AnKing Step 1 — Step 1 Coverage Audit
The AnKing Step 1 deck covers 813 of 901 subtopics in our USMLE Step 1 content outline — a 90.2% coverage rate that makes it the single most comprehensive Anki resource for Step 1 preparation. For most students, the AnKing Step 1 deck is enough to form the backbone of their study plan. But 88 subtopics have zero cards, and 141 more have fewer than 4 cards. Knowing where those gaps are matters.
The AnKing Step 1 (Overhaul) Deck is a community-maintained deck built on top of the Zanki and Lightyear foundations, now maintained via AnkiHub with continuous updates. It contains 20,902 total cards, of which 17,363 map directly to Step 1 exam content. The deck is strongest in Microbiology (98.3% coverage, 4,039 cards), Neurology (98.3%, 1,649 cards), and Respiratory (95.4%, 845 cards) — the high-yield systems that have historically dominated Step 1. These areas are dense, well-tagged, and reliable. Where it struggles is in General Pharmacology (75.0% coverage, 27 of 36 subtopics), Psychiatry (80.0%, 60 of 75), and Immunology (81.8%, 27 of 33). Some of the missing subtopics are genuinely high-yield: Preload and Afterload, Hemodynamic Profiles of Shock, Anticoagulant Reversal, and NK Cells and Missing-Self all have zero cards in the deck.
This page publishes the only independent, subtopic-level coverage audit of the AnKing Step 1 deck against Lacunos's 901-subtopic Step 1 content outline. No other site shows you exactly which topics are missing and which are thin. The full gap table is below.
Step 1 cards = cards that mapped to our 901-subtopic Step 1 content outline. Cards covering other material are excluded.
Coverage by area
| Area | Coverage | Cards |
|---|---|---|
| Microbiology | 59/60 (98.3%) | 4,039 |
| Neurology and Special Senses | 58/59 (98.3%) | 1,649 |
| General Pathology | 26/27 (96.3%) | 495 |
| Respiratory | 62/65 (95.4%) | 845 |
| Hematology and Oncology | 58/61 (95.1%) | 1,380 |
| Gastrointestinal | 70/74 (94.6%) | 1,101 |
| Biochemistry | 52/55 (94.5%) | 1,231 |
| Renal | 53/57 (93.0%) | 848 |
| Musculoskeletal, Skin, and Connective Tissue | 66/72 (91.7%) | 1,293 |
| Reproductive | 71/80 (88.8%) | 902 |
| Endocrine | 46/53 (86.8%) | 1,108 |
| Public Health Sciences | 25/30 (83.3%) | 180 |
| Cardiovascular | 53/64 (82.8%) | 1,691 |
| Immunology | 27/33 (81.8%) | 466 |
| Psychiatry | 60/75 (80.0%) | 721 |
| General Pharmacology | 27/36 (75.0%) | 511 |
| Total | 813/901 (90.2%) | 17,363 mapped |
Gaps — zero cards (88 subtopics)
High-yield gaps
- HYFermentation and NAD+ RegenerationBiochemistry
- HYPreload and AfterloadCardiovascular
- HYHemodynamic Profiles of ShockCardiovascular
- HYRight Ventricular InfarctionCardiovascular
- HYAdrenergic Receptors and AgonistsCardiovascular
- HYThyroid Emergencies (Storm and Myxedema Coma)Endocrine
- HYOsteoporosisEndocrine
- HYCarcinoid Tumor and Carcinoid SyndromeEndocrine
- HYAnticoagulant ReversalGeneral Pharmacology
- HYNK Cells and Missing-SelfImmunology
- HYComplement Functions and RegulationImmunology
- HYT Cell Activation and CostimulationImmunology
- HYEncapsulated OrganismsMicrobiology
- HYOsteomalacia and RicketsMusculoskeletal, Skin, and Connective Tissue
- HYCase-Control StudiesPublic Health Sciences
- HYRenal Vasculature (Afferent / Efferent / Vasa Recta)Renal
- HYPelvic Inflammatory Disease (PID)Reproductive
- HYHPV (Condyloma and Cancer)Reproductive
- HYChlamydia trachomatisReproductive
- HYNeisseria gonorrhoeaeReproductive
- HYSyphilis (Primary, Secondary, Tertiary, Congenital)Reproductive
Other gaps
- Genetic Code PropertiesBiochemistry
- Karyotyping and FISHBiochemistry
- Heart Development and LoopingCardiovascular
- Cardiac SeptationCardiovascular
- Fetal Circulation and TransitionCardiovascular
- Post-MI Arrhythmia and ICD IndicationsCardiovascular
- Takotsubo (Stress) CardiomyopathyCardiovascular
- Cocaine-Induced Chest Pain / MICardiovascular
- Cholinergic Receptors and AgentsCardiovascular
- Paget Disease of BoneEndocrine
- … and 57 more
Thin spots — 1 to 3 cards (141 subtopics)
- 1Eukaryotic RNA ProcessingBiochemistry
- 1Southern, Northern, and Western BlotsBiochemistry
- 1CRISPR and Gene Therapy ConceptsBiochemistry
- 1Hardy-Weinberg PrincipleBiochemistry
- 1Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu)Biochemistry
- 1Glycolysis Regulation (PFK-1 and Friends)Biochemistry
- 1NSTEMI Risk Stratification and TimingCardiovascular
- 1ACS Antiplatelet and Anticoagulant TherapyCardiovascular
- 1Acute Limb IschemiaCardiovascular
- 1Pulmonary HypertensionCardiovascular
- … and 131 more
How to pair AnKing Step 1 with other resources
AnKing covers the core well — but the gap areas point directly to which resources to pair it with. For Cardiovascular (82.8% coverage), the deck is missing foundational hemodynamic concepts like Preload and Afterload and Hemodynamic Profiles of Shock. Boards & Beyond's cardiovascular module fills these conceptual gaps efficiently, and its physiology focus complements AnKing's fact-heavy card style. For General Pharmacology (75.0%) and Immunology (81.8%), First Aid remains essential — read the relevant chapters actively rather than passively, since AnKing doesn't have cards anchoring several key mechanisms. Sketchy Pharm covers the drug classes AnKing thins out on, particularly in autonomic pharmacology where Adrenergic Receptors and Agonists has zero dedicated cards. Pathoma is the standard pairing for Psychiatry and General Pathology review — Psychiatry is AnKing's weakest high-subtopic-count system at 80.0%, and Pathoma's structured walkthrough catches what the deck misses.
The workflow most high-scorers use: watch Boards & Beyond or Pathoma for a system, do the corresponding AnKing cards, then cross-check First Aid to confirm the gaps are covered. For the 88 zero-card subtopics, you cannot rely on AnKing alone — you need an active reading source. The r/medicalschoolanki community and AnkiHub both host supplemental decks that patch specific gap areas if you want to stay in Anki rather than switch to text.
Frequently asked questions
Is AnKing enough for Step 1?
AnKing covers 90.2% of USMLE Step 1 subtopics (813 of 901), making it sufficient as a primary study resource for most students. However, 88 subtopics have zero cards — including high-yield topics like Hemodynamic Profiles of Shock and Anticoagulant Reversal — so pairing with First Aid or Boards & Beyond is necessary to close the gaps. Students who use AnKing as their backbone and actively read First Aid for weak systems consistently report the best outcomes.
How many cards are in AnKing?
The AnKing Step 1 (Overhaul) Deck contains 20,902 total cards. Of those, 17,363 cards map directly to USMLE Step 1 exam content, and 3,491 are out-of-scope cards covering material beyond the Step 1 outline. Most students suspend the out-of-scope cards and work through the mapped 17,363.
What does AnKing not cover for Step 1?
AnKing has 88 subtopics with zero cards and 141 subtopics with fewer than 4 cards across Lacunos's 901-subtopic Step 1 outline. The biggest coverage gaps are in General Pharmacology (75.0%), Psychiatry (80.0%), and Immunology (81.8%), with specific zero-card topics including Preload and Afterload, Thyroid Emergencies, Osteoporosis, NK Cells and Missing-Self, and Anticoagulant Reversal. These are not obscure topics — several appear consistently on Step 1 practice exams.
What is the weakest subject in the AnKing Step 1 deck?
General Pharmacology is AnKing's weakest subject by coverage, with only 75.0% of subtopics represented (27 of 36) across 511 cards. Psychiatry has the most uncovered subtopics in absolute terms — 15 gaps out of 75 subtopics at 80.0% coverage. Students targeting a high Step 1 score should treat both subjects as requiring active supplementation beyond the deck.