USMLE Vault · Step 1
How to Use My Anki Decks the Right Way
Give me 60 seconds and I'll help you avoid 90% of the mistakes IMGs make with Anki for Step 1.
For Step 1 there are only two Anki decks I personally recommend. I built both — after going through every other Step 1 deck out there — and they work completely differently from the bloated decks you've seen.
They are not 30,000-card monsters you maintain forever. They're lean, page-anchored, and built for your exam date. Pick a tab below.
Foundation AnkiRevise all of First Aid
NBME BoosterBreak the score ceiling
🫘 The Foundation Anki deck
No matter how many times you read First Aid passively, it doesn't stick. The Foundation Anki deck is a page-by-page aggregation of the entire First Aid — the actual high-yield lines and data points of every page, explained simply and asked actively. It's the fastest way to recall the whole book and every high-yield point.
What's inside
- ~2,400 cards covering First Aid page by page.
- Every high-yield point per page — pulled straight from the lines of First Aid.
- The First Aid page number is on every card, so you can backlink to the exact page anytime.
- Organized system by system, in First Aid order. No orphan cards, no endless backlog.
How to do a full First Aid revision with it
1
Go system by system. Pick a system and complete all its cards before moving on. You're revising the book in its real order, not jumping around.
2
Keep your First Aid open beside you. If a card triggers even a slight hesitation on a concept, open that exact page, read the topic, and read a couple of lines above and below it. That's how you fix the gap on the spot — the page number is right there on the card.
3
~400 cards a day. The whole deck is ~2,400 cards. At 400/day you finish a complete First Aid pass in 5–6 days. It's genuinely doable.
Why this beats rereading: reading is passive — your eyes move, nothing locks in. Active recall forces your brain to retrieve each high-yield point, which is exactly what the exam asks you to do. You cover the same content, but it actually retains.
Two ways to use this deck
① While studying a system — before that system's UWorld
You've read First Aid alongside the Vault, you've tried UWorld, and your scores won't move past 65%. Pause. Watch the Mehlman Medical video playlist for that system, then run the Foundation Anki deck for that same system — these are the direct First Aid lines, arranged page-wise for every high-yield topic. You'll revise the whole system in about 2 days, get back on UWorld, and watch your scores climb.
② Pre-NBME reset — revise all of First Aid fast
You've finished UWorld and your first NBME is coming up. You want to revise all of First Aid — but it's a 700-page book, you can't reread it. Instead, run the Foundation Anki deck. Because it's page-by-page linked to First Aid, you cover every high-yield topic of the entire book, actively recalling each one — without the frustration of flipping the same old pages.
Do this today: open
usmlevault.com/anki → Foundation Anki → pick your weakest system → do 400 cards with First Aid open beside you.
📘 The NBME Anki Series Deck
This deck is built from questions taken directly from NBME 20 through NBME 33, divided system by system. It makes you actively recall every topic those NBMEs have already tested. This is what actually breaks the ceiling on your scores.
Why it works
The NBME recycles itself. The high-yield topics on NBME 30–31 were already tested on NBME 20–25. If you front-load those recycled topics through active recall, you're literally studying tomorrow's test — without doing a single new question.
The method when you're stuck
You've taken a few NBMEs — say 28, 29, 30 — and you can't push past 55–60%. Here's exactly what to do:
1
Start the NBME Anki deck from NBME 20 through NBME 30.
2
Do the entire deck system by system — not form by form. Finish every system.
You'll watch your score grow by at least 5–10% — because you've solidified the exact patterns the NBME uses to test you, instead of passively re-skimming old forms.
Do this today: open
usmlevault.com/anki → NBME Booster → select every system → work through the forms you've already taken, system by system, before your next exam.
What this does to scores
• Students who came in scoring 45% were hitting 69–75% on NBMEs within 6 weeks using these two decks.
• Mid-system slump: stuck under 65% on UWorld → Mehlman + Foundation Anki for that system → back on UWorld with scores climbing.
• Plateaued at 65% on NBME 28 & 29 → ran the NBME Booster deck 20–29 system by system → next form jumped 5–10%.
UWorld scores rise alongside — same active-recall foundation.
The NBME Booster — the exact running order
Your next NBME form is already written, and most of it is recycled. The NBME retires forms, not logic — the concepts on 30 and 31 were already tested on 20 through 25 with different vignettes.
So fourteen retired forms — 20 through 33 — are distilled into 4,174 one-line recall cards, sorted into system decks.
1
Run it system by system. Never form by form. This is the whole method and almost everyone gets it backwards. Forms are how the questions were packaged; systems are how your knowledge is stored.
2
Finish every system, then attempt your next form. Not halfway through. The point is to walk into the form having already harvested the pattern library the previous forms handed you.
3
Timing: the final one to two weeks, and before you move to the newer forms. Not earlier — run it before your content is built and you are testing yourself on material you have not learned yet.
Treat the score as a syllabus. Taking another form without harvesting the last one is paying for the same diagnosis twice. The form already told you, in writing, what it will ask again — most students read the number, feel something, and file the document away unread.
Which form to take and when: the exact NBME order. The last fortnight: The Final 14 Days.
Pick & Mix — drilling only what you keep failing
You are spending your best hour of the day being quizzed on things you already know. That is what a review queue is: it surfaces what is due, not what is weak.
Most of tomorrow morning's cards are material you have already proven. The handful you keep failing stay buried in the same pile — so the weakest part of your prep gets the least attention, every single day.
Every student's real weak list is embarrassingly short. Renal acid-base. The autonomic drugs. Two murmurs. Maybe forty things. That short list decides your score — and the reason it never gets fixed is not discipline, it is that nothing in your setup lets you study it on its own.
1
Build the session. Pick & Mix filters across every deck at once — by system, series, tag or NBME form. Choose the systems that are failing you, and only the cards you flagged or missed.
2
Run it the night after a bad block, and daily in your final two weeks. It takes about a minute to build.
3
Nothing falls out of rotation. Those cards still count toward your normal spaced repetition — you are not running a second, parallel deck.
Do this tonight: open
usmlevault.com/anki → Pick & Mix → select your two worst systems → filter to flagged and missed only. That session is the forty things standing between you and your next five points.
Where the decks sit in the plan.
Want the exact system-by-system breakdown?
Everything in this guide — the method, the deck, the PDFs — is inside USMLE Vault:
Get it on usmlevault.com/anki →