Abstract
BACKGROUND: Deepseek-R1, an open-source large language model (LLM), has generated significant global interest in the past months. OBJECTIVE: This study aimed to compare the performance of DeepSeek and OpenAI LLMs on the Chinese National Medical Licensing Examination (NMLE) and evaluate their potential in medical education. METHODS: This cross-sectional study assessed 2 DeepSeek models (DeepSeek-R1 and DeepSeek-V3), 3 OpenAI models (ChatGPT-o1 pro, ChatGPT-o3 mini, and GPT-4o), and 2 additional Chinese LLMs (ERNIE 4.5 Turbo and Qwen 3) using the 2021 NMLE. Model performance was evaluated based on overall accuracy, accuracy across question types (A1, A2, A3 and A4, and B1), case analysis and non-case analysis questions, medical specialties, and accuracy consensus between different model combinations. RESULTS: All LLMs successfully passed the NMLE. DeepSeek-R1 achieved the highest accuracy (573/597, 96%), followed by DeepSeek-V3 (558/600, 93%), both of which significantly outperformed ChatGPT-o1 pro (450/600, 75%), ChatGPT-o3 mini (455/600, 75.8%), and GPT-4o (452/600, 75.3%; P<.001 for all comparisons). Performance disparities were consistent across various question types (A1, A2, A3 and A4, and B1), case analysis and non-case analysis questions, different types of case analyses, and medical specialties. The accuracy consensus between DeepSeek-R1 and DeepSeek-V3 reached 97.7% (544/557), significantly outperforming DeepSeek-R1 alone (P=.04). Two additional Chinese LLMs, ERNIE 4.5 Turbo (572/600, 95.3%) and Qwen 3 (555/600, 92.5%), also exhibited significantly better performance compared to the 3 OpenAI models (all P<.001). CONCLUSIONS: This study demonstrates that DeepSeek-R1 and DeepSeek-V3 significantly outperform OpenAI models on the NMLE. DeepSeek models show promise as tools for medical education and exam preparation in the Chinese language.