The Illusion of Readiness in Health AI

Yu Gu; Jingjing Fu; Xiaodong Liu; Jeya Maria Jose Valanarasu; Noel CF Codella; Reuben Tan; Qianchu Liu; Ying Jin; Sheng Zhang; Jinyu Wang; Rui Wang; Lei Song; Guanghui Qin; Naoto Usuyama; Cliff Wong; Hao Cheng; HoHin Lee; Praneeth Sanapathi; Sarah Hilado; Tristan Naumann; Javier Alvarez-Valle; Jiang Bian; Mu Wei; Khalil Malik; Lidong Zhou; Jianfeng Gao; Eric Horvitz; Matthew P. Lungren; Doug Burger; Eric Topol; Hoifung Poon; Paul Vozila

arXiv · 2509.18234

The Illusion of Readiness in Health AI

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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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Yu Gu, Jingjing Fu, Xiaodong Liu, Jeya Maria Jose Valanarasu, Noel CF Codella, Reuben Tan, Qianchu Liu, Ying Jin, Sheng Zhang, Jinyu Wang, Rui Wang, Lei Song, Guanghui Qin, Naoto Usuyama, Cliff Wong, Hao Cheng, HoHin Lee, Praneeth Sanapathi, Sarah Hilado, Tristan Naumann, Javier Alvarez-Valle, Jiang Bian, Mu Wei, Khalil Malik, Lidong Zhou, Jianfeng Gao, Eric Horvitz, Matthew P. Lungren, Doug Burger, Eric Topol, Hoifung Poon, Paul Vozila. 2025-09-22. The Illusion of Readiness in Health AI. https://arxiv.org/abs/2509.18234

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