As the performance of large language models (LLMs) continues to advance, their adoption in the medical domain is increasing. However, most existing risk evaluations largely focused on general safety benchmarks. In the medical applications, LLMs may be used by a wide range of users, ranging from general users and patients to clinicians, with diverse levels of expertise and the model’s outputs can have a direct impact on human health which raises serious safety concerns. In this paper, we introduce MedRiskEval, a medical risk evaluation benchmark tailored to the medical domain. To fill the gap in previous benchmarks that only focused on the clinician perspective, we introduce a new patient-oriented dataset called PatientSafetyBench containing 466 samples across 5 critical risk categories. Leveraging our new benchmark alongside existing datasets, we evaluate a variety of open- and closed-source LLMs. To the best of our knowledge, this work establishes an initial foundation for safer deployment of LLMs in healthcare.

Large Language Models (LLMs) such as ChatGPT demonstrate significant potential in the medical domain and are often evaluated using multiple-choice questions (MCQs) modeled on exams like the USMLE. However, such benchmarks may overestimate true clinical understanding by rewarding pattern recognition and test-taking heuristics. To investigate this, we created a fictional medical benchmark centered on an imaginary organ, the Glianorex, allowing us to separate memorized knowledge from reasoning ability. We generated textbooks and MCQs in English and French using leading LLMs, then evaluated proprietary, open-source, and domain-specific models in a zero-shot setting. Despite the fictional content, models achieved an average score of 64%, while physicians scored only 27%. Fine-tuned medical models outperformed base models in English but not in French. Ablation and interpretability analyses revealed that models frequently relied on shallow cues, test-taking strategies, and hallucinated reasoning to identify the correct choice. These results suggest that standard MCQ-based evaluations may not effectively measure clinical reasoning and highlight the need for more robust, clinically meaningful assessment methods for LLMs.