Performance of artificial intelligence on a simulated Canadian urology board exam

Introduction: Generative artificial intelligence (AI) has proven to be a powerful tool with increasing applications in clinical care and medical education. CHATGPT has performed adequately on many specialty certification and knowledge assessment exams. The objective of this study was to assess the performance of CHATGPT 4 on a multiple-choice exam meant to simulate the Canadian urology board exam. Methods: Graduating urology residents representing all Canadian training programs gather yearly for a mock exam that simulates their upcoming board-certifying exam. The exam consists of written multiple-choice questions (MCQs) and an oral objective structured clinical examination (OSCE). The 2022 exam was taken by 29 graduating residents and was administered to CHATGPT 4. Results: CHATGPT 4 scored 46% on the MCQ exam, whereas the mean and median scores of graduating urology residents were 62.6%, and 62.7%, respectively. This would place CHATGPT's score 1.8 standard deviations from the median. The percentile rank of CHATGPT would be in the sixth percentile. CHATGPT scores on different topics of the exam were as follows: oncology 35%, andrology/benign prostatic hyperplasia 62%, physiology/anatomy 67%, incontinence/female urology 23%, infections 71%, urolithiasis 57%, and trauma/reconstruction 17%, with ChatGPT 4’s oncology performance being significantly below that of postgraduate year 5 residents. Conclusions: CHATGPT 4 underperforms on an MCQ exam meant to simulate the Canadian board exam. Ongoing assessments of the capability of generative AI is needed as these models evolve and are trained on additional urology content.