Artificial Intelligence and Medical Education – A Pandora’s Box for the 21st Century

ChatGPT (Chat Generative Pre-trained Transformer), the artificial intelligence (AI) chatbot developed by OpenAI, became the fastest-growing internet application in history. Generative AI, which includes large language models such as GPT, can produce human-like text and imitate human thought.

Technology Adoption Is Different in Medicine

Medical education cannot afford a wait-and-see policy; it must address AI’s effects immediately. Many valid concerns have been raised about AI in medicine, including its tendency to invent information and present it as fact, possible implications for patient privacy, and the risk of introducing inaccuracies into source data.

Focusing on these immediate challenges may cause us to overlook AI’s far-reaching effects on medical education and the thinking and practice patterns of future generations of doctors. This concerns us.

Throughout history, technology has changed how doctors think. The invention of the stethoscope in the 19th century helped develop and refine the physical examination, leading doctors to see themselves as diagnostic detectives. More recently, information technology reshaped clinical reasoning frameworks. As Lawrence Weed, who devised problem-oriented medical records, famously argued, how doctors structure data affects how they think. Modern billing structures, quality-improvement systems and today’s electronic health record, with its associated stagnation, have all been deeply influenced by this approach to record keeping.

Since its release in autumn 2022, ChatGPT has shown the potential to change practice as much as problem-oriented medical records. It has passed licensing and clinical reasoning examinations and can imitate doctors’ diagnostic thinking patterns. While higher education wrestles with “the end of the college essay”, medical schools’ personal statements will follow. Major healthcare companies are partnering with technology firms to deploy AI widely and rapidly across healthcare. Chatbots aiming to replace doctors for some medical encounters will also become commercially available.

Change Has Begun

Changes in medical education are already evident, confronting the field with an existential choice: should educators actively integrate AI into doctors’ training, preparing them to use this transformative technology safely and effectively in healthcare? Or should we allow outside influences from people who are not health professionals, prioritising operational efficiency and profit, to determine what integration looks like? We strongly believe curriculum designers, programme and institutional leaders, and accrediting bodies need to consider AI.

The philosopher Jacques Derrida introduced the concept of a “pharmakon”, something that can both heal and harm. AI likewise brings opportunities and threats. Given what is at stake—the future of healthcare, in our view—we believe medical education should lead the integration of AI into clinical practice. This will not be easy, especially given the pace of change and lack of guiding literature, but Pandora’s box is already open. Unless we shape our own future, powerful technology companies will gladly shape it for us.