The Illusion of Readiness in Health AI

Yu Gu, Jingjing Fu, Xiaodong Liu, Jeya Maria Jose Valanarasu, Noel CF Codella +27 more
9/22/2025
cs.AIcs.CLcs.LG

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Abstract

Large language models have demonstrated remarkable performance in a wide range of medical benchmarks. Yet underneath the seemingly promising results lie salient growth areas, especially in cutting-edge frontiers such as multimodal reasoning. In this paper, we introduce a series of adversarial stress tests to systematically assess the robustness of flagship models and medical benchmarks. Our study reveals prevalent brittleness in the presence of simple adversarial transformations: leading systems can guess the right answer even with key inputs removed, yet may get confused by the slightest prompt alterations, while fabricating convincing yet flawed reasoning traces. Using clinician-guided rubrics, we demonstrate that popular medical benchmarks vary widely in what they truly measure. Our study reveals significant competency gaps of frontier AI in attaining real-world readiness for health applications. If we want AI to earn trust in healthcare, we must demand more than leaderboard wins and must hold AI systems accountable to ensure robustness, sound reasoning, and alignment with real medical demands.

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Cite this paper

@article{gu2025illusion,
  title  = {The Illusion of Readiness in Health AI},
  author = {Yu Gu and Jingjing Fu and Xiaodong Liu and Jeya Maria Jose Valanarasu and Noel CF Codella and Reuben Tan and Qianchu Liu and Ying Jin and Sheng Zhang and Jinyu Wang and Rui Wang and Lei Song and Guanghui Qin and Naoto Usuyama and Cliff Wong and Hao Cheng and HoHin Lee and Praneeth Sanapathi and Sarah Hilado and Tristan Naumann and Javier Alvarez-Valle and Jiang Bian and Mu Wei and Khalil Malik and Lidong Zhou and Jianfeng Gao and Eric Horvitz and Matthew P. Lungren and Doug Burger and Eric Topol and Hoifung Poon and Paul Vozila},
  year   = {2025},
  eprint = {2509.18234},
  archivePrefix = {arXiv},
  url    = {http://arxiv.org/abs/2509.18234v3}
}

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