Why LLMs Give In: Conversational Factors and Reasoning Behind Medical Sycophancy

arXiv:2608.01017 · cs.CL, cs.AI · Submitted 2026-08-02 · Read on arXiv

cs.CL, cs.AI

Submitted: 2026-08-02

Updated: 2026-08-31

Comments: 21 pages, 7 figures, 14 tables

License: http://arxiv.org/licenses/nonexclusive-distrib/1.0/

Terminology

• Sycophancy — 141× in this paper · explained in 4 episodes
• Grounding — 33× in this paper · explained in 3 episodes
• Trace — 21× in this paper · explained in 2 episodes
• Accuracy — 6× in this paper · explained in 1 episode
• Hallucination — 4× in this paper · explained in 3 episodes
• LLM judge — 4× in this paper · explained in 2 episodes
• Verification — 4× in this paper · explained in 2 episodes
• Benchmark — 3× in this paper · explained in 2 episodes
• Benchmarking — 2× in this paper · explained in 3 episodes
• Core — 2× in this paper · explained in 2 episodes
• Reasoning Traces — 2× in this paper · explained in 3 episodes
• Robustness — 2× in this paper · explained in 5 episodes
• Alignment — 1× in this paper · explained in 1 episode
• Chain-of-Thought Prompting — 1× in this paper · explained in 2 episodes
• Clustering — 1× in this paper · explained in 2 episodes
• Decode — 1× in this paper · explained in 2 episodes
• Failure Modes — 1× in this paper · explained in 3 episodes
• Generative AI — 1× in this paper · explained in 2 episodes
• LLM-as-a-Judge — 1× in this paper · explained in 3 episodes
• Personalization — 1× in this paper · explained in 2 episodes
• RAG — 1× in this paper · explained in 3 episodes
• Systematic Bias — 1× in this paper · explained in 3 episodes
• alpha — 1× in this paper · explained in 1 episode

Sources

• Intelligence Without Integrity: Why Capable LLMs May Undermine Reliability
• gpt-oss-120b & gpt-oss-20b Model Card
• Training language models to follow instructions with human feedback
• Measuring Faithfulness in Chain-of-Thought Reasoning
• Towards Understanding Sycophancy in Language Models
• Shallow Robustness, Deep Vulnerabilities: Multi-Turn Evaluation of Medical LLMs
• EchoBench: Benchmarking Sycophancy in Medical Large Vision-Language Models
• Sycophancy Is Not One Thing: Causal Separation of Sycophantic Behaviors in LLMs
• MedCaseReasoning: Evaluating and learning diagnostic reasoning from clinical case reports

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