# Capabilities of GPT-4 on Medical Challenge Problems

arXiv: https://arxiv.org/abs/2303.13375 · HTML: https://mlsanity.com/paper/2303.13375/

## Key facts

- Cited by 638 papers in the map (data through 14 Oct 2026).
- Builds on 27 of its 77 references that are in the map.
- First posted on arXiv 20 Mar 2023.

## Builds on (most cited first, 27 of 27)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Measuring Massive Multitask Language Understanding](https://mlsanity.com/paper/2009.03300/) (2020)
- [Scaling Laws for Neural Language Models](https://mlsanity.com/paper/2001.08361/) (2020)
- [Self-Consistency Improves Chain of Thought Reasoning in Language Models](https://mlsanity.com/paper/2203.11171/) (2022)
- [Large Language Models are Zero-Shot Reasoners](https://mlsanity.com/paper/2205.11916/) (2022)
- [On the Opportunities and Risks of Foundation Models](https://mlsanity.com/paper/2108.07258/) (2021)
- [Deep reinforcement learning from human preferences](https://mlsanity.com/paper/1706.03741/) (2017)
- [Training a Helpful and Harmless Assistant with Reinforcement Learning from Human Feedback](https://mlsanity.com/paper/2204.05862/) (2022)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [WebGPT: Browser-assisted question-answering with human feedback](https://mlsanity.com/paper/2112.09332/) (2021)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [A Reductions Approach to Fair Classification](https://mlsanity.com/paper/1803.02453/) (2018)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning](https://mlsanity.com/paper/1711.05225/) (2017)
- [Measurement and Fairness](https://mlsanity.com/paper/1912.05511/) (2019)
- [InterpretML: A Unified Framework for Machine Learning Interpretability](https://mlsanity.com/paper/1909.09223/) (2019)
- [Can large language models reason about medical questions?](https://mlsanity.com/paper/2207.08143/) (2022)
- [A Universal Law of Robustness via Isoperimetry](https://mlsanity.com/paper/2105.12806/) (2021)
- [Learning to Complement Humans](https://mlsanity.com/paper/2005.00582/) (2020)
- [Reading Between the Lines: Modeling User Behavior and Costs in AI-Assisted Programming](https://mlsanity.com/paper/2210.14306/) (2022)
- [An Empirical Analysis of Backward Compatibility in Machine Learning Systems](https://mlsanity.com/paper/2008.04572/) (2020)
- [Who Goes First? Influences of Human-AI Workflow on Decision Making in Clinical Imaging](https://mlsanity.com/paper/2205.09696/) (2022)

## Built on by (most cited first, 30 of 638)

- [GPT-4o System Card](https://mlsanity.com/paper/2410.21276/) (2024)
- [Sparks of Artificial General Intelligence: Early experiments with GPT-4](https://mlsanity.com/paper/2303.12712/) (2023)
- [A Survey of Large Language Models](https://mlsanity.com/paper/2303.18223/) (2023)
- [MathVista: Evaluating Mathematical Reasoning of Foundation Models in Visual Contexts](https://mlsanity.com/paper/2310.02255/) (2023)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [FActScore: Fine-grained Atomic Evaluation of Factual Precision in Long Form Text Generation](https://mlsanity.com/paper/2305.14251/) (2023)
- [CRITIC: Large Language Models Can Self-Correct with Tool-Interactive Critiquing](https://mlsanity.com/paper/2305.11738/) (2023)
- [HealthBench: Evaluating Large Language Models Towards Improved Human Health](https://mlsanity.com/paper/2505.08775/) (2025)
- [Towards Expert-Level Medical Question Answering with Large Language Models](https://mlsanity.com/paper/2305.09617/) (2023)
- [Causal Reasoning and Large Language Models: Opening a New Frontier for Causality](https://mlsanity.com/paper/2305.00050/) (2023)
- [PMC-VQA: Visual Instruction Tuning for Medical Visual Question Answering](https://mlsanity.com/paper/2305.10415/) (2023)
- [Benchmarking Retrieval-Augmented Generation for Medicine](https://mlsanity.com/paper/2402.13178/) (2024)
- [Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine](https://mlsanity.com/paper/2311.16452/) (2023)
- [MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoning](https://mlsanity.com/paper/2311.10537/) (2023)
- [BioMistral: A Collection of Open-Source Pretrained Large Language Models for Medical Domains](https://mlsanity.com/paper/2402.10373/) (2024)
- [MEDITRON-70B: Scaling Medical Pretraining for Large Language Models](https://mlsanity.com/paper/2311.16079/) (2023)
- [How is ChatGPT's behavior changing over time?](https://mlsanity.com/paper/2307.09009/) (2023)
- [FinanceBench: A New Benchmark for Financial Question Answering](https://mlsanity.com/paper/2311.11944/) (2023)
- [Reasoning or Reciting? Exploring the Capabilities and Limitations of Language Models Through Counterfactual Tasks](https://mlsanity.com/paper/2307.02477/) (2023)
- [Leak, Cheat, Repeat: Data Contamination and Evaluation Malpractices in Closed-Source LLMs](https://mlsanity.com/paper/2402.03927/) (2024)
- [Survey on Factuality in Large Language Models: Knowledge, Retrieval and Domain-Specificity](https://mlsanity.com/paper/2310.07521/) (2023)
- [Evaluating Large Language Models: A Comprehensive Survey](https://mlsanity.com/paper/2310.19736/) (2023)
- [CodeS: Towards Building Open-source Language Models for Text-to-SQL](https://mlsanity.com/paper/2402.16347/) (2024)
- [What can Large Language Models do in chemistry? A comprehensive benchmark on eight tasks](https://mlsanity.com/paper/2305.18365/) (2023)
- [SciMON: Scientific Inspiration Machines Optimized for Novelty](https://mlsanity.com/paper/2305.14259/) (2023)
- [Fine-Tuning or Retrieval? Comparing Knowledge Injection in LLMs](https://mlsanity.com/paper/2312.05934/) (2023)
- [A Survey of Large Language Models for Healthcare: from Data, Technology, and Applications to Accountability and Ethics](https://mlsanity.com/paper/2310.05694/) (2023)
- [Sociotechnical Safety Evaluation of Generative AI Systems](https://mlsanity.com/paper/2310.11986/) (2023)
- [Fundamental Limitations of Alignment in Large Language Models](https://mlsanity.com/paper/2304.11082/) (2023)
- [A Survey of Large Language Models in Medicine: Progress, Application, and Challenge](https://mlsanity.com/paper/2311.05112/) (2023)

## Abstract (arXiv)

Large language models (LLMs) have demonstrated remarkable capabilities in natural language understanding and generation across various domains, including medicine. We present a comprehensive evaluation of GPT-4, a state-of-the-art LLM, on medical competency examinations and benchmark datasets. GPT-4 is a general-purpose model that is not specialized for medical problems through training or engineered to solve clinical tasks. Our analysis covers two sets of official practice materials for the USMLE, a three-step examination program used to assess clinical competency and grant licensure in the United States. We also evaluate performance on the MultiMedQA suite of benchmark datasets. Beyond measuring model performance, experiments were conducted to investigate the influence of test questions containing both text and images on model performance, probe for memorization of content during training, and study probability calibration, which is of critical importance in high-stakes applications like medicine. Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. We also explore the behavior of the model qualitatively through a case study that shows the ability of GPT-4 to explain medical reasoning, personalize explanations to students, and interactively craft new counterfactual scenarios around a medical case. Implications of the findings are discussed for potential uses of GPT-4 in medical education, assessment, and clinical practice, with appropriate attention to challenges of accuracy and safety.