During the last year the number of artificial intelligence (AI) anatomical and surgical images found in websites and social media (Facebook, Instagram, TikTok, etc.) has grown exponentially. The same has happened with posts and articles from so-called experts targeting the public, medical students, and health professionals. Unfortunately, many of these have glaring anatomical errors (1). The reason for this trend is an unscrupulous race to obtain an increased number of followers which leads to monetization of a website, posts, individuals, or groups.
The authors using AI prompts that create these images publish them as fast as they are produced without a thought as to the correctness of what’s being created by AI. Their followers, also without a thought or question of the content or image, like, share, copy and distribute these on the Internet. An example is the publication (now retracted) of rat stem cells using AI imagery. The image generated is of such bad taste, yet it was peer-reviewed and published. The image shows a rat with large genitalia. I cannot in good conscience publish the image here. For more information see “Sources” 2, 3 (a newspaper article on the problem), and the publisher's retraction.
Another glaring example is this video that shows the heart valves in action. It is not accurate. The movement and synchrony of the valves is wrong, they do not open, the pulmonary valve, which normally has three leaflets, shows four. The coronary arteries are in the wrong location and there an extra coronary on the right side. No one could live with that aortic valve. Yet, this image has 10.K likes and 2.5K shares! Ignorance is being shared. Just because it looks sexy, it does not mean that it is correct! (1).
The problem is that these websites and images are being used by health care professionals, students, and medical industry training groups without questioning the accuracy of the information being copied and redistributed externally and internally in training documents. This is not an uninformed statement. I have seen it personally, not in one, but in several companies.
The pressure that training groups in the medical arena and in other industries have is to reduce costs and training time. For those of you who know me and whom I have trained, you may recall how two decades ago training for a surgical devices representative could take six, ten weeks, and sometimes longer. I do know of one company that required a six-month internship before considering someone ready! Many of those who underwent this training are today in high-level corporate positions or by now have retired very well.
Today, the race is on to reduce face-to-face training time because it is perceived to be expensive, but the cost of poor and inaccurate training for a company is much, much more expensive! Other trends are the use of computer-based training (reduces cost), and reducing the amount of information passed on to the trainee (reduces time). The interesting situation here is that there are forces within these companies that are uninterested in learning more, just training enough to do a basic job.
Another alarming trend is that knowledge acquired in training is geared toward acing the internal tests (checking the boxes) and not necessarily geared toward working use of that knowledge when interacting with a medical professional.
The need to generate training material forces many to copy and paste images and concepts from the Internet. Just because a concept is available on the Internet does not make it correct. In fact, there are many reputable websites and books that have erroneous information. Here is an example from a medical devices company that shows “anatomical positions” (there is only one anatomical position) when the image should be labeled “surgical positions”. If you click on the image you will see a larger image with corrections.
The next image by a reputable medical illustrator shows the groups of ribs, but there is a mistake: False ribs are only 8 – 10, not 8-12! Yet this image is being used for training. I do not know if this image was incorrectly labeled by a third party.
I have seen many companies give a sales representative, manager, engineer, or other employee the responsibility to develop presentations and computer-based training, and what do they do? Go on the Internet for information. Here is where that computer acronym becomes a painful reality: GIGO “garbage in, garbage out”. For me, this is unacceptable, as this could affect a patient!
The only way to ensure the information is correct is to use an expert (but of course that’s not free). This leads to another problem: The Dunning-Kruger effect. This is a phenomenon where some people believe that they are much more competent, knowledgeable, or capable than they really are. Furthermore, they convince their peers and their company of it. David Dunning and Justin Kruger In their 1999 article coined the term “unskilled and unaware of it”, which is sadly becoming commonplace today.
Click for a larger image
Another example of these AI generated images is this view of the spine, spinal cord and spinal nerves and branches. The zygapophysial joints look fused (they are not), the dural (thecal) sac fills the vertebral canal (it does not), the spinal nerve and its branches are wrong. Interestingly, I did comment on the mistakes in the image to the author. The answer I received was: ”the more easy the illustration, the more the students will get into it. A complicated high info video may scare undergraduate freshers. That's why I post things in simple”. So, is it correct to teach something wrong? Call me old-fashioned, but I do not think so.
I could go on and on with these examples. Case in point: Image 1 is an AI generated image of the vagus nerve. It is wrong on so many levels! Contrast that with image 2, which is a public domain image from the 1794 “Tabulae Neurologicae” by Antonio Scarpa. The arrow shows the right vagus nerve.
Text available online should not be copied without ensuring that it is correct. An example: “The lungs are enclosed by the pleural sacs, which are attached to the mediastinum”. The first part is correct, each lung is contained in a separate pleural sac (only 86% of the time, the rest of us may have a communication between both pleural sacs). But the pleural sacs are not attached to the mediastinum! The mediastinum is a concept, the region between the pleural sacs, not a real structure.
Lastly, there are copyright issues where it has become so simple to highlight, copy, and paste that many do not think twice about using proprietary text and images without considering the consequences of this activity. One of the most used and abused books is Frank Netter’s Atlas of Human Anatomy. You can see it all over the Internet in posts that appear daily. This is a technique to increase traffic and clicks. Just because it was published in one of these social media posts, does not mean that we can freely use it in training materials. This abuse is rampant in social media where so-called experts copy and paste images from books and other websites.
Additionally, these deepfake "experts" are generating click-bait videos that use audio tracks (probably also AI generated from text) scaring and fooling people on social media.
The Internet is an extremely powerful tool, yet it is important to remember that not everything on the Internet is true, accurate, and readily available for copy and paste functions. Not all information should be believed at face value. I sincerely hope that this trend changes.
Why do I think this is so important? In the medical devices industry our first responsibility is to the patient and to be able to provide the best care. A healthy distrust of every bit of information we use, and investing time and resources to attain accuracy will help us toward this objective.
Following are some additional examples, some so fake as to be hilarious, but someone is watching them and believing what they are seeing and hearing.
The first video shows structures inferior to the transverse colon that do not exist, besides that, peristaltic movements are not like that... it looks more like heart contractions! The second video shows a moving thyroid gland and the vascular and nerve structures are all wrong! The third one is ridiculously wrong!! These videos hare captioned in Spanish, but you can find the same in any other language.
Personal note: I have purposely tried to avoid identifying individuals, websites, companies, etc. while writing this article. I have also decided to add this AI generated image to my list of pet peeves.
"The whole problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts.”
Bertrand Russel
Sources:
1. “It looks sexy, but it is wrong. Tensions in creativity and accuracy using genAi for biomedical visualization” Zimman, R; Saharan, S; McGill, G; Garrison, L. 2025 https://arxiv.org/pdf/2507.14494
2. “RETRACTED “Cellular functions of spermatogonial stem cells in relation to JAK/STAT signaling pathway” Guo,X; Dong, L; Hao, D. Frontiers in Cell and Developmental Biology. 2024 PDF Link here
3. “AI-generated nonsense about rat with giant penis published by leading scientific journal” The Telegraph, 2024.
4. “Emotionally unskilled, unaware, and uninterested in learning more: Reactions to feedback about deficits in emotional intelligence” Sheldon, O. J., Dunning, D., & Ames, D. R. (2014). Journal of Applied Psychology, 99(1), 125–137. https://doi.org/10.1037/a0034138
5. “Unskilled and unaware of it: How difficulties in recognizing one's own incompetence lead to inflated self-assessments” Kruger, J., & Dunning, D. (1999). Journal of Personality and Social Psychology, 77(6), 1121–1134. https://doi.org/10.1037/0022-3514.77.6.1121
6. “Chapter 5- The Dunning–Kruger Effect: On Being Ignorant of One's Own Ignorance” Olson, HM; Zanna, MP. Advances in Experimental Social Psychology (2011) – 44: 247-296 https://doi.org/10.1016/B978-0-12-385522-0.00005-6 (these are snippets, not the whole chapter)
7. "How people are being tricked by deepfake doctor videos on social media" New York Post July 17, 2024
8. "Positioning in Anesthesia and Surgery" Martin, JT; Warner, MA 3rd Ed. 1997 USA W.B. Saunders
9. https://elearningdoc.com/the-hidden-costs-of-inadequate-training/