Sycophantic AI, critical-feedback tolerance, and the case for productive friction in medical training

Concerns about generative AI in medical training often focus on eroded reasoning and deskilling. Such competence-based accounts are incomplete. We identify a neglected casualty: critical-feedback tolerance (CFT), the capacity to receive disconfirming evaluative feedback and remain productively engaged. Affirmation-optimized systems may lower CFT undetectably, surfacing only under authentic critique. This conceptual Perspective defines CFT, differentiates it from six established constructs, specifies measurable facets, and states explicit refutation conditions.