From “teaching by word and deed” to “intelligent mentorship”: ethical reconsiderations of AI-enabled medical education — lessons from China

Artificial intelligence (AI), as a major driving force of the Fourth Industrial Revolution, is profoundly reshaping the landscape of medical education. Driven by the extensive use of intelligent algorithms, big data analysis, and virtual simulation, a new "fourth-generation medical education" is taking shape, emphasizing health orientation, interdisciplinary integration, and intelligent empowerment. The application of AI in medical education significantly enhances instructional efficiency and personalization, advancing reforms in lesson planning, curriculum design, and virtual clinical simulation. However, an inherent tension exists between the humanistic nature of medical education and the mechanical logic of AI: its integration into teaching may cause alienation in teacher-student relationships, weakening of medical humanism, and ethical dilemmas such as algorithmic bias and privacy infringement. Taking China's medical education practices as an example, this paper systematically examines the ethical challenges of AI-enabled medical education and proposes a three-dimensional ethical reconstruction framework: (1) reshaping teacher-student relationships to preserve the balance between teaching and learning; (2) reinforcing medical humanism to safeguard the compassionate essence of education; and (3) improving ethical governance through coordinated efforts among government, society, hospitals, and universities. The sustainable development of AI-empowered medical education lies in upholding the moral essence of "humanity within intelligence," preserving the warmth of "teaching by word and deed" while integrating technological rationality with humanistic care.