By no means do I consider the approach to be the only correct one, but I had a lot of success with this.
#1. Suspend and forget all cards. Yes, all of them. It might be counterintuitive / anti-algorithm, but I think a fresh start is nice (plus you will benefit from seeing cards again before your shelf exams).
#2. I was also a die-hard Boards and Beyond → follow with Anki cards type user. I needed to learn from a primary source before doing cards. I didn’t use it for Step 2 and didn’t feel like I had the time. My primary source became question banks (it isn’t as bad as you think… you will know probably 50-60% already) with careful review of questions, even the ones that I got right.
#3. Get the AnKing UW QID add-on and make your life easier. After every block you do, copy the string of QIDs and paste into the add-on. All cards related will populate and you can unsuspend as needed. This was a huge time saver for me and helped alleviate the anxiety of needing to do something before the cards.
#4. If your Step 1 knowledge is feeling really weak: Before each rotation, go ahead and search for the cards that overlap with Step 1. For example, if starting family medicine, search “tag:#AK_Step2_v12::!Shelf::FM::no_dupes tag:#AK_Step1_v12” and unsuspend in large chunks (let’s say 250 per day for 4 days to get through them), hitting “easy” as much as possible to skip learning steps for cards you 100% know. Be careful here or you’ll end up with too many cards to do daily while also trying to complete clinical rotations… it is a recipe for disaster.
Please let me know if you have any questions!