Best Anki Decks for USMLE Step 1 (2026 Guide)

If you're a medical student preparing for boards, you've probably already heard one piece of advice more than any other: use Anki. But once you open Reddit, Student Doctor Network, or any med school group chat, the real confusion begins. Which deck should you actually download? Is the AnKing Step 1 deck still the gold standard? Do you even need 30,000 flashcards for a pass/fail exam?

This guide cuts through the noise. We've researched every major deck, dug into community discussions, and reviewed the latest data to bring you a clear, up-to-date breakdown of the best anki decks for USMLE Step 1 in 2026, along with practical advice on settings, scheduling, and strategy.

Why Anki Still Matters in the Pass/Fail Era

Before diving into specific decks, let's address the elephant in the room: Step 1 went pass/fail in January 2022. So why bother with thousands of flashcards?

Here's the reality. First-time pass rates for US MD students have declined from 95% in 2021 to roughly 89% in recent years, and the trend is even steeper for DO students and IMGs. Research suggests the decline stems partly from reduced study effort under the new scoring system. That 1-in-10 failure rate carries serious consequences for your career, especially in competitive specialties.

Meanwhile, the knowledge you build for Step 1 feeds directly into Step 2 CK, which is now the primary scored exam that residency programs care about. Using Anki for USMLE Step 1 isn't just about passing, it's about building the foundation you'll rely on for years.

Published studies consistently show a significant positive correlation between mature Anki card counts and preclinical exam scores. One cohort study found that AnKing percent mature was the only statistically significant predictor of course exam performance, explaining over a third of score variability.

The evidence is clear: spaced repetition works. The question is which deck to use and how.

The Best Anki Decks for USMLE Step 1, Ranked

1. AnKing Step 1 Deck (V12) — The Undisputed Champion

If you only take one recommendation from this entire article, let it be this: the AnKing Step 1 deck is the single best Anki resource for Step 1 preparation in 2026.

The AnKing Step Deck contains over 30,000 cards and is used by more than 100,000 medical students. It's not just big — it's meticulously organized and continuously updated. The deck is tagged to virtually every major Step 1 resource, including First Aid, Boards & Beyond, Pathoma, all Sketchy products, Physeo, Costanzo, and roughly 98% of UWorld questions.

What makes the AnKing Step 1 deck truly special is that it's a living document. The most recent major update (Update #25) delivered over 55,000 individual note changes, introduced new overlap tags distinguishing Step 1-only versus Step 2-only content, and added custom 3D medical illustrations. The deck has accumulated over 200,000 cumulative updates since launching on AnkiHub.

The AnKing deck Step 1 distribution now runs through AnkiHub, a collaborative platform that pushes updates in real time. The Core subscription runs $5/month, while the Pro plan at $10/month adds AI-powered Smart Search and direct integration with Boards & Beyond and First Aid Forward content. Scholarships are available. The older V11 version is still free to download, but it's over two years outdated and no longer receiving improvements.

Best for: Any student who wants comprehensive, actively maintained coverage of all Step 1 material with seamless resource integration.

2. Zanki — The Original That Lives On Inside AnKing

Zanki was the deck that started it all for modern USMLE Anki prep. Created in 2017–2018, it contained roughly 25,000–28,000 cloze-deletion cards built from First Aid, Costanzo Physiology, Pathoma, and Sketchy. It defined the format and depth that every subsequent deck was measured against.

Here's the important thing to know: Zanki is no longer maintained as a standalone deck. Its cards have been absorbed into the AnKing Step 1 deck, where they continue to receive corrections, updates, and new media. If you're searching for Zanki in 2026, the answer is to download AnKing — you'll get every Zanki card plus years of community improvements.

Best for: Historical context only.

3. Lightyear — For the Boards & Beyond Devotee

Lightyear (~22,500 cards) takes a philosophically different approach from AnKing. Instead of cloze deletions organized by topic, it uses a Q&A format organized to follow the Boards & Beyond video lectures almost timestamp by timestamp. The workflow is straightforward: watch a B&B video, then immediately review the matching Lightyear cards.

The Cheesy Lightyear variant expanded this to ~27,000 cards by adding images from First Aid, Pixorize, and DirtyUSMLE. However, Lightyear is no longer actively maintained by its original creator, and community-maintained forks vary in quality.

Best for: Students deeply committed to a B&B-first workflow who prefer Q&A over cloze format.

4. Soze's Step 1 Master Deck — The Minimalist's Choice

In the pass/fail era, Soze's deck (~3,500 cards) has emerged as the go-to lightweight alternative. Created as a Boards & Beyond companion, it focuses exclusively on high-yield clinical pearls and skips the deep foundational science detail that larger decks cover.

Student Doctor Network forums frequently recommend it for the pass/fail era, with users pointing out that massive decks like Zanki and Lightyear were designed for a scored exam. The logic: if you just need to pass, why grind 30,000 cards when 3,500 targeted ones, combined with UWorld and Pathoma, might be enough?

There's a real trade-off here, though. Soze won't build the deep knowledge base that pays dividends on Step 2 CK. And with that ~10% failure rate, "just enough" is a risky game.

Best for: Students at strong programs who are confident in their foundation and want maximum time efficiency for a pass. Pair with UWorld, Pathoma, and Sketchy.

 
5. Pepper Decks (Micro & Pharm) — Small but Mighty Supplements

The Pepper decks are beloved for their concise, visual approach to two of Step 1's most memorization-heavy subjects:

• Pepper Sketchy Micro (~990 cards): Q&A format covering Sketchy Microbiology, with Sketchy images on the back of each card.

• Pepper Sketchy Pharm (~1,333 cards): Same format for pharmacology. Widely described by students as one of the best Sketchy Pharm Anki decks available.

These are supplements, not standalone decks. But if micro or pharm is a weak area, Pepper cards are worth adding to your rotation. They're small enough to finish quickly and reinforce the Sketchy visual memory system extremely well.

Best for: Targeted micro and pharm reinforcement alongside a comprehensive primary deck.

6. Duke's Pathoma — Focused Pathology Review

Duke's Pathoma (~2,000 cards) covers pathology chapter by chapter, mirroring Dr. Sattar's Pathoma lectures with roughly 100 cards per chapter. It's a no-frills, focused pathology resource, especially useful during dedicated study when you want a targeted review of specific Pathoma chapters.

Not comprehensive enough to be your only deck, but a solid supplement if pathology is a weak point.

Best for: Dedicated-period pathology reinforcement.

7. Newer Decks Worth Knowing About

A few newer entrants have gained traction in 2025–2026:

• Mnemosyne (v3.0) offers 13,840 cloze-format cards built from USMLE-Rx Flash Facts and aligned to First Aid 2025, a cleaner, more focused alternative to AnKing's sprawling library.

• tbtrentMD's First Aid deck on AnkiHub aims to cover all of First Aid 2025 with ongoing community updates.

• CoreStepPrep is a premium deck integrating Step 1 and Step 2 CK content designed to pair with their question bank.

None of these have come close to displacing AnKing's dominance, but they offer valid alternatives for students who find AnKing's size overwhelming.

Quick Comparison Table

Deck	Cards	Format	Primary Sources	Maintained?	Best For
AnKing V12	30,000+	Cloze	FA, Pathoma, Sketchy, B&B, UWorld	✅ Daily updates	Comprehensive all-in-one prep
Zanki	~26,000	Cloze	FA, Costanzo, Pathoma, Sketchy	✗ Merged into AnKing	Use AnKing instead
Lightyear	~22,500	Q&A	Boards & Beyond	⚠️ Community forks	B&B-first video workflow
Soze	~3,500	Q&A	B&B clinical pearls	✗ Final version	Lightweight P/F era prep
Pepper Micro	~990	Q&A	Sketchy Micro	✗	Micro supplement
Pepper Pharm	~1,333	Q&A	Sketchy Pharm	✗	Pharm supplement
Duke's Pathoma	~2,000	Q&A	Pathoma	✗	Pathology supplement
Mnemosyne	~13,840	Cloze	Rx Flash Facts, FA 2025	✅	Mid-size focused alternative

Optimize Your Anki Settings With FSRS

Choosing the right deck is only half the battle. How you configure Anki matters just as much, and the biggest development in this space is FSRS (Free Spaced Repetition Scheduler).

FSRS is a machine-learning algorithm trained on hundreds of millions of reviews that replaces the legacy SM-2 system built into Anki. It delivers approximately 20–30% fewer daily reviews at equivalent retention rates and eliminates the notorious "ease hell" problem where pressing "Hard" too often under SM-2 trapped cards in an endless review spiral. FSRS is built into Anki version 23.10 and later. Here's how to set it up:

1. Update Anki to 23.10+

2. Go to Deck Options → FSRS and toggle it on

3. Click "Optimize" (you need ~400+ reviews for personalized parameters)

4. Set your desired retention to 0.90 (90%) — the consensus sweet spot for med students

5. Set learning steps to a single step of 10–15 minutes

6. Set the maximum interval to the number of days until your exam

With FSRS, multiple same-day learning steps and steps longer than 12–14 hours are specifically discouraged — keep it simple with one short step.

If you're still on SM-2, the community-recommended settings are: learning steps of 15 1440 4320 (15 min → 1 day → 3 days), a graduating interval of 8 days, and starting ease of 250%. But switching to FSRS is strongly recommended. The efficiency gains are significant.

How to Actually Study: A Practical Workflow

Having the best Anki decks for USMLE Step 1 means nothing if you don't use them effectively. Here's the workflow that most successful students follow:

The "Suspend All, Unsuspend Selectively" Method

On day one, suspend every card in the deck. Then, as you study each topic through your primary resources (Boards & Beyond, Pathoma, Sketchy, lectures), unsuspend the matching tagged cards that same day. This ensures Anki reinforces material you've already engaged with rather than throwing cold content at you.

AnKing's tag system makes this seamless. Cards are organized by resource, chapter, and topic, so you can filter down to exactly what you just studied.

During Preclinical Years (M1/M2)

Aim for 50–80 new cards per day. This generates roughly 300–500 total daily reviews, requiring about 1–2 hours. Watch for your total review count. When it consistently exceeds 700+ cards daily, you're heading toward burnout territory.

A morning Anki routine of 45–60 minutes before class is one of the most effective ways to build consistency. Many students also use mobile Anki for review during commutes, lunch breaks, and downtime between lectures.

During Dedicated Study (4–8 Weeks Pre-Exam)

Shift your focus. Anki becomes secondary to UWorld during dedicated. Drop new cards to 20–50 per day (only from missed UWorld concepts), and keep total Anki time to 30–60 minutes. The bulk of your study hours should go to timed UWorld blocks, practice NBMEs, and targeted weak-area review.

A sample dedicated day might look like:

• 6:00–6:30 AM — Anki reviews (150–200 cards)

• 7:00 AM–12:00 PM — Two UWorld blocks + thorough review

• 12:00–1:00 PM — Lunch + mobile Anki

• 1:00–5:00 PM — UWorld review + weak-topic reinforcement (Pathoma, Sketchy)

• 5:00–6:00 PM — Remaining Anki + unsuspend cards from missed UWorld questions

• Evening — Light First Aid reading

Readiness Benchmarks

Community data suggests students with 11,000–16,500 matured AnKing cards at ~90% true retention, combined with a complete pass through UWorld, generally report comfortable Step 1 passage. Track your mature card percentage; it's one of the most concrete measures of readiness available.

The Big Picture: Which Deck Should YOU Choose?

Here's a decision framework to make this simple:

Choose the AnKing Step 1 deck if you want the most comprehensive, actively maintained option that will carry you from M1 through Step 2. This is the right choice for most students. Subscribe to AnkiHub ($5/month), suspend everything, and unsuspend as you study.

Choose Soze if you're at a strong program, have a solid foundation, and want a minimalist approach to a pass/fail exam. Pair it with UWorld, Pathoma, and Sketchy. Understand the trade-off: less work now, but less Step 2 CK foundation later.

Add Pepper decks if microbiology or pharmacology are persistent weak areas and you want targeted, visual reinforcement.

Skip Zanki and standalone Lightyear — their content lives on (and has been improved) inside AnKing.

Whatever you choose, remember that consistency trumps deck selection. The best Anki deck for USMLE Step 1 is the one you actually review every single day. Set sustainable daily targets, enable FSRS, trust the algorithm, and show up.

Good luck with your boards. You've got this.

And if you need guidance, an accountability partner, or general help with your Step 1 prep, we offer 1-on-1 Step 1 tutoring here at MedBoardTutors. Schedule a free tutoring consultation now to know how best we can help you.