We covered everything from nitty-gritty material, to decisive test-taking habits.
Anki is free flashcard software built on two ideas: active recall and spaced repetition. The deck you choose matters less than how you use it, but the choice still matters. Deck details below come from AnkiHub, which distributes the most widely used USMLE deck, as listed on October 21, 2026; the method notes come from the Anki manual and from how we work with students.
1. Understand what Anki does
The Anki manual describes active recall as being asked a question and trying to remember the answer, and spaced repetition as spreading reviews out over time, so that you study a card when you are about to forget it. Anki now includes FSRS, a newer scheduling algorithm, as an alternative to its older SM-2 scheduler (Anki manual).
2. Know the main USMLE deck
AnkiHub describes the AnKing Step Deck as the largest, most up-to-date flashcard deck for Step 1, 2 and 3, with over 30,000 cards organised by resources such as Sketchy, Boards and Beyond and First Aid. It is included in AnkiHub's Core plan, listed at $6 a month; it is not in the free plan. Approved updates from the deck's maintainers are sent to subscribers automatically (AnkiHub).
| Option | What it is | Cost (as listed) |
|---|---|---|
| AnKing Step Deck | Large shared deck for Steps 1-3, tagged by resource | AnkiHub Core plan, $6/month |
| Your own deck | Cards you write from your misses | Free |
| Question bank flashcards | Cards inside your QBank, e.g. UWorld | Included with the QBank |
3. Unsuspend, do not download everything
This part is our advice. Thirty thousand cards is far more than anyone should review. The resource tags let you unsuspend only the cards that match what you studied that day or the questions you missed. Start suspended, and add cards deliberately.
4. Size the reviews to your schedule
Reviews grow with every new card you add. If Anki takes longer than your questions each day, your card load is too big for your schedule. We set a ceiling on daily new cards from the time you actually have, and lower it in the weeks before an exam.
| Stage | New cards | Main job of Anki |
|---|---|---|
| Early preclinical or clerkship | Steady, from what you study | Build long-term memory |
| Dedicated period | Mainly from question misses | Fix the gaps questions reveal |
| Last 1-2 weeks | Few or none | Keep reviews light; protect question time |
5. Turn misses into cards
The highest-yield cards are the ones that come from your own question misses. After each block, add or unsuspend one card per miss, or put the point on a running list of misconceptions. That ties the deck to what the exam is actually catching you on.
6. Avoid the common traps
- Adding cards faster than you can review them.
- Doing Anki first every day, so questions get the tired hours.
- Using Anki in place of questions instead of alongside them.
- Keeping thousands of overdue cards out of guilt; reset the plan instead.
7. Make the deck fit you
Our tutors rebuild students' decks around spaced repetition so reviews fit inside the schedule instead of taking it over. That is part of every plan we build; see how many questions a day, our UWorld review and Step 1 tutoring.
Anki for Step 1 versus a Step 2 CK Anki deck
The two exams reward different memory. Step 1 is pass/fail and leans on mechanisms; Step 2 CK is scored and asks what you would do next for a patient. That changes which cards earn their place.
| Step 1 | Step 2 CK | |
|---|---|---|
| How it is reported | Pass/fail only since January 26, 2022 (USMLE) | Three-digit score; 218 to pass since July 1, 2025 (USMLE) |
| Exam day | One 8-hour session, fourteen 30-minute blocks from May 14, 2026 (USMLE) | One 9-hour session, sixteen 30-minute blocks from May 7, 2026 (USMLE) |
| Questions | About 280 (USMLE) | About 316 (USMLE) |
| What the cards should hold | Mechanisms, pathways, drug classes, buzzwords that unlock a diagnosis | Next steps, first-line treatments, screening ages and intervals, when to admit |
| Where Anki sits in the day | Capped reviews after questions; new cards from misses | Shorter still; clerkship tags during rotations, misses only in dedicated |
Anki for Step 1
During preclinical years, unsuspend cards by the resource tag for each lecture block, so the deck follows your course rather than running ahead of it. In dedicated, stop adding broad coverage and add cards only from question misses. If Anki is taking longer than your question blocks, the new-card limit is too high for the weeks you have; our sample Step 1 schedule budgets about an hour and a half a day for it.
The Step 2 CK Anki deck: what to use
There is no need for a second deck. AnkiHub describes the AnKing Step Deck as covering Step 1, 2 and 3 (AnkiHub), so most students keep the same collection and change what they unsuspend. During clerkships, unsuspend the clinical cards for the rotation you are on; in Step 2 CK dedicated, add cards only from question misses.
Students who did not use Anki for Step 1 do not need to start a 30,000-card deck in third year. A small personal deck written from Step 2 CK question misses, mostly next-step and management facts, covers the gaps that cost points with far fewer reviews.
Carrying a Step 1 deck into Step 2 CK
Keep it, but stop protecting it. Mechanism cards you already know cold can be suspended, which frees review time for clinical cards. Students who keep every Step 1 card active through clerkships often arrive at Step 2 CK dedicated with an hour of reviews a day before they have opened a question bank.
Worked example: how reviews grow
Anki's daily reviews depend on how many new cards you add. As a rough illustration of the arithmetic: if you add 50 new cards a day, then after a few weeks you are reviewing several hundred cards a day, because every card keeps coming back at growing intervals. At about 8 seconds a card, 400 reviews is close to an hour. That hour comes out of question time, which is why we cap new cards from the time you actually have.
| New cards a day | Rough daily reviews after a few weeks | Time at ~8 sec a card |
|---|---|---|
| 20 | 150-250 | 20-35 minutes |
| 50 | 350-500 | 45-70 minutes |
| 100 | 700-1,000 | 1.5-2.2 hours |
These figures are our rough estimates from working with students, not Anki's; your numbers depend on settings and how often you get cards right. Anki shows your real forecast in its statistics screen.
A timeline for Anki across the Steps
| Stage | Deck use | Daily time |
|---|---|---|
| Preclinical | Unsuspend cards for each lecture block | 30-60 minutes |
| Step 1 dedicated | Cards from question misses; few new cards in the last 2 weeks | Under an hour |
| Clerkships | Clinical tags for the current rotation | 20-40 minutes |
| Step 2 CK dedicated | Cards from question misses only | Under 45 minutes |
Do you need a premade deck at all?
No. Some students do well with a small deck written entirely from their own question misses. A premade deck saves writing time and covers more facts; a personal deck is smaller and targets your gaps exactly. Many students combine them: the AnKing deck for coverage, their own cards for misses.
Settings that keep reviews under control
- A daily new-card limit set from your free time, not a default.
- A maximum reviews setting high enough that backlogs do not build up silently.
- One scheduler, chosen once; FSRS is now available as an alternative to the legacy scheduler.
- Suspend leeches, cards you keep failing, and rewrite them in your own words.
For the official description of each setting, see the Anki manual. These choices are ours, from working with students.
Clearing a backlog
A backlog of thousands of overdue cards is common after a heavy rotation. Rather than trying to clear it in a day, we stop new cards, set a fixed daily review cap that fits the schedule, and let the backlog fall over a week or two. Questions keep their usual time throughout.
Anki versus question bank flashcards
| Anki with the AnKing deck | QBank flashcards | |
|---|---|---|
| Cost | Anki is free; AnkiHub Core plan for the deck | Included with the QBank |
| Coverage | Over 30,000 cards across Steps 1-3 | Tied to the QBank's questions |
| Scheduling | Anki scheduler, including FSRS | The QBank's own spaced repetition |
| Best for | Long-term memory across years | Reinforcing questions you have just done |
Deck details from AnkiHub; QBank flashcard details from UWorld.
What we change first in a student's deck
- Lower the new-card limit to fit the day.
- Suspend cards from topics already mastered in questions.
- Unsuspend cards that match recent question misses.
- Move Anki after the first question block, not before.
How the AnKing deck is organised
AnkiHub describes the AnKing Step Deck as organised by resources such as Sketchy, Boards and Beyond and First Aid (AnkiHub). In practice that means tags: you can search for the tag of the lecture, video or chapter you just studied and unsuspend only those cards. The footnote on AnkiHub notes that some content, such as First Aid Forward or Boards and Beyond material, needs a premium AnkiHub subscription plus the matching resource subscription.
Worked example: one study day with Anki
| Time | Activity |
|---|---|
| Morning | Two timed question blocks |
| Midday | Review both blocks; unsuspend or write one card per content miss |
| Afternoon | Targeted content review from the misses |
| Evening | Anki reviews, capped to fit; no new cards after 9 p.m. |
This is our default day for dedicated study. The point is the order: questions first, Anki in support.
Signs your Anki habit is working
- Reviews finish in the time you set.
- Cards you miss in Anki are the same topics you miss in questions, and both fall over time.
- You add fewer new cards each week as gaps close.
Anki at a glance
| Item | Detail | Source |
|---|---|---|
| Anki software | Flashcards with active recall and spaced repetition | Anki manual |
| Scheduler | FSRS available as an alternative to the legacy SM-2 | Anki manual |
| AnKing Step Deck | Over 30,000 cards for Steps 1-3, organised by resource | AnkiHub |
| Deck access | AnkiHub Core plan, listed at $6 a month | AnkiHub |
| Updates | Approved changes sent to subscribers automatically | AnkiHub |
Our verdict
For most USMLE students the AnKing Step Deck is the practical default because it is large, tagged to common resources and kept up to date. Its value depends on unsuspending cards deliberately and keeping reviews inside your schedule. Students who prefer fewer, more personal cards do well building their own from question misses. Either way, questions come first and Anki supports them.
