Anila Jaleel
Rashid Aziz
Ghulam Farid
Muhammad Zahid Bashir1- 1Shalamar Medical and Dental College, Lahore, Pakistan
- 2Altamont Group, Shalamar Medical and Dental College, Dubai, United Arab Emirates
Introduction
The integration of artificial intelligence (AI) in education varies significantly across the globe, influenced by factors such as technological infrastructure, economic development, and policy frameworks. In developed nations, AI is increasingly utilized to personalize learning experiences, automate administrative tasks, and enhance educational outcomes. For instance, the global AI in education market was valued at approximately $2.5 billion in 2022 and is projected to reach $6 billion by 2025, reflecting substantial investments in AI-driven educational technologies (Khurshid et al., 2024). In contrast, developing countries face challenges in adopting AI in education due to limited resources (Wang et al., 2023), inadequate infrastructure, and a shortage of skilled personnel. Despite these obstacles, AI holds potential to address educational disparities by providing personalized learning and overcoming financial and technological divides. The World Economic Forum highlights AI's capacity to transform education systems globally, emphasizing its role in creating more inclusive and effective learning environments (Mikeladze et al., 2024).
Rapid innovation in digital technology has revolutionized the learning process not only in developed but also in developing countries. Teachers and supervisors now act as facilitators and mentors. While AI has positively impacted medical education—supporting clinical case development, course design, virtual patients, and assistance, it also challenges academic integrity, especially in developing countries (Khan et al., 2023). Ensuring adherence to ethical codes and principles, such as honesty, trust, fairness, respect, and responsibility, is increasingly difficult, threatening the credibility of educational institutions and the value of their credentials (Rane N. L. et al., 2024). The widespread use of ChatGPT by undergraduate and postgraduate students for seeking response to questions through ChatGPT rather using authentic sources like textbooks or journal articles has raised concerns about maintaining academic integrity in learning and writing (Rane N. et al., 2024). This presents a significant challenge for educators, who must design higher-order thinking questions and develop fair assessment methods in the digital era. Equally important is teaching students to use tools like ChatGPT constructively in their learning process. ChatGPT offer diverse applications in medical education, including generating clinical case studies, acting as virtual test subjects or patients, facilitating research, developing course plans, and providing personalized feedback (Abd-Alrazaq et al., 2023). However, their integration poses significant challenges, such as plagiarism, misinformation, overreliance, inequity, privacy concerns, and copyright issues. Transitioning medical education from an information-driven model to an AI-driven approach requires addressing these challenges. This study analyzes the opportunities and challenges faced by faculty and students in developing countries and outlines future directions for evidence-based best practices (Hadi et al., 2023).
In November 2024, we reviewed 30 studies in English language highlighting the use of ChatGPT in developing countries and extracted data from 18 peer reviewed studies that focused on opportunities and challenges related to AI in developing countries. Studies in English language from year 2023 and 2024 were included while those in language other than English and before 2023 were excluded. The data was extracted from sources like PubMed, Web of Science, Elsevier, and Google Scholar, with keywords such as academic integrity, opportunities, challenges, limitations, AI, ChatGPT, and language models. Data extraction was conducted by three independent reviewers, with consensus achieved through discussion to minimize bias. The extracted data was analyzed using NVIVO, which transcribed the information and identified key themes and subthemes (Table 1).
Table 1. Summary of the published studies from developing countries.
Opportunities of LLMs for faculty and students in developing countries
World bank classifies the low income and low middle income countries based on gross national income (GNI) of 1025$ or less and 1026 to 4135$ respectively. These both are included in developing countries (World Bank, 2025).
Accessibility
In developing countries, low literacy rates are often linked to the high cost of private education, which remains unaffordable for middle- and low-income citizens. Post-COVID-19 inflation has further strained economies, shifting national priorities toward economic survival over education and health (World Bank, 2025). As a result, many children remain out of school. ChatGPT and similar AI models offer a potential solution by enabling the development of digital education models, allowing students to access basic education from home through online courses. For educators, ChatGPT can assist in creating course frameworks, making educational content development more efficient. Additionally, the ease of access to information provided by these tools can foster greater awareness, enabling societies to pool resources and address community needs effectively.
Curriculum development and implementation
Advancements in AI technology have transformed the need for curriculum reform and implementation strategies, particularly in medical education. AI tools like ChatGPT facilitate curriculum development by streamlining tasks such as creating assessment tools (e.g., Multiple choice questions (MCQs) and Short essay questions (SEQs), designing Objective structured clinical examinations (OSCE), validating assessment methods, and simplifying curriculum implementation (Sengupta et al., 2024). To maximize the benefits of these tools, faculty should integrate them into academic sessions, enabling students to enhance their knowledge and skills more efficiently. This calls for a reorganization of teaching and learning strategies to align with technological advancements, ensuring students can fully leverage the potential of AI in their education.
Independent and self-paced learning
AI tools like ChatGPT enable students to learn at their own pace and according to their individual capabilities, addressing differences in learning styles without requiring significant financial investment (Hunaepi and Suharta, 2024). This approach promotes a culture of self-directed learning, as advocated by medical educationists globally (Figure 1). Medical schools can integrate hybrid teaching models—combining asynchronous and synchronous methods—to leverage digital technology for both learning and assessment. These models create a more conducive learning environment while simultaneously reducing the overall cost of education.
Figure 1. Conceptual impact of digital technology. (A) Pre-ChatGPT use learning environment. (B) Post-ChatGPT use learning environment.
Healthcare
AI technology has revolutionized access to healthcare in underserved rural areas through telemedicine, bridging gaps where physical medical facilities are unavailable. Previously, patients in these areas faced high mortality rates from manageable illnesses due to lack of access to care. AI-driven digital technology now offers preventive measures and improved health outcomes. Additionally, telemedicine provides job opportunities for doctors who cannot operate physical clinics, allowing them to serve as a valuable resource for patients in remote areas (Mogavi et al., 2024).
Promoting research
The developing world lags behind developed countries in generating and pursuing novel research ideas, often replicating studies conducted in Western countries rather than fostering original research tailored to local populations. This occurs due to lack of technology and research driven policies, which is dependent on provision of resources. Resources depends on economy which cannot be afforded by these countries due to poverty. This limits capacity-building among youth and stifles innovation, which could otherwise contribute to economic growth. AI technology, such as ChatGPT, can help bridge this gap by facilitating the generation of innovative ideas. By promoting a culture of creativity and original research, AI empowers individuals, institutions, and societies to pursue projects that are both locally relevant and globally impactful (Thacharodi et al., 2024).
Challenges and possible solutions
Plagiarism and originality
The rising use of AI tools by students poses dual challenge to maintain academic integrity and originality. Although it aids students to bridge the gap of under resource to education in these counties, however some institutes lack the facility to detect AI generated texts and the faculty is also not trained to detect plagiarism in assignments, exams, research, and data manipulation, posing serious threats to academic honesty and integrity. The solution is not to restrict AI usage but to integrate digital technology into curricula, along with robust implementation and assessment tools (Mhlanga, 2023a).
Critical thinking
Over-reliance on AI for simple tasks, such as drafting applications, or emails, is diminishing students' critical thinking skills. Many students have become adept at generating AI prompts and copying results without evaluation. This replaces active intellectual engagement to solve problems with quick pre-formulated outputs without logic and analysis by the students. This has led to proficiency over depth. This may cause students to by-pass the process of thinking, analysis and original constructs generation in developing countries where rote learning is already in place. This could undermine their ability to think independently, innovate and adapt to real world challenges. To address this issue the students and faculty should be trained to critically analyze and review AI outputs, ensuring they refine and validate the content before using it in their academic work (Almatrafi et al., 2024).
Verification and authentication
Institutions face challenges in verifying the authenticity of students' work as AI becomes increasingly integrated into learning. Advanced tools like text generators, coding assistants and algorithms may mimic human originality which is difficult to detect. AI detection tolls also lack reliability as false negatives and biases against non-native English. This can be mitigated by establishing clear policies and guidelines for AI use in academics, applicable at both national and international levels. The faculty should be trained to detect the style of writing and encourage students to do more class work, flipped classrooms and viva examinations so as to verify what they have learnt. This can be mitigated by establishing clear policies and guidelines for AI use in academics, applicable at both national and international levels (Rane N. L. et al., 2024; Rane N. et al., 2024).
Cultural and socioeconomic factors
The introduction of AI bring trans formative changes in health, education and governance in developing countries but its adaption is restricted by multiple challenges regarding cultural attitudes and resource inequities. AI integration is limited in some countries due to language barrier as AI is mostly in English language limiting its use in these countries. Limited digital infrastructure, internet connectivity and limited data storage capacity also add to the challenges (Parker et al., 2024; Sozon et al., 2024). Limited resources and high publication costs often forces faculty and students to cover expenses themselves, leading to practices like gifted authorship to share resources,. Addressing these issues require systemic changes to foster equitable access to academic resources and support. Developing countries should focus on home ground AI development according to their cultural and socioeconomic needs (Figure 2).
Figure 2. Pictorial view in tabulated form of challenges and opportunities in use of AI digital technology (ChatGPT) in developing countries. This figure shows the pictorial representation and tabulated form of summary of opportunities and challenges of use of ChatGPT as discussed in 18 extracted studies on it.
Conclusion
Although AI tools like ChatGPT present significant opportunities for faculty and students, but also poses challenges to academic integrity in developing countries. The key lies in developing international policies and guidelines to ensure safe and effective use. Integrating digital technology into medical curricula and redesigning teaching sessions can help students leverage these tools responsibly. While concerns about plagiarism and over-reliance persist, strategic measures and responsible use can allow educational institutions to enhance learning while upholding academic integrity.
Recommendations
Establish Clear Guidelines: Educational institutions should create clear, internationally standardized policies outlining the permissible use of AI tools like ChatGPT. These guidelines should be binding and enforceable across institutions.
• Redefine Authorship and Compliance: Authorship standards for publications should be redefined, including legal implications for non-compliance. Institutions should also set limits on AI usage for manuscript writing.
• Integrate AI into Learning Sessions: Incorporate AI tools into student learning activities, such as small group discussions and project-based learning. Redesign teaching sessions to promote the effective and ethical use of AI technology.
• Implement AI Plagiarism Detection Tools: Make AI plagiarism detection software widely available, requiring all institutions to use it for assignments and academic writing.
• Conduct Training Programs: Organize seminars and workshops for faculty and students to promote the ethical use of AI tools and raise awareness about academic integrity.
• Engage Stakeholders: Involve all stakeholders in discussions about AI technology to address its challenges and benefits. This collective effort will enhance awareness and help maintain academic integrity.
• Clinical trial number: not applicable.
Author contributions
AJ: Conceptualization, Visualization, Writing – original draft, Writing – review & editing. RA: Data curation, Formal analysis, Writing – original draft, Writing – review & editing. GF: Data curation, Formal analysis, Writing – original draft, Writing – review & editing. MZB: Resources, Supervision, Validation, Writing – original draft, Writing – review & editing.
Funding
The author(s) declare that no financial support was received for the research and/or publication of this article.
Acknowledgments
We owe thanks to administration Shalamar Medical and Dental College for supporting the research culture at the institute.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Generative AI statement
The author(s) declare that no Gen AI was used in the creation of this manuscript.
Publisher's note
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Keywords: ChatGPT, academic integrity, plagiarism, curriculum, medical education
Citation: Jaleel A, Aziz R, Farid G and Bashir MZ (2025) The impact of ChatGPT on academic integrity in medical education: a developing nation perspective. Front. Educ. 10:1554444. doi: 10.3389/feduc.2025.1554444
Received: 20 January 2025; Accepted: 25 April 2025;
Published: 21 May 2025.
Edited by:
Paraskevi Papadopoulou, American College of Greece, GreeceReviewed by:
Wright Jacob, King's College London, United KingdomAkbar Akbar, State Islamic Institute of Palopo, Indonesia
Copyright © 2025 Jaleel, Aziz, Farid and Bashir. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Anila Jaleel, YW5pbGFqYWxlZWxAZ21haWwuY29t