# A Practical Framework for Evaluating Medical AI Security: Reproducible Assessment of Jailbreaking and Privacy Vulnerabilities Across Clinical Specialties

arXiv: https://arxiv.org/abs/2512.08185 · HTML: https://mlsanity.com/paper/2512.08185/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Safety alignment, refusal and guardrails, one of 12 directions in LLM safety and security.
- Builds on 32 of its 42 references that are in the map.
- First posted on arXiv 9 Dec 2025.

## Placed in

- LLM safety and security / [Safety alignment, refusal and guardrails](https://mlsanity.com/safety/safety-alignment-refusal-and-guardrails/)

## Builds on (most cited first, 30 of 32)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Judging LLM-as-a-Judge with MT-Bench and Chatbot Arena](https://mlsanity.com/paper/2306.05685/) (2023)
- [Universal and Transferable Adversarial Attacks on Aligned Language Models](https://mlsanity.com/paper/2307.15043/) (2023)
- [Constitutional AI: Harmlessness from AI Feedback](https://mlsanity.com/paper/2212.08073/) (2022)
- [Membership Inference Attacks against Machine Learning Models](https://mlsanity.com/paper/1610.05820/) (2016)
- [Extracting Training Data from Large Language Models](https://mlsanity.com/paper/2012.07805/) (2020)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Jailbroken: How Does LLM Safety Training Fail?](https://mlsanity.com/paper/2307.02483/) (2023)
- [Concrete Problems in AI Safety](https://mlsanity.com/paper/1606.06565/) (2016)
- [HarmBench: A Standardized Evaluation Framework for Automated Red Teaming and Robust Refusal](https://mlsanity.com/paper/2402.04249/) (2024)
- [Jailbreaking Black Box Large Language Models in Twenty Queries](https://mlsanity.com/paper/2310.08419/) (2023)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [AutoDAN: Generating Stealthy Jailbreak Prompts on Aligned Large Language Models](https://mlsanity.com/paper/2310.04451/) (2023)
- [Red Teaming Language Models to Reduce Harms: Methods, Scaling Behaviors, and Lessons Learned](https://mlsanity.com/paper/2209.07858/) (2022)
- [Tree of Attacks: Jailbreaking Black-Box LLMs Automatically](https://mlsanity.com/paper/2312.02119/) (2023)
- [Baseline Defenses for Adversarial Attacks Against Aligned Language Models](https://mlsanity.com/paper/2309.00614/) (2023)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [BioGPT: Generative Pre-trained Transformer for Biomedical Text Generation and Mining](https://mlsanity.com/paper/2210.10341/) (2022)
- [DecodingTrust: A Comprehensive Assessment of Trustworthiness in GPT Models](https://mlsanity.com/paper/2306.11698/) (2023)
- [ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission](https://mlsanity.com/paper/1904.05342/) (2019)
- [SmoothLLM: Defending Large Language Models Against Jailbreaking Attacks](https://mlsanity.com/paper/2310.03684/) (2023)
- [Scalable Extraction of Training Data from (Production) Language Models](https://mlsanity.com/paper/2311.17035/) (2023)
- [Med-Flamingo: a Multimodal Medical Few-shot Learner](https://mlsanity.com/paper/2307.15189/) (2023)
- [Safety-Tuned LLaMAs: Lessons From Improving the Safety of Large Language Models that Follow Instructions](https://mlsanity.com/paper/2309.07875/) (2023)
- [Towards Expert-Level Medical Question Answering with Large Language Models](https://mlsanity.com/paper/2305.09617/) (2023)
- [Visual Adversarial Examples Jailbreak Aligned Large Language Models](https://mlsanity.com/paper/2306.13213/) (2023)
- [MasterKey: Automated Jailbreak Across Multiple Large Language Model Chatbots](https://mlsanity.com/paper/2307.08715/) (2023)

## Abstract (arXiv)

Medical Large Language Models (LLMs) are increasingly deployed for clinical decision support across diverse specialties, yet systematic evaluation of their robustness to adversarial misuse and privacy leakage remains inaccessible to most researchers. Existing security benchmarks require GPU clusters, commercial API access, or protected health data -- barriers that limit community participation in this critical research area. We propose a practical, fully reproducible framework for evaluating medical AI security under realistic resource constraints. Our framework design covers multiple medical specialties stratified by clinical risk -- from high-risk domains such as emergency medicine and psychiatry to general practice -- addressing jailbreaking attacks (role-playing, authority impersonation, multi-turn manipulation) and privacy extraction attacks. All evaluation utilizes synthetic patient records requiring no IRB approval. The framework is designed to run entirely on consumer CPU hardware using freely available models, eliminating cost barriers. We present the framework specification including threat models, data generation methodology, evaluation protocols, and scoring rubrics. This proposal establishes a foundation for comparative security assessment of medical-specialist models and defense mechanisms, advancing the broader goal of ensuring safe and trustworthy medical AI systems.