Uptake of Large Language Models by London Medical Students: Exploratory Qualitative Interview Study

Abstract

BACKGROUND: The popularity of large language models (LLMs) has grown exponentially across health care. Despite the wealth of literature on proposed applications in medical education, there remains a critical gap regarding their real-world use, benefits, and challenges as experienced by medical students themselves. OBJECTIVE: We aimed to explore qualitatively and characterize the perceived benefits, facilitators, and barriers associated with the use of LLMs among a cohort of London-based medical students. METHODS: Semistructured interviews were conducted with 15 medical students from preclinical and clinical stages at London-based medical schools. Guided by the technology acceptance model, interview transcripts underwent an inductive thematic analysis to identify themes on actual system use, perceived usefulness, ease of use, and attitudes toward LLMs. RESULTS: All participants reported frequent use of ChatGPT for concise topic summarization, clarification of complex concepts, generation of examination-style questions, and summarization of research. Students described LLMs as a complementary tool to traditional materials, valuing their immediacy ("Instead of getting a textbook, I can ask ChatGPT to summarise something in X words and read it in under a minute") and ease of use. Peer demonstration and device-agnostic accessibility emerged as key facilitators. Of note, wider applications such as simulating clinical interviews were discovered through peers rather than through formal teaching. Significant barriers were reported. Hallucinations, fabricated references, and outdated information led to loss of trust, with more junior students finding inaccurate outputs difficult to detect ("I stopped using it because I found it to be inaccurate, and I don't want to be learning the wrong things"). Half of the participants interviewed reported a sense of overreliance, defaulting to its use for answers with a perceived loss of critical thinking ability. Students noted inequalities in access to advanced features and voiced concerns about privacy when using LLMs in clinical scenarios. CONCLUSIONS: LLMs have been widely adopted by medical students. While students perceived the efficiency, flexibility, and conversational interface of LLMs as beneficial, substantial reservations remain regarding their reliability, potential de-skilling, and the loss of academic integrity. These findings underpin the urgent need for curricula to both support safe LLM use and also adapt assessment and teaching strategies for artificial intelligence-augmented student practice. Future research should broaden geographical representation, investigate applications in low-resource settings, and integrate educators' perspectives to establish future curricular guidance in an artificial intelligence era.

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