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ChatGPT-4o is Not a Reliable Study Source for Orthopaedic Surgery Residents.

Neil Jain1, Caleb Gottlich2, John Fisher2

  • 1Department of Orthopaedic Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania.

JB & JS Open Access
|September 10, 2025
PubMed
Summary
This summary is machine-generated.

Artificial intelligence (AI) tool ChatGPT-4o shows inconsistent performance on orthopaedic surgery exams, scoring similarly to residents but with flawed explanations. Its use for medical education requires further validation.

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Area of Science:

  • Medical Education
  • Artificial Intelligence in Medicine
  • Orthopaedic Surgery

Background:

  • The adoption of AI platforms like ChatGPT is rising among medical residents for educational purposes.
  • Previous ChatGPT versions underperformed compared to orthopaedic surgery residents on exams, particularly with image-based questions.
  • ChatGPT-4o, a newer model, aims to address these limitations but requires evaluation.

Purpose of the Study:

  • To assess ChatGPT-4o's accuracy in answering Orthopaedic In-Training Examination (OITE) questions.
  • To evaluate the educational quality of ChatGPT-4o's explanations for orthopaedic surgery trainees.

Main Methods:

  • ChatGPT-4o processed OITE questions from 2020-2022.
  • The AI's raw scores were compared against ACGME-accredited orthopaedic resident performance.
  • Answer explanations were analyzed for consistency with AAOS expert content, categorizing responses as ideal, inadequate, or unacceptable.

Main Results:

  • ChatGPT-4o achieved scores of 68.8% (2020), 63.4% (2021), and 70.1% (2022), comparable to PGY-5, PGY2-3, and PGY-4 residents, respectively.
  • Ideal response quality (correct answer with consistent explanation) was achieved for 58.7% of questions.
  • Performance on media-based questions (60.0%) was significantly lower than non-media questions (73.1%).

Conclusions:

  • ChatGPT-4o demonstrates inconsistent performance on the OITE, with a significant portion of responses being unacceptable or lacking adequate explanations.
  • The AI's limitations in handling media-based orthopaedic surgery questions persist.
  • The efficacy of using ChatGPT for orthopaedic surgery resident education remains unvalidated.