What it takes to be great: ChatGPT's top 5 descriptors of great surgeons by race, ethnicity, gender, and sexual orientation.

Abstract

Diversity of providers in medical teams improves team communication, increases care for underserved populations, enhances patient compliance, and reduces linguistic and cultural barriers. However, institutional racism, sexism, and implicit bias continue to hinder the academic advancement of underrepresented-in-medicine surgeons. This study explores the concept of a "great surgeon" defined by ChatGPT (Chat Generative Pre-Trained Transformer), an online artificial intelligence platform that "learns" from human writing and reveals how implicit biases may influence perceptions of leadership, competence, and worth in academic surgery across gender, race, and sexual orientation. ChatGPT 3.5 was prompted to provide the "top 5 descriptors of a great surgeon," serving as the control. Subsequent queries added identifiers (gender, race, and sexual orientation) to generate 14 surgeon phenotypes. Responses were qualitatively compared against the control to identify potential bias. Control descriptors were "skilled, confident, meticulous, diligent, and innovative." Great male surgeons returned identical descriptors, whereas female, gay male, and gay female surgeons were "compassionate and empathetic," rather than confident. Great Black male/gay male/gay female surgeons were "skilled, exceptional, resilient, trailblazing, and inspirational." Great Black female surgeons were uniquely tenacious. Great Latin/Hispanic surgeons were "bilingual and effective communicators, culturally competent and empathetic, resilient and determined, and advocates and leaders." For Latin/Hispanic female and gay female surgeons, "mentorship and community engagement" replaced "bilingual and effective communicators." ChatGPT's descriptors of a "great" surgeon varied by demographic identifiers, suggesting that it reflects implicit biases present in human communication. These findings highlight potential stereotypes influencing perceptions of underrepresented-in-medicine surgeons.