Beyond the Leaderboard: Rethinking Medical Benchmarks for Large Language Models

Wenxuan Wang, Zizhan Ma, Guo Yu, Yiu-Fai Cheung, Meidan Ding, Jie Liu, Wenting Chen, Linlin Shen


Abstract
Large language models (LLMs) show significant potential in healthcare, prompting numerous benchmarks to evaluate their capabilities. However, concerns persist regarding the reliability of these benchmarks, which often lack clinical fidelity, robust data management, and safety-oriented evaluation metrics. To address these shortcomings, we introduce MedCheck, the first lifecycle-oriented assessment framework specifically designed for medical benchmarks. Our framework deconstructs benchmark development into five stages from design to governance, and provides a comprehensive checklist of 46 medically-tailored criteria. Using MedCheck, we conducted an in-depth empirical evaluation of 56 medical LLM benchmarks. Our analysis uncovers widespread, systemic issues, including a profound disconnect from clinical practice, a crisis of data integrity due to unmitigated contamination risks, and a systematic neglect of safety-critical evaluation dimensions like model robustness and uncertainty awareness. Based on these findings, MedCheck is both a diagnostic tool for existing benchmarks and an actionable guideline for a more standardized, reliable, and transparent approach to evaluating AI in healthcare.
Anthology ID:
2026.acl-long.1996
Volume:
Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers)
Month:
July
Year:
2026
Address:
San Diego, California, United States
Editors:
Maria Liakata, Viviane P. Moreira, Jiajun Zhang, David Jurgens
Venue:
ACL
SIG:
Publisher:
Association for Computational Linguistics
Note:
Pages:
43078–43123
Language:
URL:
https://preview.aclanthology.org/ingest-acl/2026.acl-long.1996/
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Bibkey:
Cite (ACL):
Wenxuan Wang, Zizhan Ma, Guo Yu, Yiu-Fai Cheung, Meidan Ding, Jie Liu, Wenting Chen, and Linlin Shen. 2026. Beyond the Leaderboard: Rethinking Medical Benchmarks for Large Language Models. In Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers), pages 43078–43123, San Diego, California, United States. Association for Computational Linguistics.
Cite (Informal):
Beyond the Leaderboard: Rethinking Medical Benchmarks for Large Language Models (Wang et al., ACL 2026)
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PDF:
https://preview.aclanthology.org/ingest-acl/2026.acl-long.1996.pdf
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