Medical students increasingly rely on third-party resources, or study tools developed outside of formal medical education institutions, to study for the US Medical Licensing Exams (USMLE). One such third-party resource is Anki, an online flashcard platform, and the AnKing, a premade deck created by a group of medical students. While prior scholarship has begun to analyze the content and benefits of such third-party resources, few have considered how not only the content but also the design and usage patterns of such resources may perpetuate medical knowledge that is harmful to patients. Trained in both medicine and history as an MD/PhD student, the author considers how expertise from the social sciences can inform our analysis of the process by which historical medical knowledge on race, health, and disease is developed, maintained through historical change, and passed down to current medical students. Sociological methods in Science and Technology Studies informed the analysis of Anki as a political technology, where social values are embedded in its design, typical use by students, and repair mechanisms, or how the technology is maintained and updated. The author accompanies her experience studying with AnKing from 2020 to 2022 with a systematic content analysis of AnKing's training videos and social media posts (March 2025-February 2026) and of the race-based medical content in the AnKing deck (Update #14, March 2025). Historical literature on race-based medicine informed analysis of emerging themes in the deck. Anki's design with a distinct question-and-answer format and its embedded values of speed and volume in usage patterns help form implicit associations, including between race and disease risk. Its repair mechanism via mass collaboration and self-reference to other third-party resources contribute to the perpetuation of historical concepts of race-based medicine. In AnKing, 0.5% of flashcards (202/42,629) contained references to differing diagnosis and treatment patterns among racial groups. Three major definitions of race appeared: racial groups as defined by differing prevalence of disease, race as a shortcut for genetic heritability, and race as a risk factor for disease. AnKing defines clearly demarcated biological racial categories as an individual patient characteristic that increases risk of disease, lacking the historical and social context which reveal the structural role of racism in health. By considering one popular third-party resource through the lens of the history and sociology of medicine, the author demonstrates how insights from the social sciences inform how medical knowledge develops, transforms over time, and continues to perpetuate within the contemporary educational environment.
Nora O. Grand (Mon,) studied this question.