If you ask ten medical students what Anki deck they use, eight of them will say AnKing. It's the closest thing med school has to a standard curriculum in flashcard form: tens of thousands of cards built from First Aid, Pathoma, Sketchy, and Boards and Beyond, all tagged so you can pull up exactly the cards for whatever you're studying.
But here's what nobody tells you when you download it. The deck itself is the easy part. The hard part is the workflow around it: knowing which cards to unsuspend, how to line them up with your school's lectures, and what to do about the stuff your professors test that isn't in the deck at all. Get the workflow wrong and AnKing becomes 30,000 suspended cards you never touch. Get it right and it's the single highest-yield study tool in med school.
What the AnKing Deck Actually Is
AnKing started as a community project that merged the best existing decks (Zanki, Lolnotacop, and others) into one organized collection. Each card is tagged by the resource it came from, so a card might carry tags for a specific Pathoma chapter, a Boards and Beyond video, and a Sketchy image all at once. That tagging system is the whole point. Without it, AnKing would just be a giant pile of cards. With it, it's a searchable database of everything high-yield for Steps 1 through 3.
The current version is distributed through AnkiHub, which also pushes updates and errata corrections to your deck automatically. Older versions floated around for free, but if you want the maintained version with current tags and corrections, AnkiHub is where it lives now.
One thing to understand up front: AnKing is a boards deck. It covers what the USMLE tests. Your school's exams test what your lecturers taught, and those two things overlap maybe 80%. The other 20% is where students get burned, and we'll come back to that.
Setting It Up Without Drowning
The number one mistake is importing AnKing and staring at 30,000 unsuspended cards. Don't do that. Here's the setup that works:
Suspend everything first. After importing, select all cards and suspend them. Your deck should show zero due cards. This feels wrong, but it's the foundation of the entire workflow. You will unsuspend cards deliberately, topic by topic, as you learn the material. An unsuspended card is a commitment to review it on schedule, so you only unsuspend what you've actually studied.
Install the note type properly. AnKing uses a custom note type with sections on the back of each card linking to the relevant First Aid page, Sketchy image, Pathoma chapter, and other resources. When you get a card wrong, those links are how you relearn the concept in thirty seconds instead of digging through a textbook. Make sure the note type imported correctly and the resource sections display.
Learn the tag hierarchy. Open the browser and look at the tags before you study a single card. You'll see a tree organized by resource: a top-level tag for the deck, then branches for Pathoma chapters, Boards and Beyond videos, Sketchy sections, First Aid sections, and so on. Spend twenty minutes clicking through this tree. Understanding how it's organized saves you hours later when you're hunting for the cards that match this week's lectures.
The Daily Workflow: Unsuspend by Topic
The core AnKing workflow is simple once you internalize it:
- Learn a topic (lecture, video, textbook chapter).
- Find the matching cards via tags.
- Unsuspend them.
- Do your reviews every day without exception.
Step 2 is where people get stuck, so let's make it concrete. Say your lecture this week is on heart failure. You have a few ways to find the cards:
Match the lecture to a resource video. This is the fastest method when it works. If your lecture covers roughly what Pathoma covers on heart failure, find the Pathoma heart failure tags and unsuspend those cards. Many students plan their week this way: check the lecture schedule, match each lecture to a Boards and Beyond or Pathoma video, and unsuspend the corresponding tags the night before.
Search by keyword. When there's no clean video match, use Anki's browser search. Search for the key terms from your lecture, review the cards that come up to make sure they're actually relevant, and unsuspend in bulk. This takes longer but works for everything.
Unsuspend after learning, not before. This matters more than it sounds. Unsuspending cards for a topic you haven't studied yet turns your first review session into a guessing game, which is miserable and teaches you nothing. Watch the lecture or video first, then unsuspend. The cards should feel like review, not like new material.
As for volume: most students unsuspend somewhere between 50 and 150 new cards per day during preclinical years, depending on how heavy the block is. If your daily review count climbs past 400-500 and stays there, you're unsuspending faster than you can sustain. Slow down on new cards before you burn out. Your review pile is a debt that charges interest.
Matching AnKing to Your Lectures
This is the part that separates students who benefit from AnKing from students who just have it installed. Your lecturers don't teach in Pathoma order. They teach in whatever order your school's curriculum committee chose, which means every week you're doing translation work: this lecture maps to these tags.
The practical approach most students settle on:
- Sunday planning session. Look at the week's lecture schedule. For each lecture, identify the matching resource (usually a Pathoma chapter, a Boards and Beyond video, or a Sketchy section) and note which tags to unsuspend.
- Preview the night before. Skim the lecture slides or watch the matched video, then unsuspend the cards. Going into lecture already knowing the vocabulary makes the lecture itself dramatically more useful.
- Fill the gaps with your own cards. Every week you'll hit facts your professor emphasized that don't exist in AnKing. Don't skip these. Your school exams are graded on lecture content, not boards content.
That last point deserves emphasis because it's the most common failure mode. Students do all their AnKing reviews religiously, feel great about their boards knowledge, and then underperform on school exams because the professor tested the weird detail from slide 47 that isn't in any premade deck. AnKing handles the 80%. You have to handle the 20% yourself.
Handling the 20%: Lecture-Specific Cards
For the lecture minutiae that AnKing doesn't cover, you need your own cards. The traditional advice is to make them by hand, and making cards by hand does help you learn. But it's also slow, and during a heavy block, slow means it doesn't happen.
This is the exact problem SlideToAnki was built for. You upload your lecture slides and get back Anki cards covering the lecture-specific details: the professor's favorite pathways, the numbers they emphasized, the "high-yield for our exam" asides. It doesn't replace AnKing. It covers the part AnKing was never designed to cover. Most students end up running both: AnKing tags for the boards foundation, generated cards for whatever the lecturer added on top.
Whatever tool you use, the principle is the same. Premade decks give you the shared foundation efficiently. Your own cards capture the stuff only your school tests. You need both, and the students who figure this out early stop being surprised by their own exams.
Settings Worth Changing
AnKing works fine with default settings, but a few adjustments help:
New cards per day. Start conservative. You can always increase it, but digging out from under a review avalanche is miserable. Many students run 50-100 new cards daily during preclinical blocks.
Consider FSRS. Anki's newer scheduling algorithm (FSRS) generally outperforms the default SM-2 scheduler, especially over long timelines like a full preclinical curriculum. It takes some tuning to your own review history, but most students who switch don't go back.
Learn the keyboard shortcuts. You'll press the answer buttons thousands of times. Spacebar and the 1-4 keys should be muscle memory within your first week. Small friction, repeated ten thousand times, is not small.
Common Mistakes
Unsuspending too aggressively. The deck is exciting at first and every topic feels essential. Two months later you're staring at 800 reviews and considering quitting Anki entirely. Pace yourself.
Doing cards without understanding. If you're getting a card wrong repeatedly, stop and relearn the concept from the linked resource. Anki tests memory, not comprehension. Memorizing a card you don't understand produces a fragile memory that collapses on exam day.
Ignoring your school's lectures. AnKing is optimized for boards, not for Dr. Stevenson's biochemistry midterm. The students who crush both are the ones who treat AnKing as the foundation and lecture-specific cards as the other half of the job.
Never updating. If you're on AnkiHub, let the updates sync. Errata get fixed, tags improve, and cards get refined. AnKing is a living deck. A two-year-old download is missing thousands of corrections.
The Bottom Line
AnKing works because of the workflow, not because of the cards alone. Suspend everything, unsuspend deliberately by topic, match your lectures to tags every week, and cover your professors' pet details with your own cards. Do that consistently for two years and you'll walk into Step 1 having already reviewed most of the material dozens of times. That's the whole trick. There isn't another one.