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Open 8B-27B models would rank in the top 600-3,000 on the Spanish residency exam, but they never knew when to abstain and ignored the scan images

AspireAI community · arXiv
An evaluation of four open models between 8 and 27 billion parameters on 1,552 questions from eight editions of the Spanish MIR residency examination found that answering everything, the three larger models would rank among roughly the first 600 to 3,000 candidates, leaving 41 to 43 specialties still open. But abstention never paid, because even the models' least confident answers were right more often than the 25% break-even point, and medical fine-tuning reduced overconfidence at the cost of accuracy without improving how well confidence separated right from wrong. Two further findings matter for anyone running a model locally on hospital hardware: 13 to 38% of correct answers rejected a clinically sound option for a clinically unsound reason that the model's confidence did not reflect, and removing or swapping the provided clinical images left accuracy unchanged. The study is on one national exam and does not establish general clinical accuracy.
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