A Survey of Large Language Models in Medicine: Principles, Applications, and Challenges

Large language models (LLMs), such as ChatGPT, have received substantial attention due to their capabilities for understanding and generating human language. LLMs in medicine to assist physicians for patient care are emerging as a promising research direction in both artificial intelligence and clinical medicine. This review provides a comprehensive overview of the principles, applications, and challenges faced by LLMs in medicine. We address the following specific questions: 1) How should medical LLMs be built? 2) What are the measures for the downstream performance of medical LLMs? 3) How should medical LLMs be utilized in real-world clinical practice? 4) What challenges arise from the use of medical LLMs? and 5) How should we better construct and utilize medical LLMs? This review aims to provide insights into the opportunities and challenges of LLMs in medicine, and serve as a practical resource for constructing effective medical LLMs. We also maintain and regularly updated list of practical guides on medical LLMs at https://github.com/AI-in-Health/MedLLMsPracticalGuide.