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  • Title: Critical Analysis of ChatGPT 4 Omni in USMLE Disciplines, Clinical Clerkships, and Clinical Skills.
    Author: Bicknell BT, Butler D, Whalen S, Ricks J, Dixon CJ, Clark AB, Spaedy O, Skelton A, Edupuganti N, Dzubinski L, Tate H, Dyess G, Lindeman B, Lehmann LS.
    Journal: JMIR Med Educ; 2024 Sep 14; ():. PubMed ID: 39276063.
    Abstract:
    BACKGROUND: Recent studies, including those by the National Board of Medical Examiners (NBME), have highlighted the remarkable capabilities of recent large language models (LLMs) such as ChatGPT in passing the United States Medical Licensing Examination (USMLE). However, there is a gap in detailed analysis of these models' performance in specific medical content areas, thus limiting an assessment of their potential utility for medical education. OBJECTIVE: To assess and compare the accuracy of successive ChatGPT versions (GPT-3.5, GPT-4, and GPT-4 Omni) in USMLE disciplines, clinical clerkships, and the clinical skills of diagnostics and management. METHODS: This study used 750 clinical vignette-based multiple-choice questions (MCQs) to characterize the performance of successive ChatGPT versions [ChatGPT 3.5 (GPT-3.5), ChatGPT 4 (GPT-4), and ChatGPT 4 Omni (GPT-4o)] across USMLE disciplines, clinical clerkships, and in clinical skills (diagnostics and management). Accuracy was assessed using a standardized protocol, with statistical analyses conducted to compare the models' performances. RESULTS: GPT-4o achieved the highest accuracy across 750 MCQs at 90.4%, outperforming GPT-4 and GPT-3.5, which scored 81.1% and 60.0% respectively. GPT-4o's highest performances were in social sciences (95.5%), behavioral and neuroscience (94.2%), and pharmacology (93.2%). In clinical skills, GPT-4o's diagnostic accuracy was 92.7% and management accuracy 88.8%, significantly higher than its predecessors. Notably, both GPT-4o and GPT-4 significantly outperformed the medical student average accuracy of 59.3% (95% CI: 58.3-60.3). CONCLUSIONS: ChatGPT 4 Omni's performance in USMLE preclinical content areas as well as clinical skills indicates substantial improvements over its predecessors, suggesting significant potential for the use of this technology as an educational aid for medical students. These findings underscore the necessity of careful consideration of LLMs' integration into medical education, emphasizing the importance of structured curricula to guide their appropriate use and the need for ongoing critical analyses to ensure their reliability and effectiveness.
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