# Best Anki Settings for Medical School (2026 Guide)
Let's be honest—Anki's default settings are terrible for medical school. They were designed for casual language learners, not someone trying to memorize thousands of pathways, drugs, and disease presentations before Step 1.
The good news? A few simple tweaks can transform Anki from a frustrating chore into the most powerful study tool in your arsenal. This guide breaks down exactly what to change, why it matters, and how to avoid the mistakes that derail most med students.
Why Default Anki Settings Don't Work for Med School
Out of the box, Anki assumes you're learning at a leisurely pace—maybe picking up some Spanish vocabulary or memorizing state capitals. Medical school is a completely different beast. You're dealing with:
- Massive volume: Thousands of cards across multiple subjects
- High-stakes timing: Board exams with fixed dates
- Complex interconnections: Concepts that build on each other
The default settings create review piles that grow uncontrollably, leading to burnout and the dreaded "Anki bankruptcy." Let's fix that.
New Cards Per Day: Finding Your Sweet Spot
Recommended setting: 20-40 new cards per day
This is the single most important setting to get right, and it's where most med students go wrong.
Why This Range?
Every new card you learn today becomes a review card tomorrow, next week, and months from now. The relationship isn't linear—it's exponential. Here's the math that trips people up:
- 20 new cards/day → roughly 150-200 reviews/day at steady state
- 50 new cards/day → roughly 400-500 reviews/day at steady state
- 100 new cards/day → you're going to have a bad time
The 20-40 range keeps your daily reviews manageable (under 300 cards) while still making meaningful progress through large decks like AnKing.
How to Set It
- Go to your deck options (gear icon → Options)
- Under "New Cards," set "New cards/day" to your target
- Start conservative (20) and increase only after 2-3 weeks of consistent reviews
The "I'll Just Do More" Trap
Every M1 thinks they're the exception. "I'll just power through 100 new cards a day and finish AnKing in three months!"
Here's what actually happens: You feel great for two weeks. Then reviews pile up. You start skipping days. The backlog becomes terrifying. You abandon Anki entirely and tell everyone it "doesn't work."
Start with 20. Seriously.
Learning Steps: The Hidden Game-Changer
Recommended setting: 15m 1h 1d (or 10m 1h for faster learners)
Learning steps determine how many times you see a new card before it "graduates" to the review queue. This is where you build initial memory before spaced repetition takes over.
Why Not the Default 1m 10m?
The default steps (1 minute, then 10 minutes) are way too short for medical content. You might successfully recall a card 10 minutes after seeing it, but that doesn't mean you've actually learned it. You're just riding short-term memory.
Longer steps force genuine encoding. When you successfully recall a card after an hour or a day, you've actually committed it to memory.
Setting Up Multi-Day Learning Steps
To use a "1d" (one day) learning step:
- In deck options, find "Learning steps"
- Enter:
15m 1h 1440m(1440 minutes = 1 day) - Or for the truly dedicated:
15m 1h 1d(Anki accepts "d" notation)
This means you'll see each new card three times before it graduates: after 15 minutes, after an hour, and the next day. Only then does spaced repetition kick in.
Graduating Interval: When Cards Leave the Nest
Recommended setting: 3-7 days
The graduating interval is how many days until you see a card after it completes all learning steps. The default of 1 day is too aggressive for dense medical content.
Why Extend It?
If your learning steps already include a 1-day interval, having the graduating interval also be 1 day means you might see the same card two days in a row. That's overkill and wastes review time.
A 3-day graduating interval means: learn the card → see it the next day (final learning step) → see it again in 3 days (first review). This spacing is more efficient for retention.
How to Adjust
- Deck options → "Graduating interval"
- Set to 3 (conservative) or 7 (if using longer learning steps)
- Match this to your study schedule—if you study every day, 3 works great
Easy Interval: The Controversial One
Recommended setting: 7-15 days
When you hit "Easy" on a new card, it skips the remaining learning steps and jumps straight to review. The easy interval determines how long until you see it again.
Should You Even Use the Easy Button?
Honestly? Most med students should avoid the Easy button entirely. It's tempting to smash it on cards you "know," but this leads to:
- Overconfidence on material you haven't truly encoded
- Ease hell (more on this below)
- Cards disappearing for weeks when you actually needed the review
If you do use Easy, keep the interval reasonable (7-15 days). Better yet, just use Good and let the algorithm do its job.
Maximum Interval: The Ceiling
Recommended setting: 180-365 days
The maximum interval caps how long Anki will wait before showing you a card again. The default is 36500 days (100 years), which is absurd for medical education.
Why Lower It?
You probably want to see every card at least once or twice in the months leading up to Step 1. A 365-day max means even your most mature cards will come back annually. A 180-day max is more aggressive and ensures nothing falls through the cracks during dedicated.
Setting Based on Your Timeline
- M1-M2 (far from boards): 365 days is fine
- 3-6 months from Step 1: Consider 180 days
- Dedicated period: Some students go as low as 90 days
Lapse Settings: When You Forget
Recommended relearning steps: 10m 1d
Recommended new interval: 40-70%
Lapse settings control what happens when you hit "Again" on a review card. Getting these right prevents the frustrating cycle of seeing the same card repeatedly without actually learning it.
Relearning Steps
When you forget a card, it goes back into learning mode. The default single step (10m) isn't enough—the card comes back too quickly without genuine relearning.
Adding a 1-day relearning step (10m 1440m) forces you to successfully recall the card the next day before it returns to reviews. This actually fixes the memory gap.
New Interval (The "Lapse Penalty")
When you lapse a card, Anki reduces its interval. The "New interval" setting (shown as a percentage) determines how much.
- 0% (default): Card resets to graduating interval—way too harsh
- 40-70%: Card retains some of its progress while acknowledging you need more practice
Setting this to 50% means a card with a 100-day interval becomes a 50-day interval after a lapse. Still a penalty, but not starting from scratch.
Common Anki Mistakes (And How to Avoid Them)
Mistake #1: Too Many New Cards
We covered this, but it bears repeating. Your review burden is determined by decisions you made weeks ago. By the time you realize you've overcommitted, the damage is done. Start low, scale slowly.
Mistake #2: Ignoring Ease Factor (Ease Hell)
Every time you hit "Again" or "Hard," Anki decreases that card's ease factor. Over time, cards can get stuck at minimum ease (130%), causing them to appear way more often than necessary.
The fix:
- Avoid the "Hard" button (just use Again or Good)
- Consider the "Reset Ease" add-on periodically
- Or switch to FSRS, which handles this automatically
Mistake #3: Inconsistent Reviews
Anki works through consistency. Missing three days doesn't just create a backlog—it undermines the spacing effect that makes the whole system work.
If you're behind, don't try to "catch up" in one marathon session. Use the "Set Due Date" feature to spread overdue cards across several days.
Mistake #4: Never Adjusting Settings
Your optimal settings in M1 aren't the same as during dedicated. Revisit your configuration every few months, especially as board dates approach.
Add-Ons That Optimize Your Settings
FSRS (Free Spaced Repetition Scheduler)
FSRS is a game-changer. It replaces Anki's traditional algorithm with a machine-learning model that optimizes intervals based on your actual performance. Benefits include:
- No more ease hell
- Personalized intervals per card
- Better retention with fewer reviews
As of Anki 24.04+, FSRS is built directly into Anki. Enable it in deck options → "FSRS" tab.
Load Balancer
This add-on spreads your reviews more evenly across days, preventing the dreaded "500 reviews on Monday, 50 on Tuesday" situation. It's especially useful if you have an irregular study schedule.
Review Heatmap
Not a settings optimizer per se, but visualizing your consistency helps you stay accountable. Seeing a streak builds motivation to maintain it.
Putting It All Together: Recommended Settings Summary
Here's a quick reference for optimal Anki settings for medical school:
| Setting | Recommended Value |
|---------|-------------------|
| New cards/day | 20-40 |
| Learning steps | 15m 1h 1d |
| Graduating interval | 3-7 days |
| Easy interval | 7-15 days |
| Maximum interval | 180-365 days |
| Relearning steps | 10m 1d |
| New interval (lapse) | 40-70% |
The Best Cards Deserve the Best Settings
All these optimizations assume you're working with quality flashcards. Poorly written cards—vague questions, missing context, walls of text—will fail you regardless of settings.
If you're converting lecture slides or First Aid pages into flashcards, tools like SlideToAnki can help you generate well-structured cards automatically, so you can spend your time reviewing rather than formatting.
Final Thoughts
Anki isn't magic. It's a tool, and like any tool, it works best when configured properly. The settings above represent thousands of collective hours of med student trial and error.
But here's what matters more than any individual setting: consistency. A student doing 20 cards daily with default settings will outperform someone with "perfect" settings who reviews sporadically.
Configure your Anki, then trust the process. Show up every day, even when it's boring. Especially when it's boring. That's how you build the knowledge base that carries you through Step 1 and beyond.
Now close this tab and go do your reviews. Future you will be grateful.