checkout, nothing to set up.
The sheets in place of the PDF, with pen, highlighter, sticky notes and bookmarks. The questions for each chapter. Their progress.

Landscape, like Pilote Autrement: a cover, then 4 pages with one idea and one diagram per page. Built on the European Society of Cardiology guidelines.
The common core of medical school across Europe. One product per year on the shop. Each subject: about 10 chapters, each with its sheet and its questions. Every sheet checked by a doctor before it goes on sale.