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A Practical Framework for Evaluating Medical AI Security: Reproducible Assessment of Jailbreaking and Privacy Vulnerabilities Across Clinical Specialties

Authors: Jinghao Wang, Ping Zhang, Carter Yagemann

Published: 2025-12-09

arXiv ID: 2512.08185v1

Added to Library: 2025-12-10 03:01 UTC

Red Teaming

📄 Abstract

Medical Large Language Models (LLMs) are increasingly deployed for clinical decision support across diverse specialties, yet systematic evaluation of their robustness to adversarial misuse and privacy leakage remains inaccessible to most researchers. Existing security benchmarks require GPU clusters, commercial API access, or protected health data -- barriers that limit community participation in this critical research area. We propose a practical, fully reproducible framework for evaluating medical AI security under realistic resource constraints. Our framework design covers multiple medical specialties stratified by clinical risk -- from high-risk domains such as emergency medicine and psychiatry to general practice -- addressing jailbreaking attacks (role-playing, authority impersonation, multi-turn manipulation) and privacy extraction attacks. All evaluation utilizes synthetic patient records requiring no IRB approval. The framework is designed to run entirely on consumer CPU hardware using freely available models, eliminating cost barriers. We present the framework specification including threat models, data generation methodology, evaluation protocols, and scoring rubrics. This proposal establishes a foundation for comparative security assessment of medical-specialist models and defense mechanisms, advancing the broader goal of ensuring safe and trustworthy medical AI systems.

🔍 Key Points

  • The paper introduces a fully reproducible framework for assessing the security of medical AI systems against jailbreaking and privacy extraction attacks, targeting researchers with limited resources.
  • It categorizes attack vectors specific to multiple clinical specialties and organizes evaluations based on varying levels of clinical risk, enhancing the relevance of security assessments to real-world scenarios.
  • The framework utilizes synthetic patient data, eliminating the need for institutional review board (IRB) approval, thus making the methodology more accessible to researchers worldwide.
  • Standardized evaluation metrics such as Attack Success Rate (ASR) and structured statistical analysis provide a robust way to assess model vulnerabilities and compare different systems systematically.
  • By enabling wide participation in security assessments, the framework aims to accelerate advancements in ensuring the safety and reliability of medical AI applications.

💡 Why This Paper Matters

This paper is essential as it addresses a critical gap in the field of medical AI by providing an accessible and replicable framework for security assessment. Given the increasing prevalence of AI systems in healthcare, ensuring their robustness against adversarial attacks and privacy violations is paramount. The proposed framework not only democratizes access to security research but also lays the groundwork for future studies in medical AI safety, which is crucial for maintaining patient trust and safety in clinical settings.

🎯 Why It's Interesting for AI Security Researchers

The paper is of significant interest to AI security researchers as it directly tackles the pressing issues of robustness and privacy within medical AI systems. By offering a practical evaluation framework that can be utilized without expensive resources, it invites broader community engagement in the critical study of AI vulnerabilities. The framework's comprehensive approach to categorizing attacks across clinical specialties also presents a new dimension for evaluating and strengthening defenses against emerging threats, making it a vital resource for advancing AI security methodologies.

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