# Dissecting Role Cognition in Medical LLMs via Neuronal Ablation

arXiv: https://arxiv.org/abs/2510.24677 · HTML: https://mlsanity.com/paper/2510.24677/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 10 of its 32 references that are in the map.
- First posted on arXiv 28 Oct 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)

## Builds on (most cited first, 10 of 10)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [MMLU-Pro: A More Robust and Challenging Multi-Task Language Understanding Benchmark](https://mlsanity.com/paper/2406.01574/) (2024)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [A Survey on Large Language Models for Recommendation](https://mlsanity.com/paper/2305.19860/) (2023)
- [Role-Play with Large Language Models](https://mlsanity.com/paper/2305.16367/) (2023)
- [Adapted Large Language Models Can Outperform Medical Experts in Clinical Text Summarization](https://mlsanity.com/paper/2309.07430/) (2023)
- [Agent Hospital: A Simulacrum of Hospital with Evolvable Medical Agents](https://mlsanity.com/paper/2405.02957/) (2024)
- [LLM Ethics Benchmark: A Three-Dimensional Assessment System for Evaluating Moral Reasoning in Large Language Models](https://mlsanity.com/paper/2505.00853/) (2025)
- [MetaAgent: Toward Self-Evolving Agent via Tool Meta-Learning](https://mlsanity.com/paper/2508.00271/) (2025)

## Built on by (most cited first, 1 of 1)

- [Sparse Neuron Ablation Triggers Catastrophic Collapse of the Language Core in Large Vision-Language Models](https://mlsanity.com/paper/2512.00918/) (2025)

## Abstract (arXiv)

Large language models (LLMs) have gained significant traction in medical decision support systems, particularly in the context of medical question answering and role-playing simulations. A common practice, Prompt-Based Role Playing (PBRP), instructs models to adopt different clinical roles (e.g., medical students, residents, attending physicians) to simulate varied professional behaviors. However, the impact of such role prompts on model reasoning capabilities remains unclear. This study introduces the RP-Neuron-Activated Evaluation Framework(RPNA) to evaluate whether role prompts induce distinct, role-specific cognitive processes in LLMs or merely modify linguistic style. We test this framework on three medical QA datasets, employing neuron ablation and representation analysis techniques to assess changes in reasoning pathways. Our results demonstrate that role prompts do not significantly enhance the medical reasoning abilities of LLMs. Instead, they primarily affect surface-level linguistic features, with no evidence of distinct reasoning pathways or cognitive differentiation across clinical roles. Despite superficial stylistic changes, the core decision-making mechanisms of LLMs remain uniform across roles, indicating that current PBRP methods fail to replicate the cognitive complexity found in real-world medical practice. This highlights the limitations of role-playing in medical AI and emphasizes the need for models that simulate genuine cognitive processes rather than linguistic imitation.We have released the related code in the following repository:https: //github.com/IAAR-Shanghai/RolePlay_LLMDoctor