JMIR Publications

ABSTRACT

Background:

Artificial intelligence (AI) and the expanding scope of advanced practice providers (APPs) are rapidly transforming healthcare delivery. These concurrent trends have major implications for the medical workforce and clinical education.

Objective:

This study evaluates U.S. medical students' familiarity, perceived impact, and preparedness regarding AI integration and APP scope expansion in medical practice and identifies which trend they believe will more significantly affect their future career prospects.

Methods:

A cross-sectional online survey with five sections, including Demographics, Familiarity with AI and APPs, Opinions on AI, Opinions on APPs, and Final Reflections, was distributed to medical students enrolled in accredited U.S. institutions. The survey included 5-point Likert-scale, multiple-choice, and open-ended questions. Quantitative data were analyzed using descriptive statistics, and qualitative responses were examined through thematic analysis.

Results:

A total of 105 valid responses were collected from 43 U.S. medical schools. Students reported greater familiarity with AI than APP scope expansion (71.4% vs. 57.7% rating ≥3; McNemar's test, P=.032). Key AI benefits included administrative efficiency, diagnostic accuracy, and disease prevention; drawbacks included overreliance, algorithmic bias, and error risk. For APPs, benefits included reduced workload and improved access; concerns centered on inconsistent training and reduced oversight. Students rated AI's impact more positively than APP's (W = 531.0, P<.001): 52.5% viewed AI as enhancing their roles, while APP perceptions were more divided (44.2% positive, 35.6% negative). Radiology (80.0%) and pathology (61.9%) were identified as the specialists most affected by AI; family medicine (70.5%) and internal medicine (55.2%) by APP expansion. Preparedness was low for both, with 70.5% and 47.6% rating themselves 1–2 out of 5 for AI and APPs, respectively (W = 414.0, P<.001). Students were nearly evenly split on career threats: 45.6% identified APPs, 39.8% AI, and 14.6% both equally (χ² = 16.85, P<.001). Qualitative responses emphasized the need for AI education, interprofessional training, and policy literacy.

Conclusions:

This study found that medical students recognize AI and APP expansion as major forces reshaping healthcare, but feel largely unprepared for their impact. The findings highlight the need for curricular reforms that incorporate AI literacy, provide hands-on learning opportunities, and offer guidance on interprofessional collaboration, education on scope-of-practice regulations, and advocacy skills to better equip future physicians for evolving clinical environments.