A talk delivered at the Education Team meeting of the General Medical Council 9 January 2024.

1. `
ARTIFICIAL INTELLIGENCE
AND CHATGPT:
IMPACTS AND CHALLENGES FOR
MEDICAL EDUCATION
Terese Bird, Leicester Medical School Educational Designer
Dr Indrajeet Das, Glenfield Hospital, Leicester
Student Input: Zobia Wadi, Jakevir Shoker, Merlijn Surtel -
Leicester Medical School, and University of Leicester School of
Computing and Mathematical Sciences
General Medical Council Education Team Start-of-Year
Meeting – 9 January 2024 – Manchester, UK

2. NHS ARTIFICIAL INTELLIGENCE (AI) AND DIGITAL
HEALTHCARE TECHNOLOGIES CAPABILITY
FRAMEWORK – FEB 2023
https://digital-transformation.hee.nhs.uk/building-a-digital-workforce/dart-ed/horizon-scanning/ai-and-
digital-healthcare-technologies/framework-structure

3. WORKSHOP PLAN
• ChatGPT – how it works, positives and negatives (TB)
• ChatGPT’s challenge to assessment – how to mitigate against cheating (TB)
• How medical students can use Artificial Intelligence and ChatGPT (TB)
• Let’s try it! (TB)
• How AI is being used in Radiology (ID)
• Suggestions for AI in training (ID)
• Takeaway (ID)
• Q&A
1/23/2024

4. 1. HOW DOES GPT WORK – POSITIVES
AND NEGATIVES

5. GPT-3.5 IMPROVEMENTS OVER
PREVIOUS LANGUAGE MODELS
• Released Nov 2022; GPT 4.0 Mar 2023
• GPT’s improvements all stem from a new
architecture (transformer)
• GPT is:
• More scalable (parallelisation)
• Better at handling long-term dependencies
(self-attention)
• Better at handling the complexities of language
• Transformers allow for transfer learning – allows
specialised models to be easily trained
• It is a Large Language Model (LLM), not an expert
system on everything
1/23/2024
Image by Wikipedia CC0

6. CHATGPT VS SEARCH ENGINE (OPENAI,2023B)
Feature ChatGPT Search Engine
Interactivity Conversational, takes follow-up
questions
A list of relevant web pages
Contextual
'Understanding'
Aims to ”understand” the context
provide responses accordingly.
Relies on individual keyword
searches and may miss the meaning
the questions
Subjective Responses Can generate subjective opinions
(advice) and creative content (stories,
poems)in different ‘voice’ (i.e.
Donald Trump or ‘like I’m five’)
Objective, factual information
General Knowledge Trained on books, journal articles,
websites, social media - ending Jan
2022. No real-time info.
Relies on indexing and ranking
websites. Has real-time information.
Citations GPT-3.5 cannot generate
correct citations – hallucinations
Information sources are clear.
Niche/Expert Knowledge GPT offers relatively superficial
knowledge 'mile wide, inch deep’ –
including outright falsehoods
Expert, niche knowledge available.
1/23/2024

8. COMPARISON OF GPT WITH SEARCH
ENGINES
1/23/2024
BIAS - THIS OCCURRED 6-1-23
?
?
"Obviously, the doctor is
a man, and the nurse is a
woman."

9. 2. OBSERVING CHATGPT’S WRITING
ABILITY IN TYPICAL WRITING
ASSIGNMENTS – HOW TO MITIGATE
AGAINST CHEATING

10. QUALITY OF CHATGPT’S WRITING –
AND CAN IT BE DETECTED IN ASSIGNMENTS?
• Good writing in different styles (Formal, Friendly, BoJo, Yoda).
• It writes like a Year 1 university student – surface, descriptive only.
• It cannot reflect but it can pretend to.
• Light-touch criticality.
------------------------------------------------
• Be suspicious when:
• Your sources not used
• Writing is on a low level
• No reflection
• Hallucinations
1/23/2024
How to mitigate:
If essay assignment, give precise
requirements – application, reflection,
criticality, personal examples, frameworks.
Use non-essay and practical assessments
i.e. OSCEs.
If it must be an essay, do it as a live exam
with invigilators.

11. 3. HOW MEDICAL STUDENTS CAN USE AI
DOES CHATGPT ANSWER GROUPWORK
QUESTIONS AND SHORT ANSWER QUESTIONS
(SAQ)?

12. ARE THERE ANY THERAPEUTIC USES OF
HYPOTHERMIA?

13. ARE THERE ANY THERAPEUTIC USES OF
HYPOTHERMIA?
Workbook Answer
• Used in surgery to cause
vasoconstriction (less blood
loss)
• Minimises cerebral oedema
following cardiac arrest
(reduces chances of damage)
• During cardiac arrests
ChatGPT Answer
Yes, hypothermia can be used therapeutically in certain medical situations. Therapeutic hypothermia, also known as targeted
temperature management or induced hypothermia, involves deliberately lowering a person's body temperature for medical purposes.
It is typically done in a controlled and monitored setting, such as a hospital, and under the supervision of medical professionals.
Therapeutic hypothermia has been found to be beneficial in several clinical scenarios, including:
Cardiac Arrest: After a cardiac arrest, therapeutic hypothermia can be used to protect the brain and other vital organs from damage
caused by the lack of blood flow and oxygen. Cooling the body to a specific temperature range (usually between 32°C and 36°C) can
help reduce inflammation and limit neurological injuries.
Neonatal Hypoxic-Ischemic Encephalopathy (HIE): HIE is a condition that occurs when a baby's brain doesn't receive enough oxygen
and blood supply around the time of birth. Therapeutic hypothermia has shown to be effective in reducing brain damage and
improving long-term outcomes in newborns with HIE. It is considered the standard of care in many neonatal intensive care units.
Traumatic Brain Injury (TBI): Hypothermia has been investigated as a potential treatment for traumatic brain injury to minimize
secondary brain damage. Cooling the body and brain after a severe head injury may help reduce inflammation, limit cell death, and
preserve brain function.
Stroke: In some cases of ischemic stroke (caused by a blood clot blocking a blood vessel in the brain), inducing mild hypothermia has
been studied as a neuroprotective strategy to minimize brain damage and improve outcomes. However, the use of hypothermia in
stroke treatment is still under investigation and not widely adopted.
It's important to note that therapeutic hypothermia is a specialized medical procedure that requires careful patient selection, precise
temperature control, and continuous monitoring to manage potential complications. It should only be performed by trained healthcare
professionals in appropriate clinical settings.

14. HOW TO JUDGE
WHETHER IT IS
SAFE TO USE
CHATGPT
1/23/2024
(UNESCO, 2023)

15. 1/23/2024
HOW CHATGPT CAN HELP MEDICAL STUDENTS
General Study Buddy​
• “Explain diabetes as though I am five years old”​
• “Create a text- and image-based game to teach respiratory illnesses.”
• Create case studies of a patient – even if content isn't deep enough,
the structure is helpful. Work with a fellow student. Good for OSCE practice.
• "Make a table of Parkinson's Disease medicines, with columns for
dosage, for symptoms most helped, and interactions."
• “Read my email and make it sound more respectful.”

16. NO PLATFORM
IMMUNITY
1/23/2024
https://blog.petrieflom.law.harv
ard.edu/2023/06/05/whos-
liable-for-bad-medical-advice-
in-the-age-of-chatgpt/

17. ARTIFICIAL INTELLIGENCE WITH VIRTUAL REALITY IN
CLINICAL LEARNING
OXFORD MEDICAL SIMULATIONS

18. 4. LET’S TRY IT!
• On your phone, install Microsoft Copilot. It’s free. You don’t
need to have a Microsoft account already, nor do you need to use
your work Microsoft details.
OR
• Using any browser on any device, go to chat.openai.com and
create a free account.
1/23/2024

19. PHASE1 QUESTIONS
1.Why do we not inhale what we are trying to swallow? Which poses more of a challenge
to the swallowing mechanism – fluids or solids?
2. Briefly describe the mechanism of and explain the importance of the glycosylation of
newly synthesised proteins in the Golgi apparatus.
3. Is a neurotransmitter a hormone?
4. What prevents the bacteria in the colon from invading the colonic wall and underlying
tissues?
5.uBriefly compare and contrast the cellular structures and function of red and
yellow bone marrows. What special attribute does yellow bone marrow have when
RBC counts are low (as in anaemia)?

20. WHAT IS MYOGLOBIN AND HOW DOES IT DIFFER TO
HAEMOGLOBIN IN ITS FUNCTION?
WHAT ARE TREATMENTS FOR ALZHEIMER’S DISEASE?
HOW CAN I TELL IF THE PATIENT HAS SEVERE ASTHMA?

21. 1/23/2024
HOW WE MUST ”WARN” MEDICAL STUDENTS
• Check “ChatGPT facts” against known reputable source
• Letting ChatGPT write your essay is a probity and disciplinary issue.
• Using ChatGPT to do academic writing “risks students being denied the
opportunity for academic exploration, the cultivation of their intellectual
curiosity, and the recognition and development of scholarly interests that
can only be curated by time dedicated to study.” (Armitage, 2023)

22. THANK YOU!
Terese Bird
Tmb10@leicester.ac.uk
TwitterX: @tbirdcymru
Dr Indrajeet Das
i.das@nhs.net
1/23/2024

23. REFERENCES
• Armitage, R. C. (2023) ‘ChatGPT: the threats to medical education’, Postgraduate Medical Journal, 2023,
pp. 1–2. doi: 10.1093/POSTMJ/QGAD046.
• Crispen P, N. C. (ed) (2023) Instructor guidelines for student use of generative artificial intelligence for
academic work. Los Angeles, CA, USA. Available at: https://academicsenate.usc.edu/wp-
content/uploads/sites/6/2023/02/CIS-Generative-AI-Guidelines-20230214.pdf.
• Leicester, U. of (2023) AI-writers and Higher Education. Available at:
https://uniofleicester.sharepoint.com/sites/staff/learning-teaching-assessment/SitePages/AI-writers-
and-Higher-Education.aspx (Accessed: 10 July 2023).
• OpenAI (2023a) ChatGPT: Reflect on your teaching.
• OpenAI (2023b) ChatGPT chat: How are you different from a search engine?
• UNESCO (2023) ChatGPT, artificial intelligence and higher education – UNESCO-IESALC. Available at:
https://www.iesalc.unesco.org/en/2023/04/28/chatgpt-artificial-intelligence-and-higher-education/
(Accessed: 11 July 2023).
1/23/2024