Daily Papers

Multi-document (MD) processing is crucial for LLMs to handle real-world tasks such as summarization and question-answering across large sets of documents. While LLMs have improved at processing long inputs, MD contexts still present challenges, such as managing inter-document dependencies, redundancy, and incoherent structures. We introduce MDCure, a scalable and effective fine-tuning pipeline to enhance the MD capabilities of LLMs without the computational cost of pre-training or reliance on human annotated data. MDCure is based on generation of high-quality synthetic MD instruction data from sets of related articles via targeted prompts. We further introduce MDCureRM, a multi-objective reward model which filters generated data based on their training utility for MD settings. With MDCure, we fine-tune a variety of LLMs, from the FlanT5, Qwen2, and LLAMA3.1 model families, up to 70B parameters in size. Extensive evaluations on a wide range of MD and long-context benchmarks spanning various tasks show MDCure consistently improves performance over pre-trained baselines and over corresponding base models by up to 75.5%. Our code, datasets, and models are available at https://github.com/yale-nlp/MDCure.

Table reasoning is a challenging task that requires understanding both natural language questions and structured tabular data. Large language models (LLMs) have shown impressive capabilities in natural language understanding and generation, but they often struggle with large tables due to their limited input length. In this paper, we propose TabSQLify, a novel method that leverages text-to-SQL generation to decompose tables into smaller and relevant sub-tables, containing only essential information for answering questions or verifying statements, before performing the reasoning task. In our comprehensive evaluation on four challenging datasets, our approach demonstrates comparable or superior performance compared to prevailing methods reliant on full tables as input. Moreover, our method can reduce the input context length significantly, making it more scalable and efficient for large-scale table reasoning applications. Our method performs remarkably well on the WikiTQ benchmark, achieving an accuracy of 64.7%. Additionally, on the TabFact benchmark, it achieves a high accuracy of 79.5%. These results surpass other LLM-based baseline models on gpt-3.5-turbo (chatgpt). TabSQLify can reduce the table size significantly alleviating the computational load on LLMs when handling large tables without compromising performance.

Recent advancements in large language models (LLMs) have expanded their capabilities beyond traditional text-based tasks to multimodal domains, integrating visual, auditory, and textual data. While multimodal LLMs have been extensively explored for high-level planning in domains like robotics and games, their potential as low-level controllers remains largely untapped. This paper explores the application of multimodal LLMs as low-level controllers in the domain of Atari video games, introducing Atari game performance as a new benchmark for evaluating the ability of multimodal LLMs to perform low-level control tasks. Unlike traditional reinforcement learning (RL) and imitation learning (IL) methods that require extensive computational resources as well as reward function specification, these LLMs utilize pre-existing multimodal knowledge to directly engage with game environments. Our study assesses multiple multimodal LLMs performance against traditional RL agents, human players, and random agents, focusing on their ability to understand and interact with complex visual scenes and formulate strategic responses. Additionally, we examine the impact of In-Context Learning (ICL) by incorporating human-demonstrated game-play trajectories to enhance the models contextual understanding. Through this investigation, we aim to determine the extent to which multimodal LLMs can leverage their extensive training to effectively function as low-level controllers, thereby redefining potential applications in dynamic and visually complex environments. Additional results and videos are available at our project webpage: https://sites.google.com/view/atari-gpt/.

Language models demonstrate both quantitative improvement and new qualitative capabilities with increasing scale. Despite their potentially transformative impact, these new capabilities are as yet poorly characterized. In order to inform future research, prepare for disruptive new model capabilities, and ameliorate socially harmful effects, it is vital that we understand the present and near-future capabilities and limitations of language models. To address this challenge, we introduce the Beyond the Imitation Game benchmark (BIG-bench). BIG-bench currently consists of 204 tasks, contributed by 442 authors across 132 institutions. Task topics are diverse, drawing problems from linguistics, childhood development, math, common-sense reasoning, biology, physics, social bias, software development, and beyond. BIG-bench focuses on tasks that are believed to be beyond the capabilities of current language models. We evaluate the behavior of OpenAI's GPT models, Google-internal dense transformer architectures, and Switch-style sparse transformers on BIG-bench, across model sizes spanning millions to hundreds of billions of parameters. In addition, a team of human expert raters performed all tasks in order to provide a strong baseline. Findings include: model performance and calibration both improve with scale, but are poor in absolute terms (and when compared with rater performance); performance is remarkably similar across model classes, though with benefits from sparsity; tasks that improve gradually and predictably commonly involve a large knowledge or memorization component, whereas tasks that exhibit "breakthrough" behavior at a critical scale often involve multiple steps or components, or brittle metrics; social bias typically increases with scale in settings with ambiguous context, but this can be improved with prompting.

Arabic, with its rich diversity of dialects, remains significantly underrepresented in Large Language Models, particularly in dialectal variations. We address this gap by introducing seven synthetic datasets in dialects alongside Modern Standard Arabic (MSA), created using Machine Translation (MT) combined with human post-editing. We present AraDiCE, a benchmark for Arabic Dialect and Cultural Evaluation. We evaluate LLMs on dialect comprehension and generation, focusing specifically on low-resource Arabic dialects. Additionally, we introduce the first-ever fine-grained benchmark designed to evaluate cultural awareness across the Gulf, Egypt, and Levant regions, providing a novel dimension to LLM evaluation. Our findings demonstrate that while Arabic-specific models like Jais and AceGPT outperform multilingual models on dialectal tasks, significant challenges persist in dialect identification, generation, and translation. This work contributes ~45K post-edited samples, a cultural benchmark, and highlights the importance of tailored training to improve LLM performance in capturing the nuances of diverse Arabic dialects and cultural contexts. We will release the dialectal translation models and benchmarks curated in this study.

Recent advancements in protein structure determination are revolutionizing our understanding of proteins. Still, a significant gap remains in the availability of comprehensive datasets that focus on the dynamics of proteins, which are crucial for understanding protein function, folding, and interactions. To address this critical gap, we introduce mdCATH, a dataset generated through an extensive set of all-atom molecular dynamics simulations of a diverse and representative collection of protein domains. This dataset comprises all-atom systems for 5,398 domains, modeled with a state-of-the-art classical force field, and simulated in five replicates each at five temperatures from 320 K to 413 K. The mdCATH dataset records coordinates and forces every 1 ns, for over 62 ms of accumulated simulation time, effectively capturing the dynamics of the various classes of domains and providing a unique resource for proteome-wide statistical analyses of protein unfolding thermodynamics and kinetics. We outline the dataset structure and showcase its potential through four easily reproducible case studies, highlighting its capabilities in advancing protein science.

Large Language Models (LLMs) have transformed software development and automated code generation. Motivated by these advancements, this paper explores the feasibility of LLMs in modifying malware source code to generate variants. We introduce LLMalMorph, a semi-automated framework that leverages semantical and syntactical code comprehension by LLMs to generate new malware variants. LLMalMorph extracts function-level information from the malware source code and employs custom-engineered prompts coupled with strategically defined code transformations to guide the LLM in generating variants without resource-intensive fine-tuning. To evaluate LLMalMorph, we collected 10 diverse Windows malware samples of varying types, complexity and functionality and generated 618 variants. Our thorough experiments demonstrate that it is possible to reduce the detection rates of antivirus engines of these malware variants to some extent while preserving malware functionalities. In addition, despite not optimizing against any Machine Learning (ML)-based malware detectors, several variants also achieved notable attack success rates against an ML-based malware classifier. We also discuss the limitations of current LLM capabilities in generating malware variants from source code and assess where this emerging technology stands in the broader context of malware variant generation.

Large Language Models (LLMs) exhibit impressive capabilities, but remain susceptible to a growing spectrum of safety risks, including jailbreaks, toxic content, hallucinations, and bias. Existing defenses often address only a single threat type or resort to rigid outright rejection, sacrificing user experience and failing to generalize across diverse and novel attacks. This paper introduces Adversarial Scenario Extrapolation (ASE), a novel inference-time computation framework that leverages Chain-of-Thought (CoT) reasoning to simultaneously enhance LLM robustness and seamlessness. ASE guides the LLM through a self-generative process of contemplating potential adversarial scenarios and formulating defensive strategies before generating a response to the user query. Comprehensive evaluation on four adversarial benchmarks with four latest LLMs shows that ASE achieves near-zero jailbreak attack success rates and minimal toxicity, while slashing outright rejections to <4%. ASE outperforms six state-of-the-art defenses in robustness-seamlessness trade-offs, with 92-99% accuracy on adversarial Q&A and 4-10x lower bias scores. By transforming adversarial perception into an intrinsic cognitive process, ASE sets a new paradigm for secure and natural human-AI interaction.

Large Language Models (LLM) with reasoning capabilities offer a promising path for improving candidate evaluation in planning frameworks, but their relative performance against traditional non-reasoning models remains largely underexplored. In this study, we benchmark a distilled 1.5B parameter reasoning model (DeepSeek-R1) against several state-of-the-art non-reasoning LLMs within a generator-discriminator LLM planning framework for the text-to-SQL task. For this, we introduce a novel method for extracting soft scores from the chain-of-thought (CoT) outputs from reasoning that enables fine-grained ranking of candidates. Our central hypothesis is that reasoning models are more effective discriminators than non-reasoning LLMs. Our results show that distilled DeepSeek-R1-1.5B achieves up to 87% higher F1 and 3.7% better discrimination accuracy than CodeLlama-7B, as well as 3.7% higher execution accuracy than CodeLlama-13B, despite having significantly fewer parameters. Furthermore, we find that there is a limit to the logical capabilities of reasoning models, and only providing more context or allowing more compute budget for reasoning is not enough to improve their discrimination performance. Finally, we demonstrate that, unlike non-reasoning LLMs, reasoning models find generation more challenging than discrimination and may underperform as generators compared to smaller non-reasoning LLMs. Our work highlights the potential of reasoning models as discriminators in agentic frameworks, far outweighing their capabilities as generators, offering insights into their optimal role within LLM planning infrastructures.

Machine learning (ML) models frequently rely on training data that may include sensitive or personal information, raising substantial privacy concerns. Legislative frameworks such as the General Data Protection Regulation (GDPR) and the California Consumer Privacy Act (CCPA) have necessitated the development of strategies that preserve privacy while maintaining the utility of data. In this paper, we investigate the capability of Large Language Models (LLMs) to generate synthetic datasets integrated with Differential Privacy (DP) mechanisms, thereby enabling data-driven research and model training without direct exposure of sensitive information. Our approach incorporates DP-based noise injection methods, including Laplace and Gaussian distributions, into the data generation process. We then evaluate the utility of these DP-enhanced synthetic datasets by comparing the performance of ML models trained on them against models trained on the original data. To substantiate privacy guarantees, we assess the resilience of the generated synthetic data to membership inference attacks and related threats. The experimental results demonstrate that integrating DP within LLM-driven synthetic data generation offers a viable balance between privacy protection and data utility. This study provides a foundational methodology and insight into the privacy-preserving capabilities of LLMs, paving the way for compliant and effective ML research and applications.

Large language models (LLMs) are renowned for their exceptional capabilities, and applying to a wide range of applications. However, this widespread use brings significant vulnerabilities. Also, it is well observed that there are huge gap which lies in the need for effective detection and mitigation strategies against malicious prompt injection attacks in large language models, as current approaches may not adequately address the complexity and evolving nature of these vulnerabilities in real-world applications. Therefore, this work focuses the impact of malicious prompt injection attacks which is one of most dangerous vulnerability on real LLMs applications. It examines to apply various BERT (Bidirectional Encoder Representations from Transformers) like multilingual BERT, DistilBert for classifying malicious prompts from legitimate prompts. Also, we observed how tokenizing the prompt texts and generating embeddings using multilingual BERT contributes to improve the performance of various machine learning methods: Gaussian Naive Bayes, Random Forest, Support Vector Machine, and Logistic Regression. The performance of each model is rigorously analyzed with various parameters to improve the binary classification to discover malicious prompts. Multilingual BERT approach to embed the prompts significantly improved and outperformed the existing works and achieves an outstanding accuracy of 96.55% by Logistic regression. Additionally, we investigated the incorrect predictions of the model to gain insights into its limitations. The findings can guide researchers in tuning various BERT for finding the most suitable model for diverse LLMs vulnerabilities.

The rapid advancement and widespread deployment of foundation model (FM) based systems have revolutionized numerous applications across various domains. However, the fast-growing capabilities and autonomy have also raised significant concerns about responsible AI and AI safety. Recently, there have been increasing attention toward implementing guardrails to ensure the runtime behavior of FM-based systems is safe and responsible. Given the early stage of FMs and their applications (such as agents), the design of guardrails have not yet been systematically studied. It remains underexplored which software qualities should be considered when designing guardrails and how these qualities can be ensured from a software architecture perspective. Therefore, in this paper, we present a taxonomy for guardrails to classify and compare the characteristics and design options of guardrails. Our taxonomy is organized into three main categories: the motivation behind adopting runtime guardrails, the quality attributes to consider, and the design options available. This taxonomy provides structured and concrete guidance for making architectural design decisions when designing guardrails and highlights trade-offs arising from the design decisions.

Natural Question Answering (QA) datasets play a crucial role in evaluating the capabilities of large language models (LLMs), ensuring their effectiveness in real-world applications. Despite the numerous QA datasets that have been developed, there is a notable lack of region-specific datasets generated by native users in their own languages. This gap hinders the effective benchmarking of LLMs for regional and cultural specificities. Furthermore, it also limits the development of fine-tuned models. In this study, we propose a scalable, language-independent framework, NativQA, to seamlessly construct culturally and regionally aligned QA datasets in native languages, for LLM evaluation and tuning. We demonstrate the efficacy of the proposed framework by designing a multilingual natural QA dataset, \mnqa, consisting of ~64k manually annotated QA pairs in seven languages, ranging from high to extremely low resource, based on queries from native speakers from 9 regions covering 18 topics. We benchmark open- and closed-source LLMs with the MultiNativQA dataset. We also showcase the framework efficacy in constructing fine-tuning data especially for low-resource and dialectally-rich languages. We made both the framework NativQA and MultiNativQA dataset publicly available for the community (https://nativqa.gitlab.io).

Decoder-only Transformers often struggle with complex reasoning tasks, particularly arithmetic reasoning requiring multiple sequential operations. In this work, we identify representation collapse in the model's intermediate layers as a key factor limiting their reasoning capabilities. To address this, we propose Sequential Variance-Covariance Regularization (Seq-VCR), which enhances the entropy of intermediate representations and prevents collapse. Combined with dummy pause tokens as substitutes for chain-of-thought (CoT) tokens, our method significantly improves performance in arithmetic reasoning problems. In the challenging 5 times 5 integer multiplication task, our approach achieves 99.5% exact match accuracy, outperforming models of the same size (which yield 0% accuracy) and GPT-4 with five-shot CoT prompting (44%). We also demonstrate superior results on arithmetic expression and longest increasing subsequence (LIS) datasets. Our findings highlight the importance of preventing intermediate layer representation collapse to enhance the reasoning capabilities of Transformers and show that Seq-VCR offers an effective solution without requiring explicit CoT supervision.

Large Language Models (LLMs) have recently gained significant attention due to their remarkable capabilities in performing diverse tasks across various domains. However, a thorough evaluation of these models is crucial before deploying them in real-world applications to ensure they produce reliable performance. Despite the well-established importance of evaluating LLMs in the community, the complexity of the evaluation process has led to varied evaluation setups, causing inconsistencies in findings and interpretations. To address this, we systematically review the primary challenges and limitations causing these inconsistencies and unreliable evaluations in various steps of LLM evaluation. Based on our critical review, we present our perspectives and recommendations to ensure LLM evaluations are reproducible, reliable, and robust.

Radiology plays a pivotal role in modern medicine due to its non-invasive diagnostic capabilities. However, the manual generation of unstructured medical reports is time consuming and prone to errors. It creates a significant bottleneck in clinical workflows. Despite advancements in AI-generated radiology reports, challenges remain in achieving detailed and accurate report generation. In this study we have evaluated different combinations of multimodal models that integrate Computer Vision and Natural Language Processing to generate comprehensive radiology reports. We employed a pretrained Vision Transformer (ViT-B16) and a SWIN Transformer as the image encoders. The BART and GPT-2 models serve as the textual decoders. We used Chest X-ray images and reports from the IU-Xray dataset to evaluate the usability of the SWIN Transformer-BART, SWIN Transformer-GPT-2, ViT-B16-BART and ViT-B16-GPT-2 models for report generation. We aimed at finding the best combination among the models. The SWIN-BART model performs as the best-performing model among the four models achieving remarkable results in almost all the evaluation metrics like ROUGE, BLEU and BERTScore.

Pruning refers to the elimination of trivial weights from neural networks. The sub-networks within an overparameterized model produced after pruning are often called Lottery tickets. This research aims to generate winning lottery tickets from a set of lottery tickets that can achieve similar accuracy to the original unpruned network. We introduce a novel winning ticket called Cyclic Overlapping Lottery Ticket (COLT) by data splitting and cyclic retraining of the pruned network from scratch. We apply a cyclic pruning algorithm that keeps only the overlapping weights of different pruned models trained on different data segments. Our results demonstrate that COLT can achieve similar accuracies (obtained by the unpruned model) while maintaining high sparsities. We show that the accuracy of COLT is on par with the winning tickets of Lottery Ticket Hypothesis (LTH) and, at times, is better. Moreover, COLTs can be generated using fewer iterations than tickets generated by the popular Iterative Magnitude Pruning (IMP) method. In addition, we also notice COLTs generated on large datasets can be transferred to small ones without compromising performance, demonstrating its generalizing capability. We conduct all our experiments on Cifar-10, Cifar-100 & TinyImageNet datasets and report superior performance than the state-of-the-art methods.

The large-scale deployment of Solidity smart contracts on the Ethereum mainnet has increasingly attracted financially-motivated attackers in recent years. A few now-infamous attacks in Ethereum's history includes DAO attack in 2016 (50 million dollars lost), Parity Wallet hack in 2017 (146 million dollars locked), Beautychain's token BEC in 2018 (900 million dollars market value fell to 0), and NFT gaming blockchain breach in 2022 ($600 million in Ether stolen). This paper presents a comprehensive investigation of the use of large language models (LLMs) and their capabilities in detecting OWASP Top Ten vulnerabilities in Solidity. We introduce a novel, class-balanced, structured, and labeled dataset named VulSmart, which we use to benchmark and compare the performance of open-source LLMs such as CodeLlama, Llama2, CodeT5 and Falcon, alongside closed-source models like GPT-3.5 Turbo and GPT-4o Mini. Our proposed SmartVD framework is rigorously tested against these models through extensive automated and manual evaluations, utilizing BLEU and ROUGE metrics to assess the effectiveness of vulnerability detection in smart contracts. We also explore three distinct prompting strategies-zero-shot, few-shot, and chain-of-thought-to evaluate the multi-class classification and generative capabilities of the SmartVD framework. Our findings reveal that SmartVD outperforms its open-source counterparts and even exceeds the performance of closed-source base models like GPT-3.5 and GPT-4 Mini. After fine-tuning, the closed-source models, GPT-3.5 Turbo and GPT-4o Mini, achieved remarkable performance with 99% accuracy in detecting vulnerabilities, 94% in identifying their types, and 98% in determining severity. Notably, SmartVD performs best with the `chain-of-thought' prompting technique, whereas the fine-tuned closed-source models excel with the `zero-shot' prompting approach.

The recent advancements of Small Language Models (SLMs) have opened new possibilities for efficient code generation. SLMs offer lightweight and cost-effective alternatives to Large Language Models (LLMs), making them attractive for use in resource-constrained environments. However, empirical understanding of SLMs, particularly their capabilities, limitations, and performance trade-offs in code generation remains limited. This study presents a comprehensive empirical evaluation of 20 open-source SLMs ranging from 0.4B to 10B parameters on five diverse code-related benchmarks (HumanEval, MBPP, Mercury, HumanEvalPack, and CodeXGLUE). The models are assessed along three dimensions: i) functional correctness of generated code, ii) computational efficiency and iii) performance across multiple programming languages. The findings of this study reveal that several compact SLMs achieve competitive results while maintaining a balance between performance and efficiency, making them viable for deployment in resource-constrained environments. However, achieving further improvements in accuracy requires switching to larger models. These models generally outperform their smaller counterparts, but they require much more computational power. We observe that for 10% performance improvements, models can require nearly a 4x increase in VRAM consumption, highlighting a trade-off between effectiveness and scalability. Besides, the multilingual performance analysis reveals that SLMs tend to perform better in languages such as Python, Java, and PHP, while exhibiting relatively weaker performance in Go, C++, and Ruby. However, statistical analysis suggests these differences are not significant, indicating a generalizability of SLMs across programming languages. Based on the findings, this work provides insights into the design and selection of SLMs for real-world code generation tasks.

Process or step-wise supervision has played a crucial role in advancing complex multi-step reasoning capabilities of Large Language Models (LLMs). However, efficient, high-quality automated process annotation remains a significant challenge. To address this, we introduce Single-Pass Annotation with Reference-Guided Evaluation (SPARE), a novel structured framework that enables single-pass, per-step annotation by aligning each solution step to one or multiple steps in a reference solution, accompanied by explicit reasoning for evaluation. We show that reference-guided step-level evaluation effectively facilitates process supervision on four datasets spanning three domains: mathematical reasoning, multi-hop compositional question answering, and spatial reasoning. We demonstrate that SPARE, when compared to baselines, improves reasoning performance when used for: (1) fine-tuning models in an offline RL setup for inference-time greedy-decoding, and (2) training reward models for ranking/aggregating multiple LLM-generated outputs. Additionally, SPARE achieves competitive performance on challenging mathematical datasets while offering 2.6 times greater efficiency, requiring only 38% of the runtime, compared to tree search-based automatic annotation. The codebase, along with a trained SPARE-PRM model, is publicly released to facilitate further research and reproducibility.

This paper presents an experience report on the development of Retrieval Augmented Generation (RAG) systems using PDF documents as the primary data source. The RAG architecture combines generative capabilities of Large Language Models (LLMs) with the precision of information retrieval. This approach has the potential to redefine how we interact with and augment both structured and unstructured knowledge in generative models to enhance transparency, accuracy, and contextuality of responses. The paper details the end-to-end pipeline, from data collection, preprocessing, to retrieval indexing and response generation, highlighting technical challenges and practical solutions. We aim to offer insights to researchers and practitioners developing similar systems using two distinct approaches: OpenAI's Assistant API with GPT Series and Llama's open-source models. The practical implications of this research lie in enhancing the reliability of generative AI systems in various sectors where domain-specific knowledge and real-time information retrieval is important. The Python code used in this work is also available at: https://github.com/GPT-Laboratory/RAG-LLM-Development-Guidebook-from-PDFs.

In recent years, Large Language Models (LLMs) have demonstrated remarkable capabilities in parsing textual data and generating code. However, their performance in tasks involving tabular data, especially those requiring symbolic reasoning, faces challenges due to the structural variance and inconsistency in table cell values often found in web tables. In this paper, we introduce NormTab, a novel framework aimed at enhancing the symbolic reasoning performance of LLMs by normalizing web tables. We study table normalization as a stand-alone, one-time preprocessing step using LLMs to support symbolic reasoning on tabular data. Our experimental evaluation, conducted on challenging web table datasets such as WikiTableQuestion and TabFact, demonstrates that leveraging NormTab significantly improves symbolic reasoning performance, showcasing the importance and effectiveness of web table normalization for enhancing LLM-based symbolic reasoning tasks.

We propose KnowGL, a tool that allows converting text into structured relational data represented as a set of ABox assertions compliant with the TBox of a given Knowledge Graph (KG), such as Wikidata. We address this problem as a sequence generation task by leveraging pre-trained sequence-to-sequence language models, e.g. BART. Given a sentence, we fine-tune such models to detect pairs of entity mentions and jointly generate a set of facts consisting of the full set of semantic annotations for a KG, such as entity labels, entity types, and their relationships. To showcase the capabilities of our tool, we build a web application consisting of a set of UI widgets that help users to navigate through the semantic data extracted from a given input text. We make the KnowGL model available at https://huggingface.co/ibm/knowgl-large.

Large Language Models (LLMs) have made significant strides in code generation and problem solving. Current approaches employ external tool-based iterative debuggers that use compiler or other tool-based runtime feedback to refine coarse programs generated by various methods. However, the effectiveness of these approaches heavily relies on the quality of the initial code generation, which remains an open challenge. In this paper, we introduce CodeSim, a novel multi-agent code generation framework that comprehensively addresses the stages of program synthesis-planning, coding, and debugging-through a human-like perception approach. As human verifies their understanding of any algorithms through visual simulation, CodeSim uniquely features a method of plan verification and internal debugging through the step-by-step simulation of input/output. Extensive experiments across seven challenging competitive problem-solving and program synthesis benchmarks demonstrate CodeSim's remarkable code generation capabilities. Our framework achieves new state-of-the-art (pass@1) results-(HumanEval 95.1%, MBPP 90.7%, APPS 22%, and CodeContests 29.1%). Furthermore, our method shows potential for even greater enhancement when cascaded with external debuggers. To facilitate further research and development in this area, we have open-sourced our framework in this link (https://kagnlp.github.io/codesim.github.io/).

Large Language Models (LLMs) are seeing significant adoption in every type of organization due to their exceptional generative capabilities. However, LLMs are found to be vulnerable to various adversarial attacks, particularly prompt injection attacks, which trick them into producing harmful or inappropriate content. Adversaries execute such attacks by crafting malicious prompts to deceive the LLMs. In this paper, we propose a novel approach based on embedding-based Machine Learning (ML) classifiers to protect LLM-based applications against this severe threat. We leverage three commonly used embedding models to generate embeddings of malicious and benign prompts and utilize ML classifiers to predict whether an input prompt is malicious. Out of several traditional ML methods, we achieve the best performance with classifiers built using Random Forest and XGBoost. Our classifiers outperform state-of-the-art prompt injection classifiers available in open-source implementations, which use encoder-only neural networks.

The autonomous AI agents using large language models can create undeniable values in all span of the society but they face security threats from adversaries that warrants immediate protective solutions because trust and safety issues arise. Considering the many-shot jailbreaking and deceptive alignment as some of the main advanced attacks, that cannot be mitigated by the static guardrails used during the supervised training, points out a crucial research priority for real world robustness. The combination of static guardrails in dynamic multi-agent system fails to defend against those attacks. We intend to enhance security for LLM-based agents through the development of new evaluation frameworks which identify and counter threats for safe operational deployment. Our work uses three examination methods to detect rogue agents through a Reverse Turing Test and analyze deceptive alignment through multi-agent simulations and develops an anti-jailbreaking system by testing it with GEMINI 1.5 pro and llama-3.3-70B, deepseek r1 models using tool-mediated adversarial scenarios. The detection capabilities are strong such as 94\% accuracy for GEMINI 1.5 pro yet the system suffers persistent vulnerabilities when under long attacks as prompt length increases attack success rates (ASR) and diversity metrics become ineffective in prediction while revealing multiple complex system faults. The findings demonstrate the necessity of adopting flexible security systems based on active monitoring that can be performed by the agents themselves together with adaptable interventions by system admin as the current models can create vulnerabilities that can lead to the unreliable and vulnerable system. So, in our work, we try to address such situations and propose a comprehensive framework to counteract the security issues.

One of the predominant methods for training world models is autoregressive prediction in the output space of the next element of a sequence. In Natural Language Processing (NLP), this takes the form of Large Language Models (LLMs) predicting the next token; in Computer Vision (CV), this takes the form of autoregressive models predicting the next frame/token/pixel. However, this approach differs from human cognition in several respects. First, human predictions about the future actively influence internal cognitive processes. Second, humans naturally evaluate the plausibility of predictions regarding future states. Based on this capability, and third, by assessing when predictions are sufficient, humans allocate a dynamic amount of time to make a prediction. This adaptive process is analogous to System 2 thinking in psychology. All these capabilities are fundamental to the success of humans at high-level reasoning and planning. Therefore, to address the limitations of traditional autoregressive models lacking these human-like capabilities, we introduce Energy-Based World Models (EBWM). EBWM involves training an Energy-Based Model (EBM) to predict the compatibility of a given context and a predicted future state. In doing so, EBWM enables models to achieve all three facets of human cognition described. Moreover, we developed a variant of the traditional autoregressive transformer tailored for Energy-Based models, termed the Energy-Based Transformer (EBT). Our results demonstrate that EBWM scales better with data and GPU Hours than traditional autoregressive transformers in CV, and that EBWM offers promising early scaling in NLP. Consequently, this approach offers an exciting path toward training future models capable of System 2 thinking and intelligently searching across state spaces.

Code synthesis, which requires a deep understanding of complex natural language problem descriptions, generation of code instructions for complex algorithms and data structures, and the successful execution of comprehensive unit tests, presents a significant challenge. While large language models (LLMs) demonstrate impressive proficiency in natural language processing, their performance in code generation tasks remains limited. In this paper, we introduce a new approach to code generation tasks leveraging multi-agent prompting that uniquely replicates the full cycle of program synthesis as observed in human developers. Our framework, MapCoder, consists of four LLM agents specifically designed to emulate the stages of this cycle: recalling relevant examples, planning, code generation, and debugging. After conducting thorough experiments, with multiple LLM ablations and analyses across eight challenging competitive problem-solving and program synthesis benchmarks, MapCoder showcases remarkable code generation capabilities, achieving new state-of-the-art results (pass@1) on HumanEval (93.9%), MBPP (83.1%), APPS (22.0%), CodeContests (28.5%), and xCodeEval (45.3%). Moreover, our method consistently delivers superior performance across various programming languages and varying problem difficulties. We open-source our framework at https://github.com/Md-Ashraful-Pramanik/MapCoder.

Ambiguity remains a fundamental challenge in Natural Language Processing (NLP) due to the inherent complexity and flexibility of human language. With the advent of Large Language Models (LLMs), addressing ambiguity has become even more critical due to their expanded capabilities and applications. In the context of Conversational Question Answering (CQA), this paper explores the definition, forms, and implications of ambiguity for language driven systems, particularly in the context of LLMs. We define key terms and concepts, categorize various disambiguation approaches enabled by LLMs, and provide a comparative analysis of their advantages and disadvantages. We also explore publicly available datasets for benchmarking ambiguity detection and resolution techniques and highlight their relevance for ongoing research. Finally, we identify open problems and future research directions, proposing areas for further investigation. By offering a comprehensive review of current research on ambiguities and disambiguation with LLMs, we aim to contribute to the development of more robust and reliable language systems.

Cyber threat intelligence (CTI) is crucial in today's cybersecurity landscape, providing essential insights to understand and mitigate the ever-evolving cyber threats. The recent rise of Large Language Models (LLMs) have shown potential in this domain, but concerns about their reliability, accuracy, and hallucinations persist. While existing benchmarks provide general evaluations of LLMs, there are no benchmarks that address the practical and applied aspects of CTI-specific tasks. To bridge this gap, we introduce CTIBench, a benchmark designed to assess LLMs' performance in CTI applications. CTIBench includes multiple datasets focused on evaluating knowledge acquired by LLMs in the cyber-threat landscape. Our evaluation of several state-of-the-art models on these tasks provides insights into their strengths and weaknesses in CTI contexts, contributing to a better understanding of LLM capabilities in CTI.

Large Language Models (LLMs) have demonstrated impressive capabilities to solve a wide range of tasks without being explicitly fine-tuned on task-specific datasets. However, deploying LLMs in the real world is not trivial, as it requires substantial computing resources. In this paper, we investigate whether smaller, compact LLMs are a good alternative to the comparatively Larger LLMs2 to address significant costs associated with utilizing LLMs in the real world. In this regard, we study the meeting summarization task in a real-world industrial environment and conduct extensive experiments by comparing the performance of fine-tuned compact LLMs (e.g., FLAN-T5, TinyLLaMA, LiteLLaMA) with zero-shot larger LLMs (e.g., LLaMA-2, GPT-3.5, PaLM-2). We observe that most smaller LLMs, even after fine-tuning, fail to outperform larger zero-shot LLMs in meeting summarization datasets. However, a notable exception is FLAN-T5 (780M parameters), which performs on par or even better than many zero-shot Larger LLMs (from 7B to above 70B parameters), while being significantly smaller. This makes compact LLMs like FLAN-T5 a suitable cost-efficient solution for real-world industrial deployment.

Initial work has been done to address fake news detection and misrepresentation of news in the Bengali language. However, no work in Bengali yet addresses the identification of specific claims in social media news that falsely manipulates a related news article. At this point, this problem has been tackled in English and a few other languages, but not in the Bengali language. In this paper, we curate a dataset of social media content labeled with information manipulation relative to reference articles, called BanMANI. The dataset collection method we describe works around the limitations of the available NLP tools in Bangla. We expect these techniques will carry over to building similar datasets in other low-resource languages. BanMANI forms the basis both for evaluating the capabilities of existing NLP systems and for training or fine-tuning new models specifically on this task. In our analysis, we find that this task challenges current LLMs both under zero-shot and fine-tuned settings.

Task-oriented dialogue generation is challenging since the underlying knowledge is often dynamic and effectively incorporating knowledge into the learning process is hard. It is particularly challenging to generate both human-like and informative responses in this setting. Recent research primarily focused on various knowledge distillation methods where the underlying relationship between the facts in a knowledge base is not effectively captured. In this paper, we go one step further and demonstrate how the structural information of a knowledge graph can improve the system's inference capabilities. Specifically, we propose DialoKG, a novel task-oriented dialogue system that effectively incorporates knowledge into a language model. Our proposed system views relational knowledge as a knowledge graph and introduces (1) a structure-aware knowledge embedding technique, and (2) a knowledge graph-weighted attention masking strategy to facilitate the system selecting relevant information during the dialogue generation. An empirical evaluation demonstrates the effectiveness of DialoKG over state-of-the-art methods on several standard benchmark datasets.

Large language models (LLMs) have garnered significant interest in natural language processing (NLP), particularly their remarkable performance in various downstream tasks in resource-rich languages. Recent studies have highlighted the limitations of LLMs in low-resource languages, primarily focusing on binary classification tasks and giving minimal attention to South Asian languages. These limitations are primarily attributed to constraints such as dataset scarcity, computational costs, and research gaps specific to low-resource languages. To address this gap, we present datasets for sentiment and hate speech tasks by translating from English to Bangla, Hindi, and Urdu, facilitating research in low-resource language processing. Further, we comprehensively examine zero-shot learning using multiple LLMs in English and widely spoken South Asian languages. Our findings indicate that GPT-4 consistently outperforms Llama 2 and Gemini, with English consistently demonstrating superior performance across diverse tasks compared to low-resource languages. Furthermore, our analysis reveals that natural language inference (NLI) exhibits the highest performance among the evaluated tasks, with GPT-4 demonstrating superior capabilities.

Recent advancements in foundation models have enhanced AI systems' capabilities in autonomous tool usage and reasoning. However, their ability in location or map-based reasoning - which improves daily life by optimizing navigation, facilitating resource discovery, and streamlining logistics - has not been systematically studied. To bridge this gap, we introduce MapEval, a benchmark designed to assess diverse and complex map-based user queries with geo-spatial reasoning. MapEval features three task types (textual, API-based, and visual) that require collecting world information via map tools, processing heterogeneous geo-spatial contexts (e.g., named entities, travel distances, user reviews or ratings, images), and compositional reasoning, which all state-of-the-art foundation models find challenging. Comprising 700 unique multiple-choice questions about locations across 180 cities and 54 countries, MapEval evaluates foundation models' ability to handle spatial relationships, map infographics, travel planning, and navigation challenges. Using MapEval, we conducted a comprehensive evaluation of 28 prominent foundation models. While no single model excelled across all tasks, Claude-3.5-Sonnet, GPT-4o, and Gemini-1.5-Pro achieved competitive performance overall. However, substantial performance gaps emerged, particularly in MapEval, where agents with Claude-3.5-Sonnet outperformed GPT-4o and Gemini-1.5-Pro by 16% and 21%, respectively, and the gaps became even more amplified when compared to open-source LLMs. Our detailed analyses provide insights into the strengths and weaknesses of current models, though all models still fall short of human performance by more than 20% on average, struggling with complex map images and rigorous geo-spatial reasoning. This gap highlights MapEval's critical role in advancing general-purpose foundation models with stronger geo-spatial understanding.

Large Language Models (LLMs) have demonstrated remarkable performance across various disciplines and tasks. However, benchmarking their capabilities with multilingual spoken queries remains largely unexplored. In this study, we introduce SpokenNativQA, the first multilingual and culturally aligned spoken question-answering (SQA) dataset designed to evaluate LLMs in real-world conversational settings. The dataset comprises approximately 33,000 naturally spoken questions and answers in multiple languages, including low-resource and dialect-rich languages, providing a robust benchmark for assessing LLM performance in speech-based interactions. SpokenNativQA addresses the limitations of text-based QA datasets by incorporating speech variability, accents, and linguistic diversity. We benchmark different ASR systems and LLMs for SQA and present our findings. We released the data at (https://huggingface.co/datasets/QCRI/SpokenNativQA) and the experimental scripts at (https://llmebench.qcri.org/) for the research community.

The search for evidence of past life on Mars presents a tremendous challenge that requires the usage of very advanced robotic technologies to overcome it. Current digital microscopic imagers and spectrometers used for astrobiological examination suffer from limitations such as insufficient resolution, narrow detection range, and lack of portability. To overcome these challenges, this research study presents modifications to the Phoenix rover to expand its capability for detecting biosignatures on Mars. This paper examines the modifications implemented on the Phoenix rover to enhance its capability to detect a broader spectrum of biosignatures. One of the notable improvements comprises the integration of advanced digital microscopic imagers and spectrometers, enabling high-resolution examination of soil samples. Additionally, the mechanical components of the device have been reinforced to enhance maneuverability and optimize subsurface sampling capabilities. Empirical investigations have demonstrated that Phoenix has the capability to navigate diverse geological environments and procure samples for the purpose of biomolecular analysis. The biomolecular instrumentation and hybrid analytical methods showcased in this study demonstrate considerable potential for future astrobiology missions on Mars. The potential for enhancing the system lies in the possibility of broadening the range of detectable biomarkers and biosignatures.

Localizing unusual activities, such as human errors or surveillance incidents, in videos holds practical significance. However, current video understanding models struggle with localizing these unusual events likely because of their insufficient representation in models' pretraining datasets. To explore foundation models' capability in localizing unusual activity, we introduce UAL-Bench, a comprehensive benchmark for unusual activity localization, featuring three video datasets: UAG-OOPS, UAG-SSBD, UAG-FunQA, and an instruction-tune dataset: OOPS-UAG-Instruct, to improve model capabilities. UAL-Bench evaluates three approaches: Video-Language Models (Vid-LLMs), instruction-tuned Vid-LLMs, and a novel integration of Vision-Language Models and Large Language Models (VLM-LLM). Our results show the VLM-LLM approach excels in localizing short-span unusual events and predicting their onset (start time) more accurately than Vid-LLMs. We also propose a new metric, R@1, TD <= p, to address limitations in existing evaluation methods. Our findings highlight the challenges posed by long-duration videos, particularly in autism diagnosis scenarios, and the need for further advancements in localization techniques. Our work not only provides a benchmark for unusual activity localization but also outlines the key challenges for existing foundation models, suggesting future research directions on this important task.

Traditional transformer-based semantic segmentation relies on quantized embeddings. However, our analysis reveals that autoencoder accuracy on segmentation mask using quantized embeddings (e.g. VQ-VAE) is 8% lower than continuous-valued embeddings (e.g. KL-VAE). Motivated by this, we propose a continuous-valued embedding framework for semantic segmentation. By reformulating semantic mask generation as a continuous image-to-embedding diffusion process, our approach eliminates the need for discrete latent representations while preserving fine-grained spatial and semantic details. Our key contribution includes a diffusion-guided autoregressive transformer that learns a continuous semantic embedding space by modeling long-range dependencies in image features. Our framework contains a unified architecture combining a VAE encoder for continuous feature extraction, a diffusion-guided transformer for conditioned embedding generation, and a VAE decoder for semantic mask reconstruction. Our setting facilitates zero-shot domain adaptation capabilities enabled by the continuity of the embedding space. Experiments across diverse datasets (e.g., Cityscapes and domain-shifted variants) demonstrate state-of-the-art robustness to distribution shifts, including adverse weather (e.g., fog, snow) and viewpoint variations. Our model also exhibits strong noise resilience, achieving robust performance (approx 95% AP compared to baseline) under gaussian noise, moderate motion blur, and moderate brightness/contrast variations, while experiencing only a moderate impact (approx 90% AP compared to baseline) from 50% salt and pepper noise, saturation and hue shifts. Code available: https://github.com/mahmed10/CAMSS.git

Engineering Design is undergoing a transformative shift with the advent of AI, marking a new era in how we approach product, system, and service planning. Large language models have demonstrated impressive capabilities in enabling this shift. Yet, with text as their only input modality, they cannot leverage the large body of visual artifacts that engineers have used for centuries and are accustomed to. This gap is addressed with the release of multimodal vision language models, such as GPT-4V, enabling AI to impact many more types of tasks. In light of these advancements, this paper presents a comprehensive evaluation of GPT-4V, a vision language model, across a wide spectrum of engineering design tasks, categorized into four main areas: Conceptual Design, System-Level and Detailed Design, Manufacturing and Inspection, and Engineering Education Tasks. Our study assesses GPT-4V's capabilities in design tasks such as sketch similarity analysis, concept selection using Pugh Charts, material selection, engineering drawing analysis, CAD generation, topology optimization, design for additive and subtractive manufacturing, spatial reasoning challenges, and textbook problems. Through this structured evaluation, we not only explore GPT-4V's proficiency in handling complex design and manufacturing challenges but also identify its limitations in complex engineering design applications. Our research establishes a foundation for future assessments of vision language models, emphasizing their immense potential for innovating and enhancing the engineering design and manufacturing landscape. It also contributes a set of benchmark testing datasets, with more than 1000 queries, for ongoing advancements and applications in this field.

Inference-time computation techniques, analogous to human System 2 Thinking, have recently become popular for improving model performances. However, most existing approaches suffer from several limitations: they are modality-specific (e.g., working only in text), problem-specific (e.g., verifiable domains like math and coding), or require additional supervision/training on top of unsupervised pretraining (e.g., verifiers or verifiable rewards). In this paper, we ask the question "Is it possible to generalize these System 2 Thinking approaches, and develop models that learn to think solely from unsupervised learning?" Interestingly, we find the answer is yes, by learning to explicitly verify the compatibility between inputs and candidate-predictions, and then re-framing prediction problems as optimization with respect to this verifier. Specifically, we train Energy-Based Transformers (EBTs) -- a new class of Energy-Based Models (EBMs) -- to assign an energy value to every input and candidate-prediction pair, enabling predictions through gradient descent-based energy minimization until convergence. Across both discrete (text) and continuous (visual) modalities, we find EBTs scale faster than the dominant Transformer++ approach during training, achieving an up to 35% higher scaling rate with respect to data, batch size, parameters, FLOPs, and depth. During inference, EBTs improve performance with System 2 Thinking by 29% more than the Transformer++ on language tasks, and EBTs outperform Diffusion Transformers on image denoising while using fewer forward passes. Further, we find that EBTs achieve better results than existing models on most downstream tasks given the same or worse pretraining performance, suggesting that EBTs generalize better than existing approaches. Consequently, EBTs are a promising new paradigm for scaling both the learning and thinking capabilities of models.

Retrieval-Augmented Generation (RAG) has been shown to enhance the factual accuracy of Large Language Models (LLMs), but existing methods often suffer from limited reasoning capabilities in effectively using the retrieved evidence, particularly when using open-source LLMs. To mitigate this gap, we introduce a novel framework, Open-RAG, designed to enhance reasoning capabilities in RAG with open-source LLMs. Our framework transforms an arbitrary dense LLM into a parameter-efficient sparse mixture of experts (MoE) model capable of handling complex reasoning tasks, including both single- and multi-hop queries. Open-RAG uniquely trains the model to navigate challenging distractors that appear relevant but are misleading. As a result, Open-RAG leverages latent learning, dynamically selecting relevant experts and integrating external knowledge effectively for more accurate and contextually relevant responses. In addition, we propose a hybrid adaptive retrieval method to determine retrieval necessity and balance the trade-off between performance gain and inference speed. Experimental results show that the Llama2-7B-based Open-RAG outperforms state-of-the-art LLMs and RAG models such as ChatGPT, Self-RAG, and Command R+ in various knowledge-intensive tasks. We open-source our code and models at https://openragmoe.github.io/

Machine learning models often struggle with distribution shifts in real-world scenarios, whereas humans exhibit robust adaptation. Models that better align with human perception may achieve higher out-of-distribution generalization. In this study, we investigate how various characteristics of large-scale computer vision models influence their alignment with human capabilities and robustness. Our findings indicate that increasing model and data size and incorporating rich semantic information and multiple modalities enhance models' alignment with human perception and their overall robustness. Our empirical analysis demonstrates a strong correlation between out-of-distribution accuracy and human alignment.

Large Language Models (LLMs) have become a cornerstone in the field of Natural Language Processing (NLP), offering transformative capabilities in understanding and generating human-like text. However, with their rising prominence, the security and vulnerability aspects of these models have garnered significant attention. This paper presents a comprehensive survey of the various forms of attacks targeting LLMs, discussing the nature and mechanisms of these attacks, their potential impacts, and current defense strategies. We delve into topics such as adversarial attacks that aim to manipulate model outputs, data poisoning that affects model training, and privacy concerns related to training data exploitation. The paper also explores the effectiveness of different attack methodologies, the resilience of LLMs against these attacks, and the implications for model integrity and user trust. By examining the latest research, we provide insights into the current landscape of LLM vulnerabilities and defense mechanisms. Our objective is to offer a nuanced understanding of LLM attacks, foster awareness within the AI community, and inspire robust solutions to mitigate these risks in future developments.

Small Language Models (SLMs) have gained substantial attention due to their ability to execute diverse language tasks successfully while using fewer computer resources. These models are particularly ideal for deployment in limited environments, such as mobile devices, on-device processing, and edge systems. In this study, we present a complete assessment of SLMs, focussing on their design frameworks, training approaches, and techniques for lowering model size and complexity. We offer a novel classification system to organize the optimization approaches applied for SLMs, encompassing strategies like pruning, quantization, and model compression. Furthermore, we assemble SLM's studies of evaluation suite with some existing datasets, establishing a rigorous platform for measuring SLM capabilities. Alongside this, we discuss the important difficulties that remain unresolved in this sector, including trade-offs between efficiency and performance, and we suggest directions for future study. We anticipate this study to serve as a beneficial guide for researchers and practitioners who aim to construct compact, efficient, and high-performing language models.

Mathematical reasoning remains one of the most challenging domains for large language models (LLMs), requiring not only linguistic understanding but also structured logical deduction and numerical precision. While recent LLMs demonstrate strong general-purpose reasoning abilities, their mathematical competence across diverse languages remains underexplored. Existing benchmarks primarily focus on English or a narrow subset of high-resource languages, leaving significant gaps in assessing multilingual and cross-lingual mathematical reasoning. To address this, we introduce MathMist, a parallel multilingual benchmark for mathematical problem solving and reasoning. MathMist encompasses over 21K aligned question-answer pairs across seven languages, representing a balanced coverage of high-, medium-, and low-resource linguistic settings. The dataset captures linguistic variety, multiple types of problem settings, and solution synthesizing capabilities. We systematically evaluate a diverse suite of models, including open-source small and medium LLMs, proprietary systems, and multilingual-reasoning-focused models, under zero-shot, chain-of-thought (CoT), and code-switched reasoning paradigms. Our results reveal persistent deficiencies in LLMs' ability to perform consistent and interpretable mathematical reasoning across languages, with pronounced degradation in low-resource settings. All the codes and data are available at GitHub: https://github.com/mahbubhimel/MathMist

Automated data visualization plays a crucial role in simplifying data interpretation, enhancing decision-making, and improving efficiency. While large language models (LLMs) have shown promise in generating visualizations from natural language, the absence of comprehensive benchmarks limits the rigorous evaluation of their capabilities. We introduce Text2Vis, a benchmark designed to assess text-to-visualization models, covering 20+ chart types and diverse data science queries, including trend analysis, correlation, outlier detection, and predictive analytics. It comprises 1,985 samples, each with a data table, natural language query, short answer, visualization code, and annotated charts. The queries involve complex reasoning, conversational turns, and dynamic data retrieval. We benchmark 11 open-source and closed-source models, revealing significant performance gaps, highlighting key challenges, and offering insights for future advancements. To close this gap, we propose the first cross-modal actor-critic agentic framework that jointly refines the textual answer and visualization code, increasing GPT-4o`s pass rate from 26% to 42% over the direct approach and improving chart quality. We also introduce an automated LLM-based evaluation framework that enables scalable assessment across thousands of samples without human annotation, measuring answer correctness, code execution success, visualization readability, and chart accuracy. We release Text2Vis at https://github.com/vis-nlp/Text2Vis.

Large language models (LLMs) have shown remarkable advances in language generation and understanding but are also prone to exhibiting harmful social biases. While recognition of these behaviors has generated an abundance of bias mitigation techniques, most require modifications to the training data, model parameters, or decoding strategy, which may be infeasible without access to a trainable model. In this work, we leverage the zero-shot capabilities of LLMs to reduce stereotyping in a technique we introduce as zero-shot self-debiasing. With two approaches, self-debiasing via explanation and self-debiasing via reprompting, we show that self-debiasing can significantly reduce the degree of stereotyping across nine different social groups while relying only on the LLM itself and a simple prompt, with explanations correctly identifying invalid assumptions and reprompting delivering the greatest reductions in bias. We hope this work opens inquiry into other zero-shot techniques for bias mitigation.

Mapping and navigation services like Google Maps, Apple Maps, Openstreet Maps, are essential for accessing various location-based data, yet they often struggle to handle natural language geospatial queries. Recent advancements in Large Language Models (LLMs) show promise in question answering (QA), but creating reliable geospatial QA datasets from map services remains challenging. We introduce MapQaTor, a web application that streamlines the creation of reproducible, traceable map-based QA datasets. With its plug-and-play architecture, MapQaTor enables seamless integration with any maps API, allowing users to gather and visualize data from diverse sources with minimal setup. By caching API responses, the platform ensures consistent ground truth, enhancing the reliability of the data even as real-world information evolves. MapQaTor centralizes data retrieval, annotation, and visualization within a single platform, offering a unique opportunity to evaluate the current state of LLM-based geospatial reasoning while advancing their capabilities for improved geospatial understanding. Evaluation metrics show that, MapQaTor speeds up the annotation process by at least 30 times compared to manual methods, underscoring its potential for developing geospatial resources, such as complex map reasoning datasets. The website is live at: https://mapqator.github.io/ and a demo video is available at: https://youtu.be/7_aV9Wmhs6Q.

Recent advances in test-time scaling have led to the emergence of thinking LLMs that exhibit self-reflective behaviors and multi-step reasoning. While RL drives this self-improvement paradigm, a recent study (Gandhi et al., 2025) shows that RL alone does not truly instill these new reasoning abilities - it merely draws out behaviors already present in the base models. This raises a question: How can we train the models that don't exhibit such thinking behavior to develop it in the first place? To this end, we propose ThinkTuning, a GRPO-based interactive training approach where we augment the rollouts of a student model with the guidance from a teacher model. A simple idea from classroom practice inspires our method: a teacher poses a problem, lets the student try an answer, then gives corrective feedback -- enough to point the mind in the right direction and then show the solution. Each piece of feedback reshapes the student's thoughts, leading them to arrive at the correct solution. Similarly, we find that this type of implicit supervision through feedback from a teacher model of the same size improves the reasoning capabilities of the student model. In particular, on average, our method shows a 3.85% improvement over zero-shot baselines across benchmarks, and on MATH-500, AIME and GPQA-Diamond it shows 2.08%, 2.23% and 3.99% improvements over the vanilla-GRPO baseline. Source code is available at https://github.com/3rdAT/ThinkTuning.

As AI grows more powerful, it will increasingly shape how we understand the world. But with this influence comes the risk of amplifying misinformation and deepening social divides-especially on consequential topics like public health where factual accuracy directly impacts well-being. Scalable Oversight aims to ensure AI truthfulness by enabling humans to supervise systems that may exceed human capabilities--yet humans themselves hold different beliefs and biases that impair their judgment. We study whether AI debate can guide biased judges toward the truth by having two AI systems debate opposing sides of controversial COVID-19 factuality claims where people hold strong prior beliefs. We conduct two studies: one with human judges holding either mainstream or skeptical beliefs evaluating factuality claims through AI-assisted debate or consultancy protocols, and a second examining the same problem with personalized AI judges designed to mimic these different human belief systems. In our human study, we find that debate-where two AI advisor systems present opposing evidence-based arguments-consistently improves judgment accuracy and confidence calibration, outperforming consultancy with a single-advisor system by 10% overall. The improvement is most significant for judges with mainstream beliefs (+15.2% accuracy), though debate also helps skeptical judges who initially misjudge claims move toward accurate views (+4.7% accuracy). In our AI judge study, we find that AI judges with human-like personas achieve even higher accuracy (78.5%) than human judges (70.1%) and default AI judges without personas (69.8%), suggesting their potential for supervising frontier AI models. These findings highlight AI debate as a promising path toward scalable, bias-resilient oversight--leveraging both diverse human and AI judgments to move closer to truth in contested domains.

The rise of large language models (LLMs) has created a need for advanced benchmarking systems beyond traditional setups. To this end, we introduce QUENCH, a novel text-based English Quizzing Benchmark manually curated and transcribed from YouTube quiz videos. QUENCH possesses masked entities and rationales for the LLMs to predict via generation. At the intersection of geographical context and common sense reasoning, QUENCH helps assess world knowledge and deduction capabilities of LLMs via a zero-shot, open-domain quizzing setup. We perform an extensive evaluation on 7 LLMs and 4 metrics, investigating the influence of model size, prompting style, geographical context, and gold-labeled rationale generation. The benchmarking concludes with an error analysis to which the LLMs are prone.

We present DR.DECR (Dense Retrieval with Distillation-Enhanced Cross-Lingual Representation), a new cross-lingual information retrieval (CLIR) system trained using multi-stage knowledge distillation (KD). The teacher of DR.DECR relies on a highly effective but computationally expensive two-stage inference process consisting of query translation and monolingual IR, while the student, DR.DECR, executes a single CLIR step. We teach DR.DECR powerful multilingual representations as well as CLIR by optimizing two corresponding KD objectives. Learning useful representations of non-English text from an English-only retriever is accomplished through a cross-lingual token alignment algorithm that relies on the representation capabilities of the underlying multilingual encoders. In both in-domain and zero-shot out-of-domain evaluation, DR.DECR demonstrates far superior accuracy over direct fine-tuning with labeled CLIR data. It is also the best single-model retriever on the XOR-TyDi benchmark at the time of this writing.

Benchmarks are important tools for tracking the rapid advancements in large language model (LLM) capabilities. However, benchmarks are not keeping pace in difficulty: LLMs now achieve over 90\% accuracy on popular benchmarks like MMLU, limiting informed measurement of state-of-the-art LLM capabilities. In response, we introduce Humanity's Last Exam (HLE), a multi-modal benchmark at the frontier of human knowledge, designed to be the final closed-ended academic benchmark of its kind with broad subject coverage. HLE consists of 3,000 questions across dozens of subjects, including mathematics, humanities, and the natural sciences. HLE is developed globally by subject-matter experts and consists of multiple-choice and short-answer questions suitable for automated grading. Each question has a known solution that is unambiguous and easily verifiable, but cannot be quickly answered via internet retrieval. State-of-the-art LLMs demonstrate low accuracy and calibration on HLE, highlighting a significant gap between current LLM capabilities and the expert human frontier on closed-ended academic questions. To inform research and policymaking upon a clear understanding of model capabilities, we publicly release HLE at https://lastexam.ai.

While large language models (LLMs) have demonstrated exceptional performance in recent natural language processing (NLP) tasks, their deployment poses substantial challenges due to high computational and memory demands in real-world applications. Recent studies have focused on enhancing smaller models through knowledge distillation from LLMs, yielding promising results. However, these models often struggle to match the performance of LLMs, especially in tasks that require reasoning. In this work, we introduce Mixed Distillation (MD) framework, which capitalizes on the strengths of Program of Thought (PoT) and Chain of Thought (CoT) capabilities within LLMs, combining multiple prompting techniques and distilling these capabilities into smaller models. Our experimental results show that MD significantly enhances the single-path and multi-path reasoning ability of smaller models in various tasks. In terms of accuracy and generality of reasoning tasks, the model generated by it exceeds the comprehensive performance of two individually distilled models. Notably, LLaMA2-7B and CodeLlama-7B using MD achieved remarkable improvements of (84.5%) and (85.5%), respectively, outperforming GPT-3.5-Turbo by (2.5%) and (3.5%), on the SVAMP benchmark.

Despite the widespread applications of machine learning force field (MLFF) on solids and small molecules, there is a notable gap in applying MLFF to complex liquid electrolytes. In this work, we introduce BAMBOO (ByteDance AI Molecular Simulation Booster), a novel framework for molecular dynamics (MD) simulations, with a demonstration of its capabilities in the context of liquid electrolytes for lithium batteries. We design a physics-inspired graph equivariant transformer architecture as the backbone of BAMBOO to learn from quantum mechanical simulations. Additionally, we pioneer an ensemble knowledge distillation approach and apply it on MLFFs to improve the stability of MD simulations. Finally, we propose the density alignment algorithm to align BAMBOO with experimental measurements. BAMBOO demonstrates state-of-the-art accuracy in predicting key electrolyte properties such as density, viscosity, and ionic conductivity across various solvents and salt combinations. Our current model, trained on more than 15 chemical species, achieves the average density error of 0.01 g/cm^3 on various compositions compared with experimental data. Moreover, our model demonstrates transferability to molecules not included in the quantum mechanical dataset. We envision this work as paving the way to a "universal MLFF" capable of simulating properties of common organic liquids.

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

With the proliferation of Large Language Models (LLMs) in diverse domains, there is a particular need for unified evaluation standards in clinical medical scenarios, where models need to be examined very thoroughly. We present CliMedBench, a comprehensive benchmark with 14 expert-guided core clinical scenarios specifically designed to assess the medical ability of LLMs across 7 pivot dimensions. It comprises 33,735 questions derived from real-world medical reports of top-tier tertiary hospitals and authentic examination exercises. The reliability of this benchmark has been confirmed in several ways. Subsequent experiments with existing LLMs have led to the following findings: (i) Chinese medical LLMs underperform on this benchmark, especially where medical reasoning and factual consistency are vital, underscoring the need for advances in clinical knowledge and diagnostic accuracy. (ii) Several general-domain LLMs demonstrate substantial potential in medical clinics, while the limited input capacity of many medical LLMs hinders their practical use. These findings reveal both the strengths and limitations of LLMs in clinical scenarios and offer critical insights for medical research.

In this paper, we introduce InMD-X, a collection of multiple large language models specifically designed to cater to the unique characteristics and demands of Internal Medicine Doctors (IMD). InMD-X represents a groundbreaking development in natural language processing, offering a suite of language models fine-tuned for various aspects of the internal medicine field. These models encompass a wide range of medical sub-specialties, enabling IMDs to perform more efficient and accurate research, diagnosis, and documentation. InMD-X's versatility and adaptability make it a valuable tool for improving the healthcare industry, enhancing communication between healthcare professionals, and advancing medical research. Each model within InMD-X is meticulously tailored to address specific challenges faced by IMDs, ensuring the highest level of precision and comprehensiveness in clinical text analysis and decision support. This paper provides an overview of the design, development, and evaluation of InMD-X, showcasing its potential to revolutionize the way internal medicine practitioners interact with medical data and information. We present results from extensive testing, demonstrating the effectiveness and practical utility of InMD-X in real-world medical scenarios.

Clinicians spend a significant amount of time reviewing medical images and transcribing their findings regarding patient diagnosis, referral and treatment in text form. Vision-language models (VLMs), which automatically interpret images and summarize their findings as text, have enormous potential to alleviate clinical workloads and increase patient access to high-quality medical care. While foundational models have stirred considerable interest in the medical community, it is unclear whether their general capabilities translate to real-world clinical utility. In this work, we show that foundation VLMs markedly underperform compared to practicing ophthalmologists on specialist tasks crucial to the care of patients with age-related macular degeneration (AMD). To address this, we initially identified the essential capabilities required for image-based clinical decision-making, and then developed a curriculum to selectively train VLMs in these skills. The resulting model, RetinaVLM, can be instructed to write reports that significantly outperform those written by leading foundation medical VLMs in disease staging (F1 score of 0.63 vs. 0.11) and patient referral (0.67 vs. 0.39), and approaches the diagnostic performance of junior ophthalmologists (who achieve 0.77 and 0.78 on the respective tasks). Furthermore, in a reader study involving two senior ophthalmologists with up to 32 years of experience, RetinaVLM's reports were found to be similarly correct (78.6% vs. 82.1%) and complete (both 78.6%) as reports written by junior ophthalmologists with up to 10 years of experience. These results demonstrate that our curriculum-based approach provides a blueprint for specializing generalist foundation medical VLMs to handle real-world clinical tasks.

Medical image analysis is essential to clinical diagnosis and treatment, which is increasingly supported by multi-modal large language models (MLLMs). However, previous research has primarily focused on 2D medical images, leaving 3D images under-explored, despite their richer spatial information. This paper aims to advance 3D medical image analysis with MLLMs. To this end, we present a large-scale 3D multi-modal medical dataset, M3D-Data, comprising 120K image-text pairs and 662K instruction-response pairs specifically tailored for various 3D medical tasks, such as image-text retrieval, report generation, visual question answering, positioning, and segmentation. Additionally, we propose M3D-LaMed, a versatile multi-modal large language model for 3D medical image analysis. Furthermore, we introduce a new 3D multi-modal medical benchmark, M3D-Bench, which facilitates automatic evaluation across eight tasks. Through comprehensive evaluation, our method proves to be a robust model for 3D medical image analysis, outperforming existing solutions. All code, data, and models are publicly available at: https://github.com/BAAI-DCAI/M3D.

Generalist foundation models such as GPT-4 have displayed surprising capabilities in a wide variety of domains and tasks. Yet, there is a prevalent assumption that they cannot match specialist capabilities of fine-tuned models. For example, most explorations to date on medical competency benchmarks have leveraged domain-specific training, as exemplified by efforts on BioGPT and Med-PaLM. We build on a prior study of GPT-4's capabilities on medical challenge benchmarks in the absence of special training. Rather than using simple prompting to highlight the model's out-of-the-box capabilities, we perform a systematic exploration of prompt engineering. We find that prompting innovation can unlock deeper specialist capabilities and show that GPT-4 easily tops prior leading results for medical benchmarks. The prompting methods we explore are general purpose, and make no specific use of domain expertise, removing the need for expert-curated content. Our experimental design carefully controls for overfitting during the prompt engineering process. We introduce Medprompt, based on a composition of several prompting strategies. With Medprompt, GPT-4 achieves state-of-the-art results on all nine of the benchmark datasets in the MultiMedQA suite. The method outperforms leading specialist models such as Med-PaLM 2 by a significant margin with an order of magnitude fewer calls to the model. Steering GPT-4 with Medprompt achieves a 27% reduction in error rate on the MedQA dataset over the best methods to date achieved with specialist models and surpasses a score of 90% for the first time. Beyond medical problems, we show the power of Medprompt to generalize to other domains and provide evidence for the broad applicability of the approach via studies of the strategy on exams in electrical engineering, machine learning, philosophy, accounting, law, nursing, and clinical psychology.

The accelerating development of general medical artificial intelligence (GMAI), powered by multimodal large language models (MLLMs), offers transformative potential for addressing persistent healthcare challenges, including workforce deficits and escalating costs. The parallel development of systematic evaluation benchmarks emerges as a critical imperative to enable performance assessment and provide technological guidance. Meanwhile, as an invaluable knowledge source, the potential of medical textbooks for benchmark development remains underexploited. Here, we present MedBookVQA, a systematic and comprehensive multimodal benchmark derived from open-access medical textbooks. To curate this benchmark, we propose a standardized pipeline for automated extraction of medical figures while contextually aligning them with corresponding medical narratives. Based on this curated data, we generate 5,000 clinically relevant questions spanning modality recognition, disease classification, anatomical identification, symptom diagnosis, and surgical procedures. A multi-tier annotation system categorizes queries through hierarchical taxonomies encompassing medical imaging modalities (42 categories), body anatomies (125 structures), and clinical specialties (31 departments), enabling nuanced analysis across medical subdomains. We evaluate a wide array of MLLMs, including proprietary, open-sourced, medical, and reasoning models, revealing significant performance disparities across task types and model categories. Our findings highlight critical capability gaps in current GMAI systems while establishing textbook-derived multimodal benchmarks as essential evaluation tools. MedBookVQA establishes textbook-derived benchmarking as a critical paradigm for advancing clinical AI, exposing limitations in GMAI systems while providing anatomically structured performance metrics across specialties.

Recent large language models (LLMs) have demonstrated significant advancements, particularly in their ability to serve as agents thereby surpassing their traditional role as chatbots. These agents can leverage their planning and tool utilization capabilities to address tasks specified at a high level. However, a standardized dataset to benchmark the agent capabilities of LLMs in medical applications is currently lacking, making the evaluation of LLMs on complex tasks in interactive healthcare environments challenging. To address this gap, we introduce MedAgentBench, a broad evaluation suite designed to assess the agent capabilities of large language models within medical records contexts. MedAgentBench encompasses 300 patient-specific clinically-derived tasks from 10 categories written by human physicians, realistic profiles of 100 patients with over 700,000 data elements, a FHIR-compliant interactive environment, and an accompanying codebase. The environment uses the standard APIs and communication infrastructure used in modern EMR systems, so it can be easily migrated into live EMR systems. MedAgentBench presents an unsaturated agent-oriented benchmark that current state-of-the-art LLMs exhibit some ability to succeed at. The best model (Claude 3.5 Sonnet v2) achieves a success rate of 69.67%. However, there is still substantial space for improvement which gives the community a next direction to optimize. Furthermore, there is significant variation in performance across task categories. MedAgentBench establishes this and is publicly available at https://github.com/stanfordmlgroup/MedAgentBench , offering a valuable framework for model developers to track progress and drive continuous improvements in the agent capabilities of large language models within the medical domain.

The burgeoning integration of 3D medical imaging into healthcare has led to a substantial increase in the workload of medical professionals. To assist clinicians in their diagnostic processes and alleviate their workload, the development of a robust system for retrieving similar case studies presents a viable solution. While the concept holds great promise, the field of 3D medical text-image retrieval is currently limited by the absence of robust evaluation benchmarks and curated datasets. To remedy this, our study presents a groundbreaking dataset, BIMCV-R (This dataset will be released upon acceptance.), which includes an extensive collection of 8,069 3D CT volumes, encompassing over 2 million slices, paired with their respective radiological reports. Expanding upon the foundational work of our dataset, we craft a retrieval strategy, MedFinder. This approach employs a dual-stream network architecture, harnessing the potential of large language models to advance the field of medical image retrieval beyond existing text-image retrieval solutions. It marks our preliminary step towards developing a system capable of facilitating text-to-image, image-to-text, and keyword-based retrieval tasks.

In recent years, there have been significant breakthroughs in the field of natural language processing, particularly with the development of large language models (LLMs). These LLMs have showcased remarkable capabilities on various benchmarks. In the healthcare field, the exact role LLMs and other future AI models will play remains unclear. There is a potential for these models in the future to be used as part of adaptive physician training, medical co-pilot applications, and digital patient interaction scenarios. The ability of AI models to participate in medical training and patient care will depend in part on their mastery of the knowledge content of specific medical fields. This study investigated the medical knowledge capability of LLMs, specifically in the context of internal medicine subspecialty multiple-choice test-taking ability. We compared the performance of several open-source LLMs (Koala 7B, Falcon 7B, Stable-Vicuna 13B, and Orca Mini 13B), to GPT-4 and Claude 2 on multiple-choice questions in the field of Nephrology. Nephrology was chosen as an example of a particularly conceptually complex subspecialty field within internal medicine. The study was conducted to evaluate the ability of LLM models to provide correct answers to nephSAP (Nephrology Self-Assessment Program) multiple-choice questions. The overall success of open-sourced LLMs in answering the 858 nephSAP multiple-choice questions correctly was 17.1% - 25.5%. In contrast, Claude 2 answered 54.4% of the questions correctly, whereas GPT-4 achieved a score of 73.3%. We show that current widely used open-sourced LLMs do poorly in their ability for zero-shot reasoning when compared to GPT-4 and Claude 2. The findings of this study potentially have significant implications for the future of subspecialty medical training and patient care.

Multimodal Large Language Models (MLLMs) have tremendous potential to improve the accuracy, availability, and cost-effectiveness of healthcare by providing automated solutions or serving as aids to medical professionals. Despite promising first steps in developing medical MLLMs in the past few years, their capabilities and limitations are not well-understood. Recently, many benchmark datasets have been proposed that test the general medical knowledge of such models across a variety of medical areas. However, the systematic failure modes and vulnerabilities of such models are severely underexplored with most medical benchmarks failing to expose the shortcomings of existing models in this safety-critical domain. In this paper, we introduce MediConfusion, a challenging medical Visual Question Answering (VQA) benchmark dataset, that probes the failure modes of medical MLLMs from a vision perspective. We reveal that state-of-the-art models are easily confused by image pairs that are otherwise visually dissimilar and clearly distinct for medical experts. Strikingly, all available models (open-source or proprietary) achieve performance below random guessing on MediConfusion, raising serious concerns about the reliability of existing medical MLLMs for healthcare deployment. We also extract common patterns of model failure that may help the design of a new generation of more trustworthy and reliable MLLMs in healthcare.

The rapid development of Large Language Models (LLMs) for healthcare applications has spurred calls for holistic evaluation beyond frequently-cited benchmarks like USMLE, to better reflect real-world performance. While real-world assessments are valuable indicators of utility, they often lag behind the pace of LLM evolution, likely rendering findings obsolete upon deployment. This temporal disconnect necessitates a comprehensive upfront evaluation that can guide model selection for specific clinical applications. We introduce MEDIC, a framework assessing LLMs across five critical dimensions of clinical competence: medical reasoning, ethics and bias, data and language understanding, in-context learning, and clinical safety. MEDIC features a novel cross-examination framework quantifying LLM performance across areas like coverage and hallucination detection, without requiring reference outputs. We apply MEDIC to evaluate LLMs on medical question-answering, safety, summarization, note generation, and other tasks. Our results show performance disparities across model sizes, baseline vs medically finetuned models, and have implications on model selection for applications requiring specific model strengths, such as low hallucination or lower cost of inference. MEDIC's multifaceted evaluation reveals these performance trade-offs, bridging the gap between theoretical capabilities and practical implementation in healthcare settings, ensuring that the most promising models are identified and adapted for diverse healthcare applications.

We present MEGA-Bench, an evaluation suite that scales multimodal evaluation to over 500 real-world tasks, to address the highly heterogeneous daily use cases of end users. Our objective is to optimize for a set of high-quality data samples that cover a highly diverse and rich set of multimodal tasks, while enabling cost-effective and accurate model evaluation. In particular, we collected 505 realistic tasks encompassing over 8,000 samples from 16 expert annotators to extensively cover the multimodal task space. Instead of unifying these problems into standard multi-choice questions (like MMMU, MMBench, and MMT-Bench), we embrace a wide range of output formats like numbers, phrases, code, \LaTeX, coordinates, JSON, free-form, etc. To accommodate these formats, we developed over 40 metrics to evaluate these tasks. Unlike existing benchmarks, MEGA-Bench offers a fine-grained capability report across multiple dimensions (e.g., application, input type, output format, skill), allowing users to interact with and visualize model capabilities in depth. We evaluate a wide variety of frontier vision-language models on MEGA-Bench to understand their capabilities across these dimensions.

We introduce MedXpertQA, a highly challenging and comprehensive benchmark to evaluate expert-level medical knowledge and advanced reasoning. MedXpertQA includes 4,460 questions spanning 17 specialties and 11 body systems. It includes two subsets, Text for text evaluation and MM for multimodal evaluation. Notably, MM introduces expert-level exam questions with diverse images and rich clinical information, including patient records and examination results, setting it apart from traditional medical multimodal benchmarks with simple QA pairs generated from image captions. MedXpertQA applies rigorous filtering and augmentation to address the insufficient difficulty of existing benchmarks like MedQA, and incorporates specialty board questions to improve clinical relevance and comprehensiveness. We perform data synthesis to mitigate data leakage risk and conduct multiple rounds of expert reviews to ensure accuracy and reliability. We evaluate 16 leading models on MedXpertQA. Moreover, medicine is deeply connected to real-world decision-making, providing a rich and representative setting for assessing reasoning abilities beyond mathematics and code. To this end, we develop a reasoning-oriented subset to facilitate the assessment of o1-like models.

Visual captioning benchmarks have become outdated with the emergence of modern multimodal large language models (MLLMs), as the brief ground-truth sentences and traditional metrics fail to assess detailed captions effectively. While recent benchmarks attempt to address this by focusing on keyword extraction or object-centric evaluation, they remain limited to vague-view or object-view analyses and incomplete visual element coverage. In this paper, we introduce CAPability, a comprehensive multi-view benchmark for evaluating visual captioning across 12 dimensions spanning six critical views. We curate nearly 11K human-annotated images and videos with visual element annotations to evaluate the generated captions. CAPability stably assesses both the correctness and thoroughness of captions using F1-score. By converting annotations to QA pairs, we further introduce a heuristic metric, know but cannot tell (KT), indicating a significant performance gap between QA and caption capabilities. Our work provides the first holistic analysis of MLLMs' captioning abilities, as we identify their strengths and weaknesses across various dimensions, guiding future research to enhance specific aspects of capabilities.

Large language models (LLMs) can potentially democratize access to medical knowledge. While many efforts have been made to harness and improve LLMs' medical knowledge and reasoning capacities, the resulting models are either closed-source (e.g., PaLM, GPT-4) or limited in scale (<= 13B parameters), which restricts their abilities. In this work, we improve access to large-scale medical LLMs by releasing MEDITRON: a suite of open-source LLMs with 7B and 70B parameters adapted to the medical domain. MEDITRON builds on Llama-2 (through our adaptation of Nvidia's Megatron-LM distributed trainer), and extends pretraining on a comprehensively curated medical corpus, including selected PubMed articles, abstracts, and internationally-recognized medical guidelines. Evaluations using four major medical benchmarks show significant performance gains over several state-of-the-art baselines before and after task-specific finetuning. Overall, MEDITRON achieves a 6% absolute performance gain over the best public baseline in its parameter class and 3% over the strongest baseline we finetuned from Llama-2. Compared to closed-source LLMs, MEDITRON-70B outperforms GPT-3.5 and Med-PaLM and is within 5% of GPT-4 and 10% of Med-PaLM-2. We release our code for curating the medical pretraining corpus and the MEDITRON model weights to drive open-source development of more capable medical LLMs.

Multimodal Large Language Models (MLLMs) have demonstrated impressive capabilities in understanding common visual elements, largely due to their large-scale datasets and advanced training strategies. However, their effectiveness in medical applications remains limited due to the inherent discrepancies between data and tasks in medical scenarios and those in the general domain. Concretely, existing medical MLLMs face the following critical limitations: (1) limited coverage of medical knowledge beyond imaging, (2) heightened susceptibility to hallucinations due to suboptimal data curation processes, (3) lack of reasoning capabilities tailored for complex medical scenarios. To address these challenges, we first propose a comprehensive data curation procedure that (1) efficiently acquires rich medical knowledge data not only from medical imaging but also from extensive medical texts and general-domain data; and (2) synthesizes accurate medical captions, visual question answering (VQA), and reasoning samples. As a result, we build a multimodal dataset enriched with extensive medical knowledge. Building on the curated data, we introduce our medical-specialized MLLM: Lingshu. Lingshu undergoes multi-stage training to embed medical expertise and enhance its task-solving capabilities progressively. Besides, we preliminarily explore the potential of applying reinforcement learning with verifiable rewards paradigm to enhance Lingshu's medical reasoning ability. Additionally, we develop MedEvalKit, a unified evaluation framework that consolidates leading multimodal and textual medical benchmarks for standardized, fair, and efficient model assessment. We evaluate the performance of Lingshu on three fundamental medical tasks, multimodal QA, text-based QA, and medical report generation. The results show that Lingshu consistently outperforms the existing open-source multimodal models on most tasks ...

Recent advances in large language models (LLMs) have demonstrated exceptional performance in various natural language processing (NLP) tasks. However, their effective application in the medical domain is hampered by a lack of medical domain knowledge. In this study, we present SA-MDKIF, a scalable and adaptable framework that aims to inject medical knowledge into general-purpose LLMs through instruction tuning, thereby enabling adaptability for various downstream tasks. SA-MDKIF consists of two stages: skill training and skill adaptation. In the first stage, we define 12 basic medical skills and use AdaLoRA to train these skills based on uniformly formatted instructional datasets that we have constructed. In the next stage, we train the skill router using task-specific downstream data and use this router to integrate the acquired skills with LLMs during inference. Experimental results on 9 different medical tasks show that SA-MDKIF improves performance by 10-20% compared to the original LLMs. Notably, this improvement is particularly pronounced for unseen medical tasks, showing an improvement of up to 30%.

Large language models (LLMs) have the potential to transform medicine, but real-world clinical scenarios contain extraneous information that can hinder performance. The rise of assistive technologies like ambient dictation, which automatically generates draft notes from live patient encounters, has the potential to introduce additional noise making it crucial to assess the ability of LLM's to filter relevant data. To investigate this, we developed MedDistractQA, a benchmark using USMLE-style questions embedded with simulated real-world distractions. Our findings show that distracting statements (polysemous words with clinical meanings used in a non-clinical context or references to unrelated health conditions) can reduce LLM accuracy by up to 17.9%. Commonly proposed solutions to improve model performance such as retrieval-augmented generation (RAG) and medical fine-tuning did not change this effect and in some cases introduced their own confounders and further degraded performance. Our findings suggest that LLMs natively lack the logical mechanisms necessary to distinguish relevant from irrelevant clinical information, posing challenges for real-world applications. MedDistractQA and our results highlights the need for robust mitigation strategies to enhance LLM resilience to extraneous information.

Language models (LMs) have demonstrated expert-level reasoning and recall abilities in medicine. However, computational costs and privacy concerns are mounting barriers to wide-scale implementation. We introduce a parsimonious adaptation of phi-3-mini, MedMobile, a 3.8 billion parameter LM capable of running on a mobile device, for medical applications. We demonstrate that MedMobile scores 75.7% on the MedQA (USMLE), surpassing the passing mark for physicians (~60%), and approaching the scores of models 100 times its size. We subsequently perform a careful set of ablations, and demonstrate that chain of thought, ensembling, and fine-tuning lead to the greatest performance gains, while unexpectedly retrieval augmented generation fails to demonstrate significant improvements

Medical reasoning in large language models (LLMs) aims to emulate clinicians' diagnostic thinking, but current benchmarks such as MedQA-USMLE, MedMCQA, and PubMedQA often mix reasoning with factual recall. We address this by separating 11 biomedical QA benchmarks into reasoning- and knowledge-focused subsets using a PubMedBERT classifier that reaches 81 percent accuracy, comparable to human performance. Our analysis shows that only 32.8 percent of questions require complex reasoning. We evaluate biomedical models (HuatuoGPT-o1, MedReason, m1) and general-domain models (DeepSeek-R1, o4-mini, Qwen3), finding consistent gaps between knowledge and reasoning performance. For example, m1 scores 60.5 on knowledge but only 47.1 on reasoning. In adversarial tests where models are misled with incorrect initial reasoning, biomedical models degrade sharply, while larger or RL-trained general models show more robustness. To address this, we train BioMed-R1 using fine-tuning and reinforcement learning on reasoning-heavy examples. It achieves the strongest performance among similarly sized models. Further gains may come from incorporating clinical case reports and training with adversarial and backtracking scenarios.

In recent years, the application of Large Language Models (LLMs) in healthcare has shown significant promise in improving the accessibility and dissemination of medical knowledge. This paper presents a detailed study of various LLMs trained on the MedQuAD medical question-answering dataset, with a focus on identifying the most effective model for providing accurate medical information. Among the models tested, the Sentence-t5 combined with Mistral 7B demonstrated superior performance, achieving a precision score of 0.762. This model's enhanced capabilities are attributed to its advanced pretraining techniques, robust architecture, and effective prompt construction methodologies. By leveraging these strengths, the Sentence-t5 + Mistral 7B model excels in understanding and generating precise medical answers. Our findings highlight the potential of integrating sophisticated LLMs in medical contexts to facilitate efficient and accurate medical knowledge retrieval, thus significantly enhancing patient education and support.

Large Language Models (LLMs) like ChatGPT demonstrate significant potential in the medical field, often evaluated using multiple-choice questions (MCQs) similar to those found on the USMLE. Despite their prevalence in medical education, MCQs have limitations that might be exacerbated when assessing LLMs. To evaluate the effectiveness of MCQs in assessing the performance of LLMs, we developed a fictional medical benchmark focused on a non-existent gland, the Glianorex. This approach allowed us to isolate the knowledge of the LLM from its test-taking abilities. We used GPT-4 to generate a comprehensive textbook on the Glianorex in both English and French and developed corresponding multiple-choice questions in both languages. We evaluated various open-source, proprietary, and domain-specific LLMs using these questions in a zero-shot setting. The models achieved average scores around 67%, with minor performance differences between larger and smaller models. Performance was slightly higher in English than in French. Fine-tuned medical models showed some improvement over their base versions in English but not in French. The uniformly high performance across models suggests that traditional MCQ-based benchmarks may not accurately measure LLMs' clinical knowledge and reasoning abilities, instead highlighting their pattern recognition skills. This study underscores the need for more robust evaluation methods to better assess the true capabilities of LLMs in medical contexts.

Global healthcare providers are exploring use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested if LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in less than 34.5% of cases and disposition in less than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities prior to public deployments in healthcare.

Recent artificial intelligence (AI) systems have reached milestones in "grand challenges" ranging from Go to protein-folding. The capability to retrieve medical knowledge, reason over it, and answer medical questions comparably to physicians has long been viewed as one such grand challenge. Large language models (LLMs) have catalyzed significant progress in medical question answering; Med-PaLM was the first model to exceed a "passing" score in US Medical Licensing Examination (USMLE) style questions with a score of 67.2% on the MedQA dataset. However, this and other prior work suggested significant room for improvement, especially when models' answers were compared to clinicians' answers. Here we present Med-PaLM 2, which bridges these gaps by leveraging a combination of base LLM improvements (PaLM 2), medical domain finetuning, and prompting strategies including a novel ensemble refinement approach. Med-PaLM 2 scored up to 86.5% on the MedQA dataset, improving upon Med-PaLM by over 19% and setting a new state-of-the-art. We also observed performance approaching or exceeding state-of-the-art across MedMCQA, PubMedQA, and MMLU clinical topics datasets. We performed detailed human evaluations on long-form questions along multiple axes relevant to clinical applications. In pairwise comparative ranking of 1066 consumer medical questions, physicians preferred Med-PaLM 2 answers to those produced by physicians on eight of nine axes pertaining to clinical utility (p < 0.001). We also observed significant improvements compared to Med-PaLM on every evaluation axis (p < 0.001) on newly introduced datasets of 240 long-form "adversarial" questions to probe LLM limitations. While further studies are necessary to validate the efficacy of these models in real-world settings, these results highlight rapid progress towards physician-level performance in medical question answering.

Large language models (LLMs) have exhibited remarkable capabilities across various domains and tasks, pushing the boundaries of our knowledge in learning and cognition. The latest model, OpenAI's o1, stands out as the first LLM with an internalized chain-of-thought technique using reinforcement learning strategies. While it has demonstrated surprisingly strong capabilities on various general language tasks, its performance in specialized fields such as medicine remains unknown. To this end, this report provides a comprehensive exploration of o1 on different medical scenarios, examining 3 key aspects: understanding, reasoning, and multilinguality. Specifically, our evaluation encompasses 6 tasks using data from 37 medical datasets, including two newly constructed and more challenging question-answering (QA) tasks based on professional medical quizzes from the New England Journal of Medicine (NEJM) and The Lancet. These datasets offer greater clinical relevance compared to standard medical QA benchmarks such as MedQA, translating more effectively into real-world clinical utility. Our analysis of o1 suggests that the enhanced reasoning ability of LLMs may (significantly) benefit their capability to understand various medical instructions and reason through complex clinical scenarios. Notably, o1 surpasses the previous GPT-4 in accuracy by an average of 6.2% and 6.6% across 19 datasets and two newly created complex QA scenarios. But meanwhile, we identify several weaknesses in both the model capability and the existing evaluation protocols, including hallucination, inconsistent multilingual ability, and discrepant metrics for evaluation. We release our raw data and model outputs at https://ucsc-vlaa.github.io/o1_medicine/ for future research.

With the increasing use of RetrievalAugmented Generation (RAG), strong retrieval models have become more important than ever. In healthcare, multimodal retrieval models that combine information from both text and images offer major advantages for many downstream tasks such as question answering, cross-modal retrieval, and multimodal summarization, since medical data often includes both formats. However, there is currently no standard benchmark to evaluate how well these models perform in medical settings. To address this gap, we introduce M3Retrieve, a Multimodal Medical Retrieval Benchmark. M3Retrieve, spans 5 domains,16 medical fields, and 4 distinct tasks, with over 1.2 Million text documents and 164K multimodal queries, all collected under approved licenses. We evaluate leading multimodal retrieval models on this benchmark to explore the challenges specific to different medical specialities and to understand their impact on retrieval performance. By releasing M3Retrieve, we aim to enable systematic evaluation, foster model innovation, and accelerate research toward building more capable and reliable multimodal retrieval systems for medical applications. The dataset and the baselines code are available in this github page https://github.com/AkashGhosh/M3Retrieve.

The emergence of advanced reasoning capabilities in Large Language Models (LLMs) marks a transformative development in healthcare applications. Beyond merely expanding functional capabilities, these reasoning mechanisms enhance decision transparency and explainability-critical requirements in medical contexts. This survey examines the transformation of medical LLMs from basic information retrieval tools to sophisticated clinical reasoning systems capable of supporting complex healthcare decisions. We provide a thorough analysis of the enabling technological foundations, with a particular focus on specialized prompting techniques like Chain-of-Thought and recent breakthroughs in Reinforcement Learning exemplified by DeepSeek-R1. Our investigation evaluates purpose-built medical frameworks while also examining emerging paradigms such as multi-agent collaborative systems and innovative prompting architectures. The survey critically assesses current evaluation methodologies for medical validation and addresses persistent challenges in field interpretation limitations, bias mitigation strategies, patient safety frameworks, and integration of multimodal clinical data. Through this survey, we seek to establish a roadmap for developing reliable LLMs that can serve as effective partners in clinical practice and medical research.

The emerging trend of advancing generalist artificial intelligence, such as GPTv4 and Gemini, has reshaped the landscape of research (academia and industry) in machine learning and many other research areas. However, domain-specific applications of such foundation models (e.g., in medicine) remain untouched or often at their very early stages. It will require an individual set of transfer learning and model adaptation techniques by further expanding and injecting these models with domain knowledge and data. The development of such technologies could be largely accelerated if the bundle of data, algorithms, and pre-trained foundation models were gathered together and open-sourced in an organized manner. In this work, we present OpenMEDLab, an open-source platform for multi-modality foundation models. It encapsulates not only solutions of pioneering attempts in prompting and fine-tuning large language and vision models for frontline clinical and bioinformatic applications but also building domain-specific foundation models with large-scale multi-modal medical data. Importantly, it opens access to a group of pre-trained foundation models for various medical image modalities, clinical text, protein engineering, etc. Inspiring and competitive results are also demonstrated for each collected approach and model in a variety of benchmarks for downstream tasks. We welcome researchers in the field of medical artificial intelligence to continuously contribute cutting-edge methods and models to OpenMEDLab, which can be accessed via https://github.com/openmedlab.

In this study, we aim to initiate the development of Radiology Foundation Model, termed as RadFM.We consider the construction of foundational models from the perspectives of data, model design, and evaluation thoroughly. Our contribution can be concluded as follows: (i), we construct a large-scale Medical Multi-modal Dataset, MedMD, consisting of 16M 2D and 3D medical scans. To the best of our knowledge, this is the first multi-modal dataset containing 3D medical scans. (ii), We propose an architecture that enables visually conditioned generative pre-training, allowing for the integration of text input interleaved with 2D or 3D medical scans to generate response for diverse radiologic tasks. The model was initially pre-trained on MedMD and subsequently domain-specific fine-tuned on RadMD, a radiologic cleaned version of MedMD, containing 3M radiologic visual-language pairs. (iii), we propose a new evaluation benchmark that comprises five tasks, aiming to comprehensively assess the capability of foundation models in handling practical clinical problems. Our experimental results confirm that RadFM significantly outperforms existing multi-modal foundation models. The codes, data, and model checkpoint will all be made publicly available to promote further research and development in the field.

The rapid development of multimodal large language models (MLLMs), such as GPT-4V, has led to significant advancements. However, these models still face challenges in medical multimodal capabilities due to limitations in the quantity and quality of medical vision-text data, stemming from data privacy concerns and high annotation costs. While pioneering approaches utilize PubMed's large-scale, de-identified medical image-text pairs to address these limitations, they still fall short due to inherent data noise. To tackle this, we refined medical image-text pairs from PubMed and employed MLLMs (GPT-4V) in an 'unblinded' capacity to denoise and reformat the data, resulting in the creation of the PubMedVision dataset with 1.3 million medical VQA samples. Our validation demonstrates that: (1) PubMedVision can significantly enhance the medical multimodal capabilities of current MLLMs, showing significant improvement in benchmarks including the MMMU Health & Medicine track; (2) manual checks by medical experts and empirical results validate the superior data quality of our dataset compared to other data construction methods. Using PubMedVision, we train a 34B medical MLLM HuatuoGPT-Vision, which shows superior performance in medical multimodal scenarios among open-source MLLMs.

The rapidly developing field of large multimodal models (LMMs) has led to the emergence of diverse models with remarkable capabilities. However, existing benchmarks fail to comprehensively, objectively and accurately evaluate whether LMMs align with the diverse needs of humans in real-world scenarios. To bridge this gap, we propose the Multi-Dimensional Insights (MDI) benchmark, which includes over 500 images covering six common scenarios of human life. Notably, the MDI-Benchmark offers two significant advantages over existing evaluations: (1) Each image is accompanied by two types of questions: simple questions to assess the model's understanding of the image, and complex questions to evaluate the model's ability to analyze and reason beyond basic content. (2) Recognizing that people of different age groups have varying needs and perspectives when faced with the same scenario, our benchmark stratifies questions into three age categories: young people, middle-aged people, and older people. This design allows for a detailed assessment of LMMs' capabilities in meeting the preferences and needs of different age groups. With MDI-Benchmark, the strong model like GPT-4o achieve 79% accuracy on age-related tasks, indicating that existing LMMs still have considerable room for improvement in addressing real-world applications. Looking ahead, we anticipate that the MDI-Benchmark will open new pathways for aligning real-world personalization in LMMs. The MDI-Benchmark data and evaluation code are available at https://mdi-benchmark.github.io/

Artificial intelligence (AI) has significant potential in healthcare applications, but its training and deployment faces challenges due to healthcare's diverse data, complex tasks, and the need to preserve privacy. Foundation models that perform well on medical tasks and require less task-specific tuning data are critical to accelerate the development of healthcare AI applications. We introduce MedGemma, a collection of medical vision-language foundation models based on Gemma 3 4B and 27B. MedGemma demonstrates advanced medical understanding and reasoning on images and text, significantly exceeding the performance of similar-sized generative models and approaching the performance of task-specific models, while maintaining the general capabilities of the Gemma 3 base models. For out-of-distribution tasks, MedGemma achieves 2.6-10% improvement on medical multimodal question answering, 15.5-18.1% improvement on chest X-ray finding classification, and 10.8% improvement on agentic evaluations compared to the base models. Fine-tuning MedGemma further improves performance in subdomains, reducing errors in electronic health record information retrieval by 50% and reaching comparable performance to existing specialized state-of-the-art methods for pneumothorax classification and histopathology patch classification. We additionally introduce MedSigLIP, a medically-tuned vision encoder derived from SigLIP. MedSigLIP powers the visual understanding capabilities of MedGemma and as an encoder achieves comparable or better performance than specialized medical image encoders. Taken together, the MedGemma collection provides a strong foundation of medical image and text capabilities, with potential to significantly accelerate medical research and development of downstream applications. The MedGemma collection, including tutorials and model weights, can be found at https://goo.gle/medgemma.

The rapid advancement of large-scale vision-language models has showcased remarkable capabilities across various tasks. However, the lack of extensive and high-quality image-text data in medicine has greatly hindered the development of large-scale medical vision-language models. In this work, we present a diagnosis-guided bootstrapping strategy that exploits both image and label information to construct vision-language datasets. Based on the constructed dataset, we developed MedDr, a generalist foundation model for healthcare capable of handling diverse medical data modalities, including radiology, pathology, dermatology, retinography, and endoscopy. Moreover, during inference, we propose a simple but effective retrieval-augmented medical diagnosis strategy, which enhances the model's generalization ability. Extensive experiments on visual question answering, medical report generation, and medical image diagnosis demonstrate the superiority of our method.

We present the Virology Capabilities Test (VCT), a large language model (LLM) benchmark that measures the capability to troubleshoot complex virology laboratory protocols. Constructed from the inputs of dozens of PhD-level expert virologists, VCT consists of 322 multimodal questions covering fundamental, tacit, and visual knowledge that is essential for practical work in virology laboratories. VCT is difficult: expert virologists with access to the internet score an average of 22.1% on questions specifically in their sub-areas of expertise. However, the most performant LLM, OpenAI's o3, reaches 43.8% accuracy, outperforming 94% of expert virologists even within their sub-areas of specialization. The ability to provide expert-level virology troubleshooting is inherently dual-use: it is useful for beneficial research, but it can also be misused. Therefore, the fact that publicly available models outperform virologists on VCT raises pressing governance considerations. We propose that the capability of LLMs to provide expert-level troubleshooting of dual-use virology work should be integrated into existing frameworks for handling dual-use technologies in the life sciences.

Large Multimodal Models (LMMs) have shown remarkable progress in the field of medical Visual Question Answering (Med-VQA), achieving high accuracy on existing benchmarks. However, their reliability under robust evaluation is questionable. This study reveals that state-of-the-art models, when subjected to simple probing evaluation, perform worse than random guessing on medical diagnosis questions. To address this critical evaluation problem, we introduce the Probing Evaluation for Medical Diagnosis (ProbMed) dataset to rigorously assess LMM performance in medical imaging through probing evaluation and procedural diagnosis. Particularly, probing evaluation features pairing original questions with negation questions with hallucinated attributes, while procedural diagnosis requires reasoning across various diagnostic dimensions for each image, including modality recognition, organ identification, clinical findings, abnormalities, and positional grounding. Our evaluation reveals that top-performing models like GPT-4V and Gemini Pro perform worse than random guessing on specialized diagnostic questions, indicating significant limitations in handling fine-grained medical inquiries. Besides, models like LLaVA-Med struggle even with more general questions, and results from CheXagent demonstrate the transferability of expertise across different modalities of the same organ, showing that specialized domain knowledge is still crucial for improving performance. This study underscores the urgent need for more robust evaluation to ensure the reliability of LMMs in critical fields like medical diagnosis, and current LMMs are still far from applicable to those fields.

Different medical imaging modalities capture diagnostic information at varying spatial resolutions, from coarse global patterns to fine-grained localized structures. However, most existing vision-language frameworks in the medical domain apply a uniform strategy for local feature extraction, overlooking the modality-specific demands. In this work, we present MedMoE, a modular and extensible vision-language processing framework that dynamically adapts visual representation based on the diagnostic context. MedMoE incorporates a Mixture-of-Experts (MoE) module conditioned on the report type, which routes multi-scale image features through specialized expert branches trained to capture modality-specific visual semantics. These experts operate over feature pyramids derived from a Swin Transformer backbone, enabling spatially adaptive attention to clinically relevant regions. This framework produces localized visual representations aligned with textual descriptions, without requiring modality-specific supervision at inference. Empirical results on diverse medical benchmarks demonstrate that MedMoE improves alignment and retrieval performance across imaging modalities, underscoring the value of modality-specialized visual representations in clinical vision-language systems.

Large multimodal models (LMMs) have demonstrated significant potential in providing innovative solutions for various biomedical tasks, including pathology analysis, radiology report generation, and biomedical assistance. However, the existing multimodal biomedical AI is typically based on foundation LLMs, thus hindering the understanding of intricate medical concepts with limited medical training data. Moreover, recent LLaVA-induced medical LMMs struggle to effectively capture the intricate relationship between the texts and the images. Therefore, we introduce Doctor Sun, a large multimodal generative model specialized in medicine, developed to encode, integrate, and interpret diverse biomedical data modalities such as text and images. In particular, Doctor Sun integrates a pre-trained vision encoder with a medical LLM and conducts two-stage training on various medical datasets, focusing on feature alignment and instruction tuning. Moreover, we release SunMed-VL, a wide-range bilingual medical multimodal dataset, along with all associated models, code, and resources, to freely support the advancement of biomedical multimodal research.

Mixture of Expert Tuning (MoE-Tuning) has effectively enhanced the performance of general MLLMs with fewer parameters, yet its application in resource-limited medical settings has not been fully explored. To address this gap, we developed MoE-TinyMed, a model tailored for medical applications that significantly lowers parameter demands. In evaluations on the VQA-RAD, SLAKE, and Path-VQA datasets, MoE-TinyMed outperformed LLaVA-Med in all Med-VQA closed settings with just 3.6B parameters. Additionally, a streamlined version with 2B parameters surpassed LLaVA-Med's performance in PathVQA, showcasing its effectiveness in resource-limited healthcare settings.

MRI is an indispensable clinical tool, offering a rich variety of tissue contrasts to support broad diagnostic and research applications. Clinical exams routinely acquire multiple structural sequences that provide complementary information for differential diagnosis, while research protocols often incorporate advanced functional, diffusion, spectroscopic, and relaxometry sequences to capture multidimensional insights into tissue structure and composition. However, these capabilities come at the cost of prolonged scan times, which reduce patient throughput, increase susceptibility to motion artifacts, and may require trade-offs in image quality or diagnostic scope. Over the last two decades, advances in image reconstruction algorithms--alongside improvements in hardware and pulse sequence design--have made it possible to accelerate acquisitions while preserving diagnostic quality. Central to this progress is the ability to incorporate prior information to regularize the solutions to the reconstruction problem. In this tutorial, we overview the basics of MRI reconstruction and highlight state-of-the-art approaches, beginning with classical methods that rely on explicit hand-crafted priors, and then turning to deep learning methods that leverage a combination of learned and crafted priors to further push the performance envelope. We also explore the translational aspects and eventual clinical implications of these methods. We conclude by discussing future directions to address remaining challenges in MRI reconstruction. The tutorial is accompanied by a Python toolbox (https://github.com/tutorial-MRI-recon/tutorial) to demonstrate select methods discussed in the article.

With the advent of Vision-Language Models (VLMs), medical artificial intelligence (AI) has experienced significant technological progress and paradigm shifts. This survey provides an extensive review of recent advancements in Medical Vision-Language Models (Med-VLMs), which integrate visual and textual data to enhance healthcare outcomes. We discuss the foundational technology behind Med-VLMs, illustrating how general models are adapted for complex medical tasks, and examine their applications in healthcare. The transformative impact of Med-VLMs on clinical practice, education, and patient care is highlighted, alongside challenges such as data scarcity, narrow task generalization, interpretability issues, and ethical concerns like fairness, accountability, and privacy. These limitations are exacerbated by uneven dataset distribution, computational demands, and regulatory hurdles. Rigorous evaluation methods and robust regulatory frameworks are essential for safe integration into healthcare workflows. Future directions include leveraging large-scale, diverse datasets, improving cross-modal generalization, and enhancing interpretability. Innovations like federated learning, lightweight architectures, and Electronic Health Record (EHR) integration are explored as pathways to democratize access and improve clinical relevance. This review aims to provide a comprehensive understanding of Med-VLMs' strengths and limitations, fostering their ethical and balanced adoption in healthcare.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

Generalist vision language models (VLMs) have made significant strides in computer vision, but they fall short in specialized fields like healthcare, where expert knowledge is essential. In traditional computer vision tasks, creative or approximate answers may be acceptable, but in healthcare, precision is paramount.Current large multimodal models like Gemini and GPT-4o are insufficient for medical tasks due to their reliance on memorized internet knowledge rather than the nuanced expertise required in healthcare. VLMs are usually trained in three stages: vision pre-training, vision-language pre-training, and instruction fine-tuning (IFT). IFT has been typically applied using a mixture of generic and healthcare data. In contrast, we propose that for medical VLMs, a fourth stage of specialized IFT is necessary, which focuses on medical data and includes information from domain expert models. Domain expert models developed for medical use are crucial because they are specifically trained for certain clinical tasks, e.g. to detect tumors and classify abnormalities through segmentation and classification, which learn fine-grained features of medical data-features that are often too intricate for a VLM to capture effectively especially in radiology. This paper introduces a new framework, VILA-M3, for medical VLMs that utilizes domain knowledge via expert models. Through our experiments, we show an improved state-of-the-art (SOTA) performance with an average improvement of ~9% over the prior SOTA model Med-Gemini and ~6% over models trained on the specific tasks. Our approach emphasizes the importance of domain expertise in creating precise, reliable VLMs for medical applications.

The integration of Computer-Assisted Diagnosis (CAD) with Large Language Models (LLMs) holds great potential in clinical applications, specifically in the roles of virtual family doctors and clinic assistants. However, current works in this field are plagued by limitations, specifically a restricted scope of applicable image domains and the provision of unreliable medical advice. This restricts their overall processing capabilities. Furthermore, the mismatch in writing style between LLMs and radiologists undermines their practical usefulness. To tackle these challenges, we introduce ChatCAD+, which is designed to be universal and reliable. It is capable of handling medical images from diverse domains and leveraging up-to-date information from reputable medical websites to provide reliable medical advice. Additionally, it incorporates a template retrieval system that improves report generation performance via exemplar reports. This approach ensures greater consistency with the expertise of human professionals. The source code is available at https://github.com/zhaozh10/ChatCAD.

Medical Vision-Language Models (MVLMs) have achieved par excellence generalization in medical image analysis, yet their performance under noisy, corrupted conditions remains largely untested. Clinical imaging is inherently susceptible to acquisition artifacts and noise; however, existing evaluations predominantly assess generally clean datasets, overlooking robustness -- i.e., the model's ability to perform under real-world distortions. To address this gap, we first introduce MediMeta-C, a corruption benchmark that systematically applies several perturbations across multiple medical imaging datasets. Combined with MedMNIST-C, this establishes a comprehensive robustness evaluation framework for MVLMs. We further propose RobustMedCLIP, a visual encoder adaptation of a pretrained MVLM that incorporates few-shot tuning to enhance resilience against corruptions. Through extensive experiments, we benchmark 5 major MVLMs across 5 medical imaging modalities, revealing that existing models exhibit severe degradation under corruption and struggle with domain-modality tradeoffs. Our findings highlight the necessity of diverse training and robust adaptation strategies, demonstrating that efficient low-rank adaptation when paired with few-shot tuning, improves robustness while preserving generalization across modalities.

As large language models (LLMs) advance in conversational and reasoning capabilities, their practical application in healthcare has become a critical research focus. However, there is a notable gap between the performance of medical LLMs on static benchmarks such as USMLE and their utility in real-world clinical decision-making. This discrepancy arises because traditional exams fail to capture the dynamic, interactive nature of medical consultations. To address this challenge, we introduce a novel dynamic verification framework that moves beyond static answer verifier, establishing a large-scale, high-fidelity interactive reinforcement learning system. Our framework comprises two key components: a Patient Simulator that creates realistic clinical environments using de-identified medical records, and a Clinical Rubrics Generator that dynamically produces multi-dimensional evaluation metrics. Building on this foundation, we develop Baichuan-M2, a 32B-parameter medical augmented reasoning model trained through a multi-stage reinforcement learning strategy with an improved Group Relative Policy Optimization (GRPO) algorithm. Evaluated on HealthBench, Baichuan-M2 outperforms all other open-source models and most advanced closed-source counterparts, achieving a score above 32 on the challenging HealthBench Hard benchmark-previously exceeded only by GPT-5. Our work demonstrates that robust dynamic verifier system is essential for aligning LLM capabilities with practical clinical applications, establishing a new Pareto front in the performance-parameter trade-off for medical AI deployment.

Security concerns related to Large Language Models (LLMs) have been extensively explored, yet the safety implications for Multimodal Large Language Models (MLLMs), particularly in medical contexts (MedMLLMs), remain insufficiently studied. This paper delves into the underexplored security vulnerabilities of MedMLLMs, especially when deployed in clinical environments where the accuracy and relevance of question-and-answer interactions are critically tested against complex medical challenges. By combining existing clinical medical data with atypical natural phenomena, we redefine two types of attacks: mismatched malicious attack (2M-attack) and optimized mismatched malicious attack (O2M-attack). Using our own constructed voluminous 3MAD dataset, which covers a wide range of medical image modalities and harmful medical scenarios, we conduct a comprehensive analysis and propose the MCM optimization method, which significantly enhances the attack success rate on MedMLLMs. Evaluations with this dataset and novel attack methods, including white-box attacks on LLaVA-Med and transfer attacks on four other state-of-the-art models, indicate that even MedMLLMs designed with enhanced security features are vulnerable to security breaches. Our work underscores the urgent need for a concerted effort to implement robust security measures and enhance the safety and efficacy of open-source MedMLLMs, particularly given the potential severity of jailbreak attacks and other malicious or clinically significant exploits in medical settings. For further research and replication, anonymous access to our code is available at https://github.com/dirtycomputer/O2M_attack. Warning: Medical large model jailbreaking may generate content that includes unverified diagnoses and treatment recommendations. Always consult professional medical advice.

LLMs have become increasingly capable at accomplishing a range of specialized-tasks and can be utilized to expand equitable access to medical knowledge. Most medical LLMs have involved extensive fine-tuning, leveraging specialized medical data and significant, thus costly, amounts of computational power. Many of the top performing LLMs are proprietary and their access is limited to very few research groups. However, open-source (OS) models represent a key area of growth for medical LLMs due to significant improvements in performance and an inherent ability to provide the transparency and compliance required in healthcare. We present OpenMedLM, a prompting platform which delivers state-of-the-art (SOTA) performance for OS LLMs on medical benchmarks. We evaluated a range of OS foundation LLMs (7B-70B) on four medical benchmarks (MedQA, MedMCQA, PubMedQA, MMLU medical-subset). We employed a series of prompting strategies, including zero-shot, few-shot, chain-of-thought (random selection and kNN selection), and ensemble/self-consistency voting. We found that OpenMedLM delivers OS SOTA results on three common medical LLM benchmarks, surpassing the previous best performing OS models that leveraged computationally costly extensive fine-tuning. The model delivers a 72.6% accuracy on the MedQA benchmark, outperforming the previous SOTA by 2.4%, and achieves 81.7% accuracy on the MMLU medical-subset, establishing itself as the first OS LLM to surpass 80% accuracy on this benchmark. Our results highlight medical-specific emergent properties in OS LLMs which have not yet been documented to date elsewhere, and showcase the benefits of further leveraging prompt engineering to improve the performance of accessible LLMs for medical applications.

This paper explores the advancements and applications of large-scale models in the medical field, with a particular focus on Medical Large Models (MedLMs). These models, encompassing Large Language Models (LLMs), Vision Models, 3D Large Models, and Multimodal Models, are revolutionizing healthcare by enhancing disease prediction, diagnostic assistance, personalized treatment planning, and drug discovery. The integration of graph neural networks in medical knowledge graphs and drug discovery highlights the potential of Large Graph Models (LGMs) in understanding complex biomedical relationships. The study also emphasizes the transformative role of Vision-Language Models (VLMs) and 3D Large Models in medical image analysis, anatomical modeling, and prosthetic design. Despite the challenges, these technologies are setting new benchmarks in medical innovation, improving diagnostic accuracy, and paving the way for personalized healthcare solutions. This paper aims to provide a comprehensive overview of the current state and future directions of large models in medicine, underscoring their significance in advancing global health.

Medical diagnostic applications require models that can process multimodal medical inputs (images, patient histories, lab results) and generate diverse outputs including both textual reports and visual content (annotations, segmentation masks, and images). Despite this need, existing medical AI systems disrupt this unified process: medical image understanding models interpret images but cannot generate visual outputs, while medical image generation models synthesize images but cannot provide textual explanations. This leads to gaps in data representation, feature integration, and task-level multimodal capabilities. To this end, we propose a multi-level framework that draws inspiration from diagnostic workflows through the Observation-Knowledge-Analysis (OKA) paradigm. Specifically, at the observation level, we construct UniMed-5M, a dataset comprising over 5.6M samples that reformat diverse unimodal data into multimodal pairs for foundational observation. At the knowledge level, we propose Progressive Curriculum Learning that systematically introduces medical multimodal knowledge. At the analysis level, we introduce UniMedVL, the first medical unified multimodal model for the simultaneous analysis of image understanding and generation tasks within a single architecture. UniMedVL achieves superior performance on five medical image understanding benchmarks, while matching specialized models in generation quality across eight medical imaging modalities. Crucially, our unified architecture enables bidirectional knowledge sharing: generation tasks enhance visual understanding features, demonstrating that integrating traditionally separate capabilities within a single medical framework unlocks improvements across diverse medical vision-language tasks. Code is available at https://github.com/uni-medical/UniMedVL.

Hospitals in India still rely on handwritten medical records despite the availability of Electronic Medical Records (EMR), complicating statistical analysis and record retrieval. Handwritten records pose a unique challenge, requiring specialized data for training models to recognize medications and their recommendation patterns. While traditional handwriting recognition approaches employ 2-D LSTMs, recent studies have explored using Multimodal Large Language Models (MLLMs) for OCR tasks. Building on this approach, we focus on extracting medication names and dosages from simulated medical records. Our methodology MIRAGE (Multimodal Identification and Recognition of Annotations in indian GEneral prescriptions) involves fine-tuning the QWEN VL, LLaVA 1.6 and Idefics2 models on 743,118 high resolution simulated medical record images-fully annotated from 1,133 doctors across India. Our approach achieves 82% accuracy in extracting medication names and dosages.

Every day, countless surgeries are performed worldwide, each within the distinct settings of operating rooms (ORs) that vary not only in their setups but also in the personnel, tools, and equipment used. This inherent diversity poses a substantial challenge for achieving a holistic understanding of the OR, as it requires models to generalize beyond their initial training datasets. To reduce this gap, we introduce ORacle, an advanced vision-language model designed for holistic OR domain modeling, which incorporates multi-view and temporal capabilities and can leverage external knowledge during inference, enabling it to adapt to previously unseen surgical scenarios. This capability is further enhanced by our novel data augmentation framework, which significantly diversifies the training dataset, ensuring ORacle's proficiency in applying the provided knowledge effectively. In rigorous testing, in scene graph generation, and downstream tasks on the 4D-OR dataset, ORacle not only demonstrates state-of-the-art performance but does so requiring less data than existing models. Furthermore, its adaptability is displayed through its ability to interpret unseen views, actions, and appearances of tools and equipment. This demonstrates ORacle's potential to significantly enhance the scalability and affordability of OR domain modeling and opens a pathway for future advancements in surgical data science. We will release our code and data upon acceptance.

This paper introduces MedMCQA, a new large-scale, Multiple-Choice Question Answering (MCQA) dataset designed to address real-world medical entrance exam questions. More than 194k high-quality AIIMS \& NEET PG entrance exam MCQs covering 2.4k healthcare topics and 21 medical subjects are collected with an average token length of 12.77 and high topical diversity. Each sample contains a question, correct answer(s), and other options which requires a deeper language understanding as it tests the 10+ reasoning abilities of a model across a wide range of medical subjects \& topics. A detailed explanation of the solution, along with the above information, is provided in this study.

Vision-Language Models (VLMs) trained via contrastive learning have achieved notable success in natural image tasks. However, their application in the medical domain remains limited due to the scarcity of openly accessible, large-scale medical image-text datasets. Existing medical VLMs either train on closed-source proprietary or relatively small open-source datasets that do not generalize well. Similarly, most models remain specific to a single or limited number of medical imaging domains, again restricting their applicability to other modalities. To address this gap, we introduce UniMed, a large-scale, open-source multi-modal medical dataset comprising over 5.3 million image-text pairs across six diverse imaging modalities: X-ray, CT, MRI, Ultrasound, Pathology, and Fundus. UniMed is developed using a data-collection framework that leverages Large Language Models (LLMs) to transform modality-specific classification datasets into image-text formats while incorporating existing image-text data from the medical domain, facilitating scalable VLM pretraining. Using UniMed, we trained UniMed-CLIP, a unified VLM for six modalities that significantly outperforms existing generalist VLMs and matches modality-specific medical VLMs, achieving notable gains in zero-shot evaluations. For instance, UniMed-CLIP improves over BiomedCLIP (trained on proprietary data) by an absolute gain of +12.61, averaged over 21 datasets, while using 3x less training data. To facilitate future research, we release UniMed dataset, training codes, and models at https://github.com/mbzuai-oryx/UniMed-CLIP.

The scaling laws and extraordinary performance of large foundation models motivate the development and utilization of such models in biomedicine. However, despite early promising results on some biomedical benchmarks, there are still major challenges that need to be addressed before these models can be used in real-world clinics. Frontier general-domain models such as GPT-4V still have significant performance gaps in multimodal biomedical applications. More importantly, less-acknowledged pragmatic issues, including accessibility, model cost, and tedious manual evaluation make it hard for clinicians to use state-of-the-art large models directly on private patient data. Here, we explore training open-source small multimodal models (SMMs) to bridge competency gaps for unmet clinical needs in radiology. To maximize data efficiency, we adopt a modular approach by incorporating state-of-the-art pre-trained models for image and text modalities, and focusing on training a lightweight adapter to ground each modality to the text embedding space, as exemplified by LLaVA-Med. For training, we assemble a large dataset of over 697 thousand radiology image-text pairs. For evaluation, we propose CheXprompt, a GPT-4-based metric for factuality evaluation, and demonstrate its parity with expert evaluation. For best practice, we conduct a systematic ablation study on various choices in data engineering and multimodal training. The resulting LlaVA-Rad (7B) model attains state-of-the-art results on standard radiology tasks such as report generation and cross-modal retrieval, even outperforming much larger models such as GPT-4V and Med-PaLM M (84B). The inference of LlaVA-Rad is fast and can be performed on a single V100 GPU in private settings, offering a promising state-of-the-art tool for real-world clinical applications.

Multimodal large language models (MLLMs) have demonstrated promising prospects in healthcare, particularly for addressing complex medical tasks, supporting multidisciplinary treatment (MDT), and enabling personalized precision medicine. However, their practical deployment faces critical challenges in resource efficiency, diagnostic accuracy, clinical considerations, and ethical privacy. To address these limitations, we propose Infi-Med, a comprehensive framework for medical MLLMs that introduces three key innovations: (1) a resource-efficient approach through curating and constructing high-quality supervised fine-tuning (SFT) datasets with minimal sample requirements, with a forward-looking design that extends to both pretraining and posttraining phases; (2) enhanced multimodal reasoning capabilities for cross-modal integration and clinical task understanding; and (3) a systematic evaluation system that assesses model performance across medical modalities and task types. Our experiments demonstrate that Infi-Med achieves state-of-the-art (SOTA) performance in general medical reasoning while maintaining rapid adaptability to clinical scenarios. The framework establishes a solid foundation for deploying MLLMs in real-world healthcare settings by balancing model effectiveness with operational constraints.

The rapid evolution of artificial intelligence, especially in large language models (LLMs), has significantly impacted various domains, including healthcare. In chest X-ray (CXR) analysis, previous studies have employed LLMs, but with limitations: either underutilizing the multi-tasking capabilities of LLMs or lacking clinical accuracy. This paper presents M4CXR, a multi-modal LLM designed to enhance CXR interpretation. The model is trained on a visual instruction-following dataset that integrates various task-specific datasets in a conversational format. As a result, the model supports multiple tasks such as medical report generation (MRG), visual grounding, and visual question answering (VQA). M4CXR achieves state-of-the-art clinical accuracy in MRG by employing a chain-of-thought prompting strategy, in which it identifies findings in CXR images and subsequently generates corresponding reports. The model is adaptable to various MRG scenarios depending on the available inputs, such as single-image, multi-image, and multi-study contexts. In addition to MRG, M4CXR performs visual grounding at a level comparable to specialized models and also demonstrates outstanding performance in VQA. Both quantitative and qualitative assessments reveal M4CXR's versatility in MRG, visual grounding, and VQA, while consistently maintaining clinical accuracy.

Accurate and efficient question-answering systems are essential for delivering high-quality patient care in the medical field. While Large Language Models (LLMs) have made remarkable strides across various domains, they continue to face significant challenges in medical question answering, particularly in understanding domain-specific terminologies and performing complex reasoning. These limitations undermine their effectiveness in critical medical applications. To address these issues, we propose a novel approach incorporating similar case generation within a multi-agent medical question-answering (MedQA) system. Specifically, we leverage the Llama3.1:70B model, a state-of-the-art LLM, in a multi-agent architecture to enhance performance on the MedQA dataset using zero-shot learning. Our method capitalizes on the model's inherent medical knowledge and reasoning capabilities, eliminating the need for additional training data. Experimental results show substantial performance gains over existing benchmark models, with improvements of 7% in both accuracy and F1-score across various medical QA tasks. Furthermore, we examine the model's interpretability and reliability in addressing complex medical queries. This research not only offers a robust solution for medical question answering but also establishes a foundation for broader applications of LLMs in the medical domain.

Recent developments in Large Language Model (LLM)-based agents have shown impressive capabilities spanning multiple domains, exemplified by deep research systems that demonstrate superior performance on complex information-seeking and synthesis tasks. While general-purpose deep research agents have shown impressive capabilities, they struggle significantly with medical domain challenges, as evidenced by leading proprietary systems achieving limited accuracy on complex medical benchmarks. The key limitations are: (1) the model lacks sufficient dense medical knowledge for clinical reasoning, and (2) the framework is constrained by the absence of specialized retrieval tools tailored for medical contexts.We present a medical deep research agent that addresses these challenges through two core innovations. First, we develop a novel data synthesis framework using medical knowledge graphs, extracting the longest chains from subgraphs around rare medical entities to generate complex multi-hop question-answer pairs. Second, we integrate a custom-built private medical retrieval engine alongside general-purpose tools, enabling accurate medical information synthesis. Our approach generates 2100+ diverse trajectories across 12 medical specialties, each averaging 4.2 tool interactions.Through a two-stage training paradigm combining supervised fine-tuning and online reinforcement learning with composite rewards, our MedResearcher-R1-32B model demonstrates exceptional performance, establishing new state-of-the-art results on medical benchmarks while maintaining competitive performance on general deep research tasks. Our work demonstrates that strategic domain-specific innovations in architecture, tool design, and training data construction can enable smaller open-source models to outperform much larger proprietary systems in specialized domains.

Models such as GPT-4 and Med-PaLM 2 have demonstrated impressive performance on a wide variety of biomedical NLP tasks. However, these models have hundreds of billions of parameters, are computationally expensive to run, require users to send their input data over the internet, and are trained on unknown data sources. Can smaller, more targeted models compete? To address this question, we build and release BioMedLM, a 2.7 billion parameter GPT-style autoregressive model trained exclusively on PubMed abstracts and full articles. When fine-tuned, BioMedLM can produce strong multiple-choice biomedical question-answering results competitive with much larger models, such as achieving a score of 57.3% on MedMCQA (dev) and 69.0% on the MMLU Medical Genetics exam. BioMedLM can also be fine-tuned to produce useful answers to patient questions on medical topics. This demonstrates that smaller models can potentially serve as transparent, privacy-preserving, economical and environmentally friendly foundations for particular NLP applications, such as in biomedicine. The model is available on the Hugging Face Hub: https://huggingface.co/stanford-crfm/BioMedLM.

The emergent abilities of large language models (LLMs) have demonstrated great potential in solving medical questions. They can possess considerable medical knowledge, but may still hallucinate and are inflexible in the knowledge updates. While Retrieval-Augmented Generation (RAG) has been proposed to enhance the medical question-answering capabilities of LLMs with external knowledge bases, it may still fail in complex cases where multiple rounds of information-seeking are required. To address such an issue, we propose iterative RAG for medicine (i-MedRAG), where LLMs can iteratively ask follow-up queries based on previous information-seeking attempts. In each iteration of i-MedRAG, the follow-up queries will be answered by a vanilla RAG system and they will be further used to guide the query generation in the next iteration. Our experiments show the improved performance of various LLMs brought by i-MedRAG compared with vanilla RAG on complex questions from clinical vignettes in the United States Medical Licensing Examination (USMLE), as well as various knowledge tests in the Massive Multitask Language Understanding (MMLU) dataset. Notably, our zero-shot i-MedRAG outperforms all existing prompt engineering and fine-tuning methods on GPT-3.5, achieving an accuracy of 69.68\% on the MedQA dataset. In addition, we characterize the scaling properties of i-MedRAG with different iterations of follow-up queries and different numbers of queries per iteration. Our case studies show that i-MedRAG can flexibly ask follow-up queries to form reasoning chains, providing an in-depth analysis of medical questions. To the best of our knowledge, this is the first-of-its-kind study on incorporating follow-up queries into medical RAG.

Large Language Models (LLMs) have introduced a new era of proficiency in comprehending complex healthcare and biomedical topics. However, there is a noticeable lack of models in languages other than English and models that can interpret multi-modal input, which is crucial for global healthcare accessibility. In response, this study introduces Qilin-Med-VL, the first Chinese large vision-language model designed to integrate the analysis of textual and visual data. Qilin-Med-VL combines a pre-trained Vision Transformer (ViT) with a foundational LLM. It undergoes a thorough two-stage curriculum training process that includes feature alignment and instruction tuning. This method enhances the model's ability to generate medical captions and answer complex medical queries. We also release ChiMed-VL, a dataset consisting of more than 1M image-text pairs. This dataset has been carefully curated to enable detailed and comprehensive interpretation of medical data using various types of images.

Large language models (LLMs) are rapidly transitioning into medical clinical use, yet their reliability under realistic, multi-turn interactions remains poorly understood. Existing evaluation frameworks typically assess single-turn question answering under idealized conditions, overlooking the complexities of medical consultations where conflicting input, misleading context, and authority influence are common. We introduce MedQA-Followup, a framework for systematically evaluating multi-turn robustness in medical question answering. Our approach distinguishes between shallow robustness (resisting misleading initial context) and deep robustness (maintaining accuracy when answers are challenged across turns), while also introducing an indirect-direct axis that separates contextual framing (indirect) from explicit suggestion (direct). Using controlled interventions on the MedQA dataset, we evaluate five state-of-the-art LLMs and find that while models perform reasonably well under shallow perturbations, they exhibit severe vulnerabilities in multi-turn settings, with accuracy dropping from 91.2% to as low as 13.5% for Claude Sonnet 4. Counterintuitively, indirect, context-based interventions are often more harmful than direct suggestions, yielding larger accuracy drops across models and exposing a significant vulnerability for clinical deployment. Further compounding analyses reveal model differences, with some showing additional performance drops under repeated interventions while others partially recovering or even improving. These findings highlight multi-turn robustness as a critical but underexplored dimension for safe and reliable deployment of medical LLMs.

Biomedical data is inherently multimodal, consisting of electronic health records, medical imaging, digital pathology, genome sequencing, wearable sensors, and more. The application of artificial intelligence tools to these multifaceted sensing technologies has the potential to revolutionize the prognosis, diagnosis, and management of human health and disease. However, current approaches to biomedical AI typically only train and evaluate with one or a small set of medical modalities and tasks. This limitation hampers the development of comprehensive tools that can leverage the rich interconnected information across many heterogeneous biomedical sensors. To address this challenge, we present MultiMed, a benchmark designed to evaluate and enable large-scale learning across a wide spectrum of medical modalities and tasks. MultiMed consists of 2.56 million samples across ten medical modalities such as medical reports, pathology, genomics, and protein data, and is structured into eleven challenging tasks, including disease prognosis, protein structure prediction, and medical question answering. Using MultiMed, we conduct comprehensive experiments benchmarking state-of-the-art unimodal, multimodal, and multitask models. Our analysis highlights the advantages of training large-scale medical models across many related modalities and tasks. Moreover, MultiMed enables studies of generalization across related medical concepts, robustness to real-world noisy data and distribution shifts, and novel modality combinations to improve prediction performance. MultiMed will be publicly available and regularly updated and welcomes inputs from the community.

Multimodal large language models (MLLMs) have shown remarkable potential in various domains, yet their application in the medical field is hindered by several challenges. General-purpose MLLMs often lack the specialized knowledge required for medical tasks, leading to uncertain or hallucinatory responses. Knowledge distillation from advanced models struggles to capture domain-specific expertise in radiology and pharmacology. Additionally, the computational cost of continual pretraining with large-scale medical data poses significant efficiency challenges. To address these issues, we propose InfiMed-Foundation-1.7B and InfiMed-Foundation-4B, two medical-specific MLLMs designed to deliver state-of-the-art performance in medical applications. We combined high-quality general-purpose and medical multimodal data and proposed a novel five-dimensional quality assessment framework to curate high-quality multimodal medical datasets. We employ low-to-high image resolution and multimodal sequence packing to enhance training efficiency, enabling the integration of extensive medical data. Furthermore, a three-stage supervised fine-tuning process ensures effective knowledge extraction for complex medical tasks. Evaluated on the MedEvalKit framework, InfiMed-Foundation-1.7B outperforms Qwen2.5VL-3B, while InfiMed-Foundation-4B surpasses HuatuoGPT-V-7B and MedGemma-27B-IT, demonstrating superior performance in medical visual question answering and diagnostic tasks. By addressing key challenges in data quality, training efficiency, and domain-specific knowledge extraction, our work paves the way for more reliable and effective AI-driven solutions in healthcare. InfiMed-Foundation-4B model is available at https://huggingface.co/InfiX-ai/InfiMed-Foundation-4B{InfiMed-Foundation-4B}.

The analysis of 3D medical images is crucial for modern healthcare, yet traditional task-specific models are becoming increasingly inadequate due to limited generalizability across diverse clinical scenarios. Multimodal large language models (MLLMs) offer a promising solution to these challenges. However, existing MLLMs have limitations in fully leveraging the rich, hierarchical information embedded in 3D medical images. Inspired by clinical practice, where radiologists focus on both 3D spatial structure and 2D planar content, we propose Med-2E3, a novel MLLM for 3D medical image analysis that integrates 3D and 2D encoders. To aggregate 2D features more effectively, we design a Text-Guided Inter-Slice (TG-IS) scoring module, which scores the attention of each 2D slice based on slice contents and task instructions. To the best of our knowledge, Med-2E3 is the first MLLM to integrate both 3D and 2D features for 3D medical image analysis. Experiments on a large-scale, open-source 3D medical multimodal benchmark demonstrate that Med-2E3 exhibits task-specific attention distribution and significantly outperforms current state-of-the-art models, with a 14% improvement in report generation and a 5% gain in medical visual question answering (VQA), highlighting the model's potential in addressing complex multimodal clinical tasks. The code will be released upon acceptance.

Recent advancements in large language model(LLM) performance on medical multiple choice question (MCQ) benchmarks have stimulated interest from healthcare providers and patients globally. Particularly in low-and middle-income countries (LMICs) facing acute physician shortages and lack of specialists, LLMs offer a potentially scalable pathway to enhance healthcare access and reduce costs. However, their effectiveness in the Global South, especially across the African continent, remains to be established. In this work, we introduce AfriMed-QA, the first large scale Pan-African English multi-specialty medical Question-Answering (QA) dataset, 15,000 questions (open and closed-ended) sourced from over 60 medical schools across 16 countries, covering 32 medical specialties. We further evaluate 30 LLMs across multiple axes including correctness and demographic bias. Our findings show significant performance variation across specialties and geographies, MCQ performance clearly lags USMLE (MedQA). We find that biomedical LLMs underperform general models and smaller edge-friendly LLMs struggle to achieve a passing score. Interestingly, human evaluations show a consistent consumer preference for LLM answers and explanations when compared with clinician answers.

The advancement of natural language processing (NLP) systems in healthcare hinges on language model ability to interpret the intricate information contained within clinical notes. This process often requires integrating information from various time points in a patient's medical history. However, most earlier clinical language models were pretrained with a context length limited to roughly one clinical document. In this study, We introduce ClinicalMamba, a specialized version of the Mamba language model, pretrained on a vast corpus of longitudinal clinical notes to address the unique linguistic characteristics and information processing needs of the medical domain. ClinicalMamba, with 130 million and 2.8 billion parameters, demonstrates a superior performance in modeling clinical language across extended text lengths compared to Mamba and clinical Llama. With few-shot learning, ClinicalMamba achieves notable benchmarks in speed and accuracy, outperforming existing clinical language models and general domain large models like GPT-4 in longitudinal clinical notes information extraction tasks.

Excellence in a wide variety of medical applications poses considerable challenges for AI, requiring advanced reasoning, access to up-to-date medical knowledge and understanding of complex multimodal data. Gemini models, with strong general capabilities in multimodal and long-context reasoning, offer exciting possibilities in medicine. Building on these core strengths of Gemini, we introduce Med-Gemini, a family of highly capable multimodal models that are specialized in medicine with the ability to seamlessly use web search, and that can be efficiently tailored to novel modalities using custom encoders. We evaluate Med-Gemini on 14 medical benchmarks, establishing new state-of-the-art (SoTA) performance on 10 of them, and surpass the GPT-4 model family on every benchmark where a direct comparison is viable, often by a wide margin. On the popular MedQA (USMLE) benchmark, our best-performing Med-Gemini model achieves SoTA performance of 91.1% accuracy, using a novel uncertainty-guided search strategy. On 7 multimodal benchmarks including NEJM Image Challenges and MMMU (health & medicine), Med-Gemini improves over GPT-4V by an average relative margin of 44.5%. We demonstrate the effectiveness of Med-Gemini's long-context capabilities through SoTA performance on a needle-in-a-haystack retrieval task from long de-identified health records and medical video question answering, surpassing prior bespoke methods using only in-context learning. Finally, Med-Gemini's performance suggests real-world utility by surpassing human experts on tasks such as medical text summarization, alongside demonstrations of promising potential for multimodal medical dialogue, medical research and education. Taken together, our results offer compelling evidence for Med-Gemini's potential, although further rigorous evaluation will be crucial before real-world deployment in this safety-critical domain.

Medical open-domain question answering demands substantial access to specialized knowledge. Recent efforts have sought to decouple knowledge from model parameters, counteracting architectural scaling and allowing for training on common low-resource hardware. The retrieve-then-read paradigm has become ubiquitous, with model predictions grounded on relevant knowledge pieces from external repositories such as PubMed, textbooks, and UMLS. An alternative path, still under-explored but made possible by the advent of domain-specific large language models, entails constructing artificial contexts through prompting. As a result, "to generate or to retrieve" is the modern equivalent of Hamlet's dilemma. This paper presents MedGENIE, the first generate-then-read framework for multiple-choice question answering in medicine. We conduct extensive experiments on MedQA-USMLE, MedMCQA, and MMLU, incorporating a practical perspective by assuming a maximum of 24GB VRAM. MedGENIE sets a new state-of-the-art (SOTA) in the open-book setting of each testbed, even allowing a small-scale reader to outcompete zero-shot closed-book 175B baselines while using up to 706times fewer parameters. Overall, our findings reveal that generated passages are more effective than retrieved counterparts in attaining higher accuracy.

Mamba, a special case of the State Space Model, is gaining popularity as an alternative to template-based deep learning approaches in medical image analysis. While transformers are powerful architectures, they have drawbacks, including quadratic computational complexity and an inability to address long-range dependencies efficiently. This limitation affects the analysis of large and complex datasets in medical imaging, where there are many spatial and temporal relationships. In contrast, Mamba offers benefits that make it well-suited for medical image analysis. It has linear time complexity, which is a significant improvement over transformers. Mamba processes longer sequences without attention mechanisms, enabling faster inference and requiring less memory. Mamba also demonstrates strong performance in merging multimodal data, improving diagnosis accuracy and patient outcomes. The organization of this paper allows readers to appreciate the capabilities of Mamba in medical imaging step by step. We begin by defining core concepts of SSMs and models, including S4, S5, and S6, followed by an exploration of Mamba architectures such as pure Mamba, U-Net variants, and hybrid models with convolutional neural networks, transformers, and Graph Neural Networks. We also cover Mamba optimizations, techniques and adaptations, scanning, datasets, applications, experimental results, and conclude with its challenges and future directions in medical imaging. This review aims to demonstrate the transformative potential of Mamba in overcoming existing barriers within medical imaging while paving the way for innovative advancements in the field. A comprehensive list of Mamba architectures applied in the medical field, reviewed in this work, is available at Github.

Multimodal Large Language Models (MLLMs) have exhibited impressive capabilities in visual understanding and reasoning, providing sightly reasonable answers, such as image descriptions. This has spurred extensive research on the evaluation of MLLMs. Most evaluation benchmarks assume that incorrect answers indicate a lack of understanding of the visual content. However, our findings reveal that, in many cases, MLLMs answer questions incorrectly despite correctly understanding the visual content. This suggests that incorrect answers do not necessarily imply a lack of comprehension but may instead result from lacking robustness to leading questions. To comprehensively measure MLLMs' understanding capability and robustness to leading questions, we introduce a MultiModal Robustness benchmark (MMR). MMR contains paired positive and negative questions across 12 categories, meticulously annotated by humans. We evaluate 18 leading MLLMs on the MMB benchmark, revealing that MLLMs suffer from fragility to leading questions despite understanding the visual content. To enhance MLLMs' understanding capability and robustness, we further present a training set with paired positive and negative visual question-answer samples. Experiments verify that MLLMs' robustness can be significantly enhanced by tuning on this new training set. The benchmark, training set, and code can be found at https://github.com/BAAI-DCAI/Multimodal-Robustness-Benchmark.

Many clinical tasks require an understanding of specialized data, such as medical images and genomics, which is not typically found in general-purpose large multimodal models. Building upon Gemini's multimodal models, we develop several models within the new Med-Gemini family that inherit core capabilities of Gemini and are optimized for medical use via fine-tuning with 2D and 3D radiology, histopathology, ophthalmology, dermatology and genomic data. Med-Gemini-2D sets a new standard for AI-based chest X-ray (CXR) report generation based on expert evaluation, exceeding previous best results across two separate datasets by an absolute margin of 1% and 12%, where 57% and 96% of AI reports on normal cases, and 43% and 65% on abnormal cases, are evaluated as "equivalent or better" than the original radiologists' reports. We demonstrate the first ever large multimodal model-based report generation for 3D computed tomography (CT) volumes using Med-Gemini-3D, with 53% of AI reports considered clinically acceptable, although additional research is needed to meet expert radiologist reporting quality. Beyond report generation, Med-Gemini-2D surpasses the previous best performance in CXR visual question answering (VQA) and performs well in CXR classification and radiology VQA, exceeding SoTA or baselines on 17 of 20 tasks. In histopathology, ophthalmology, and dermatology image classification, Med-Gemini-2D surpasses baselines across 18 out of 20 tasks and approaches task-specific model performance. Beyond imaging, Med-Gemini-Polygenic outperforms the standard linear polygenic risk score-based approach for disease risk prediction and generalizes to genetically correlated diseases for which it has never been trained. Although further development and evaluation are necessary in the safety-critical medical domain, our results highlight the potential of Med-Gemini across a wide range of medical tasks.

The development of vision-language models (VLMs) is driven by large-scale and diverse multimodal datasets. However, progress toward generalist biomedical VLMs is limited by the lack of annotated, publicly accessible datasets across biology and medicine. Existing efforts are restricted to narrow domains, missing the full diversity of biomedical knowledge encoded in scientific literature. To address this gap, we introduce BIOMEDICA, a scalable, open-source framework to extract, annotate, and serialize the entirety of the PubMed Central Open Access subset into an easy-to-use, publicly accessible dataset.Our framework produces a comprehensive archive with over 24 million unique image-text pairs from over 6 million articles. Metadata and expert-guided annotations are also provided. We demonstrate the utility and accessibility of our resource by releasing BMCA-CLIP, a suite of CLIP-style models continuously pre-trained on the BIOMEDICA dataset via streaming, eliminating the need to download 27 TB of data locally.On average, our models achieve state-of-the-art performance across 40 tasks - spanning pathology, radiology, ophthalmology, dermatology, surgery, molecular biology, parasitology, and cell biology - excelling in zero-shot classification with a 6.56% average improvement (as high as 29.8% and 17.5% in dermatology and ophthalmology, respectively), and stronger image-text retrieval, all while using 10x less compute. To foster reproducibility and collaboration, we release our codebase and dataset for the broader research community.

Endoscopic procedures are essential for diagnosing and treating internal diseases, and multi-modal large language models (MLLMs) are increasingly applied to assist in endoscopy analysis. However, current benchmarks are limited, as they typically cover specific endoscopic scenarios and a small set of clinical tasks, failing to capture the real-world diversity of endoscopic scenarios and the full range of skills needed in clinical workflows. To address these issues, we introduce EndoBench, the first comprehensive benchmark specifically designed to assess MLLMs across the full spectrum of endoscopic practice with multi-dimensional capacities. EndoBench encompasses 4 distinct endoscopic scenarios, 12 specialized clinical tasks with 12 secondary subtasks, and 5 levels of visual prompting granularities, resulting in 6,832 rigorously validated VQA pairs from 21 diverse datasets. Our multi-dimensional evaluation framework mirrors the clinical workflow--spanning anatomical recognition, lesion analysis, spatial localization, and surgical operations--to holistically gauge the perceptual and diagnostic abilities of MLLMs in realistic scenarios. We benchmark 23 state-of-the-art models, including general-purpose, medical-specialized, and proprietary MLLMs, and establish human clinician performance as a reference standard. Our extensive experiments reveal: (1) proprietary MLLMs outperform open-source and medical-specialized models overall, but still trail human experts; (2) medical-domain supervised fine-tuning substantially boosts task-specific accuracy; and (3) model performance remains sensitive to prompt format and clinical task complexity. EndoBench establishes a new standard for evaluating and advancing MLLMs in endoscopy, highlighting both progress and persistent gaps between current models and expert clinical reasoning. We publicly release our benchmark and code.

Large vision-language models (LVLMs) have shown great promise in medical applications, particularly in visual question answering (MedVQA) and diagnosis from medical images. However, existing datasets and models often fail to consider critical aspects of medical diagnostics, such as the integration of historical records and the analysis of disease progression over time. In this paper, we introduce MMXU (Multimodal and MultiX-ray Understanding), a novel dataset for MedVQA that focuses on identifying changes in specific regions between two patient visits. Unlike previous datasets that primarily address single-image questions, MMXU enables multi-image questions, incorporating both current and historical patient data. We demonstrate the limitations of current LVLMs in identifying disease progression on MMXU-test, even those that perform well on traditional benchmarks. To address this, we propose a MedRecord-Augmented Generation (MAG) approach, incorporating both global and regional historical records. Our experiments show that integrating historical records significantly enhances diagnostic accuracy by at least 20\%, bridging the gap between current LVLMs and human expert performance. Additionally, we fine-tune models with MAG on MMXU-dev, which demonstrates notable improvements. We hope this work could illuminate the avenue of advancing the use of LVLMs in medical diagnostics by emphasizing the importance of historical context in interpreting medical images. Our dataset is released at https://github.com/linjiemu/MMXU{https://github.com/linjiemu/MMXU}.

Medical image retrieval is essential for clinical decision-making and translational research, relying on discriminative visual representations. Yet, current methods remain fragmented, relying on separate architectures and training strategies for 2D, 3D, and video-based medical data. This modality-specific design hampers scalability and inhibits the development of unified representations. To enable unified learning, we curate a large-scale hybrid-modality dataset comprising 867,653 medical imaging samples, including 2D X-rays and ultrasounds, RGB endoscopy videos, and 3D CT scans. Leveraging this dataset, we train M3Ret, a unified visual encoder without any modality-specific customization. It successfully learns transferable representations using both generative (MAE) and contrastive (SimDINO) self-supervised learning (SSL) paradigms. Our approach sets a new state-of-the-art in zero-shot image-to-image retrieval across all individual modalities, surpassing strong baselines such as DINOv3 and the text-supervised BMC-CLIP. More remarkably, strong cross-modal alignment emerges without paired data, and the model generalizes to unseen MRI tasks, despite never observing MRI during pretraining, demonstrating the generalizability of purely visual self-supervision to unseen modalities. Comprehensive analyses further validate the scalability of our framework across model and data sizes. These findings deliver a promising signal to the medical imaging community, positioning M3Ret as a step toward foundation models for visual SSL in multimodal medical image understanding.

Vision-language models (VLMs) have advanced reasoning in natural scenes, but their role in medical imaging remains underexplored. Medical reasoning tasks demand robust image analysis and well-justified answers, posing challenges due to the complexity of medical images. Transparency and trustworthiness are essential for clinical adoption and regulatory compliance. We introduce Med-R1, a framework exploring reinforcement learning (RL) to enhance VLMs' generalizability and trustworthiness in medical reasoning. Leveraging the DeepSeek strategy, we employ Group Relative Policy Optimization (GRPO) to guide reasoning paths via reward signals. Unlike supervised fine-tuning (SFT), which often overfits and lacks generalization, RL fosters robust and diverse reasoning. Med-R1 is evaluated across eight medical imaging modalities: CT, MRI, Ultrasound, Dermoscopy, Fundus Photography, Optical Coherence Tomography (OCT), Microscopy, and X-ray Imaging. Compared to its base model, Qwen2-VL-2B, Med-R1 achieves a 29.94% accuracy improvement and outperforms Qwen2-VL-72B, which has 36 times more parameters. Testing across five question types-modality recognition, anatomy identification, disease diagnosis, lesion grading, and biological attribute analysis Med-R1 demonstrates superior generalization, exceeding Qwen2-VL-2B by 32.06% and surpassing Qwen2-VL-72B in question-type generalization. These findings show that RL improves medical reasoning and enables parameter-efficient models to outperform significantly larger ones. With interpretable reasoning outputs, Med-R1 represents a promising step toward generalizable, trustworthy, and clinically viable medical VLMs.

We present Eir Thai Medical LLM, a large language model with 8 billion parameters, specifically designed to enhance the accuracy of handling medical tasks in the Thai language. This model focuses on providing clear and easy-to-understand answers for both healthcare professionals and patients, thereby improving the efficiency of diagnosis and treatment processes. Human evaluation was conducted to ensure that the model adheres to care standards and provides unbiased answers. To prioritize data security, the model is deployed within the hospital's internal network, ensuring both high security and faster processing speeds. The internal API connection is secured with encryption and strict authentication measures to prevent data leaks and unauthorized access. We evaluated several open-source large language models with 8 billion parameters on four medical benchmarks: MedQA, MedMCQA, PubMedQA, and the medical subset of MMLU. The best-performing baselines were used to develop Eir Thai Medical LLM. Our evaluation employed multiple questioning strategies, including zero-shot, few-shot, chain-of-thought reasoning, and ensemble/self-consistency voting methods. Our model outperformed commercially available Thai-language large language models by more than 10%. In addition, we developed enhanced model testing tailored for clinical use in Thai across 18 clinical tasks, where our model exceeded GPT-4o performance by more than 11%

Med42-v2 introduces a suite of clinical large language models (LLMs) designed to address the limitations of generic models in healthcare settings. These models are built on Llama3 architecture and fine-tuned using specialized clinical data. They underwent multi-stage preference alignment to effectively respond to natural prompts. While generic models are often preference-aligned to avoid answering clinical queries as a precaution, Med42-v2 is specifically trained to overcome this limitation, enabling its use in clinical settings. Med42-v2 models demonstrate superior performance compared to the original Llama3 models in both 8B and 70B parameter configurations and GPT-4 across various medical benchmarks. These LLMs are developed to understand clinical queries, perform reasoning tasks, and provide valuable assistance in clinical environments. The models are now publicly available at https://huggingface.co/m42-health{https://huggingface.co/m42-health}.

Recent advances in reinforcement learning with verifiable, rule-based rewards have greatly enhanced the reasoning capabilities and out-of-distribution generalization of VLMs/LLMs, obviating the need for manually crafted reasoning chains. Despite these promising developments in the general domain, their translation to medical imaging remains limited. Current medical reinforcement fine-tuning (RFT) methods predominantly focus on close-ended VQA, thereby restricting the model's ability to engage in world knowledge retrieval and flexible task adaptation. More critically, these methods fall short of addressing the critical clinical demand for open-ended, reasoning-intensive decision-making. To bridge this gap, we introduce MedCCO, the first multimodal reinforcement learning framework tailored for medical VQA that unifies close-ended and open-ended data within a curriculum-driven RFT paradigm. Specifically, MedCCO is initially fine-tuned on a diverse set of close-ended medical VQA tasks to establish domain-grounded reasoning capabilities, and is then progressively adapted to open-ended tasks to foster deeper knowledge enhancement and clinical interpretability. We validate MedCCO across eight challenging medical VQA benchmarks, spanning both close-ended and open-ended settings. Experimental results show that MedCCO consistently enhances performance and generalization, achieving a 11.4\% accuracy gain across three in-domain tasks, and a 5.7\% improvement on five out-of-domain benchmarks. These findings highlight the promise of curriculum-guided RL in advancing robust, clinically-relevant reasoning in medical multimodal language models.

Large Language Models (LLMs) have demonstrated significant potential in handling specialized tasks, including medical problem-solving. However, most studies predominantly focus on English-language contexts. This study introduces a novel benchmark dataset based on Polish medical licensing and specialization exams (LEK, LDEK, PES) taken by medical doctor candidates and practicing doctors pursuing specialization. The dataset was web-scraped from publicly available resources provided by the Medical Examination Center and the Chief Medical Chamber. It comprises over 24,000 exam questions, including a subset of parallel Polish-English corpora, where the English portion was professionally translated by the examination center for foreign candidates. By creating a structured benchmark from these existing exam questions, we systematically evaluate state-of-the-art LLMs, including general-purpose, domain-specific, and Polish-specific models, and compare their performance against human medical students. Our analysis reveals that while models like GPT-4o achieve near-human performance, significant challenges persist in cross-lingual translation and domain-specific understanding. These findings underscore disparities in model performance across languages and medical specialties, highlighting the limitations and ethical considerations of deploying LLMs in clinical practice.

Multimodal large language models (MLLMs) have made significant strides, yet they face challenges in the medical domain due to limited specialized knowledge. While recent medical MLLMs demonstrate strong performance in lab settings, they often struggle in real-world applications, highlighting a substantial gap between research and practice. In this paper, we seek to address this gap at various stages of the end-to-end learning pipeline, including data collection, model fine-tuning, and evaluation. At the data collection stage, we introduce SemiHVision, a dataset that combines human annotations with automated augmentation techniques to improve both medical knowledge representation and diagnostic reasoning. For model fine-tuning, we trained PMC-Cambrian-8B-AN over 2400 H100 GPU hours, resulting in performance that surpasses public medical models like HuatuoGPT-Vision-34B (79.0% vs. 66.7%) and private general models like Claude3-Opus (55.7%) on traditional benchmarks such as SLAKE and VQA-RAD. In the evaluation phase, we observed that traditional benchmarks cannot accurately reflect realistic clinical task capabilities. To overcome this limitation and provide more targeted guidance for model evaluation, we introduce the JAMA Clinical Challenge, a novel benchmark specifically designed to evaluate diagnostic reasoning. On this benchmark, PMC-Cambrian-AN achieves state-of-the-art performance with a GPT-4 score of 1.29, significantly outperforming HuatuoGPT-Vision-34B (1.13) and Claude3-Opus (1.17), demonstrating its superior diagnostic reasoning abilities.

Recent progress in multimodal large language models (MLLMs) has demonstrated promising performance on medical benchmarks and in preliminary trials as clinical assistants. Yet, our pilot audit of diagnostic cases uncovers a critical failure mode: instability in early evidence interpretation precedes hallucination, creating branching reasoning trajectories that cascade into globally inconsistent conclusions. This highlights the need for clinical reasoning agents that constrain stochasticity and hallucination while producing auditable decision flows. We introduce MedMMV, a controllable multimodal multi-agent framework for reliable and verifiable clinical reasoning. MedMMV stabilizes reasoning through diversified short rollouts, grounds intermediate steps in a structured evidence graph under the supervision of a Hallucination Detector, and aggregates candidate paths with a Combined Uncertainty scorer. On six medical benchmarks, MedMMV improves accuracy by up to 12.7% and, more critically, demonstrates superior reliability. Blind physician evaluations confirm that MedMMV substantially increases reasoning truthfulness without sacrificing informational content. By controlling instability through a verifiable, multi-agent process, our framework provides a robust path toward deploying trustworthy AI systems in high-stakes domains like clinical decision support.

Foundation models are becoming valuable tools in medicine. Yet despite their promise, the best way to leverage Large Language Models (LLMs) in complex medical tasks remains an open question. We introduce a novel multi-agent framework, named Medical Decision-making Agents (MDAgents) that helps address this gap by automatically assigning a collaboration structure to a team of LLMs. The assigned solo or group collaboration structure is tailored to the medical task at hand, emulating real-world medical decision-making processes adapted to tasks of varying complexities. We evaluate our framework and baseline methods using state-of-the-art LLMs across a suite of real-world medical knowledge and medical diagnosis benchmarks, including a comparison of LLMs' medical complexity classification against human physicians. MDAgents achieved the best performance in seven out of ten benchmarks on tasks requiring an understanding of medical knowledge and multi-modal reasoning, showing a significant improvement of up to 4.2% (p < 0.05) compared to previous methods' best performances. Ablation studies reveal that MDAgents effectively determines medical complexity to optimize for efficiency and accuracy across diverse medical tasks. Notably, the combination of moderator review and external medical knowledge in group collaboration resulted in an average accuracy improvement of 11.8%. Our code can be found at https://github.com/mitmedialab/MDAgents.

Large Language Models (LLMs) provide a possibility to make a great breakthrough in medicine. The establishment of a standardized medical benchmark becomes a fundamental cornerstone to measure progression. However, medical environments in different regions have their local characteristics, e.g., the ubiquity and significance of traditional Chinese medicine within China. Therefore, merely translating English-based medical evaluation may result in contextual incongruities to a local region. To solve the issue, we propose a localized medical benchmark called CMB, a Comprehensive Medical Benchmark in Chinese, designed and rooted entirely within the native Chinese linguistic and cultural framework. While traditional Chinese medicine is integral to this evaluation, it does not constitute its entirety. Using this benchmark, we have evaluated several prominent large-scale LLMs, including ChatGPT, GPT-4, dedicated Chinese LLMs, and LLMs specialized in the medical domain. It is worth noting that our benchmark is not devised as a leaderboard competition but as an instrument for self-assessment of model advancements. We hope this benchmark could facilitate the widespread adoption and enhancement of medical LLMs within China. Check details in https://cmedbenchmark.llmzoo.com/.

Multimodal foundation models that can holistically process text alongside images, video, audio, and other sensory modalities are increasingly used in a variety of real-world applications. However, it is challenging to characterize and study progress in multimodal foundation models, given the range of possible modeling decisions, tasks, and domains. In this paper, we introduce Holistic Evaluation of Multimodal Models (HEMM) to systematically evaluate the capabilities of multimodal foundation models across a set of 3 dimensions: basic skills, information flow, and real-world use cases. Basic multimodal skills are internal abilities required to solve problems, such as learning interactions across modalities, fine-grained alignment, multi-step reasoning, and the ability to handle external knowledge. Information flow studies how multimodal content changes during a task through querying, translation, editing, and fusion. Use cases span domain-specific challenges introduced in real-world multimedia, affective computing, natural sciences, healthcare, and human-computer interaction applications. Through comprehensive experiments across the 30 tasks in HEMM, we (1) identify key dataset dimensions (e.g., basic skills, information flows, and use cases) that pose challenges to today's models, and (2) distill performance trends regarding how different modeling dimensions (e.g., scale, pre-training data, multimodal alignment, pre-training, and instruction tuning objectives) influence performance. Our conclusions regarding challenging multimodal interactions, use cases, and tasks requiring reasoning and external knowledge, the benefits of data and model scale, and the impacts of instruction tuning yield actionable insights for future work in multimodal foundation models.

The integration of Large Language Models (LLMs) into healthcare applications offers promising advancements in medical diagnostics, treatment recommendations, and patient care. However, the susceptibility of LLMs to adversarial attacks poses a significant threat, potentially leading to harmful outcomes in delicate medical contexts. This study investigates the vulnerability of LLMs to two types of adversarial attacks in three medical tasks. Utilizing real-world patient data, we demonstrate that both open-source and proprietary LLMs are susceptible to manipulation across multiple tasks. This research further reveals that domain-specific tasks demand more adversarial data in model fine-tuning than general domain tasks for effective attack execution, especially for more capable models. We discover that while integrating adversarial data does not markedly degrade overall model performance on medical benchmarks, it does lead to noticeable shifts in fine-tuned model weights, suggesting a potential pathway for detecting and countering model attacks. This research highlights the urgent need for robust security measures and the development of defensive mechanisms to safeguard LLMs in medical applications, to ensure their safe and effective deployment in healthcare settings.

Medical vision-and-language models (MVLMs) have attracted substantial interest due to their capability to offer a natural language interface for interpreting complex medical data. Their applications are versatile and have the potential to improve diagnostic accuracy and decision-making for individual patients while also contributing to enhanced public health monitoring, disease surveillance, and policy-making through more efficient analysis of large data sets. MVLMS integrate natural language processing with medical images to enable a more comprehensive and contextual understanding of medical images alongside their corresponding textual information. Unlike general vision-and-language models trained on diverse, non-specialized datasets, MVLMs are purpose-built for the medical domain, automatically extracting and interpreting critical information from medical images and textual reports to support clinical decision-making. Popular clinical applications of MVLMs include automated medical report generation, medical visual question answering, medical multimodal segmentation, diagnosis and prognosis and medical image-text retrieval. Here, we provide a comprehensive overview of MVLMs and the various medical tasks to which they have been applied. We conduct a detailed analysis of various vision-and-language model architectures, focusing on their distinct strategies for cross-modal integration/exploitation of medical visual and textual features. We also examine the datasets used for these tasks and compare the performance of different models based on standardized evaluation metrics. Furthermore, we highlight potential challenges and summarize future research trends and directions. The full collection of papers and codes is available at: https://github.com/YtongXie/Medical-Vision-and-Language-Tasks-and-Methodologies-A-Survey.

The Multimodal Large Language Model (MLLM) is currently experiencing rapid growth, driven by the advanced capabilities of LLMs. Unlike earlier specialists, existing MLLMs are evolving towards a Multimodal Generalist paradigm. Initially limited to understanding multiple modalities, these models have advanced to not only comprehend but also generate across modalities. Their capabilities have expanded from coarse-grained to fine-grained multimodal understanding and from supporting limited modalities to arbitrary ones. While many benchmarks exist to assess MLLMs, a critical question arises: Can we simply assume that higher performance across tasks indicates a stronger MLLM capability, bringing us closer to human-level AI? We argue that the answer is not as straightforward as it seems. This project introduces General-Level, an evaluation framework that defines 5-scale levels of MLLM performance and generality, offering a methodology to compare MLLMs and gauge the progress of existing systems towards more robust multimodal generalists and, ultimately, towards AGI. At the core of the framework is the concept of Synergy, which measures whether models maintain consistent capabilities across comprehension and generation, and across multiple modalities. To support this evaluation, we present General-Bench, which encompasses a broader spectrum of skills, modalities, formats, and capabilities, including over 700 tasks and 325,800 instances. The evaluation results that involve over 100 existing state-of-the-art MLLMs uncover the capability rankings of generalists, highlighting the challenges in reaching genuine AI. We expect this project to pave the way for future research on next-generation multimodal foundation models, providing a robust infrastructure to accelerate the realization of AGI. Project page: https://generalist.top/

In the era of modern healthcare, swiftly generating medical question summaries is crucial for informed and timely patient care. Despite the increasing complexity and volume of medical data, existing studies have focused solely on text-based summarization, neglecting the integration of visual information. Recognizing the untapped potential of combining textual queries with visual representations of medical conditions, we introduce the Multimodal Medical Question Summarization (MMQS) Dataset. This dataset, a major contribution to our work, pairs medical queries with visual aids, facilitating a richer and more nuanced understanding of patient needs. We also propose a framework, utilizing the power of Contrastive Language Image Pretraining(CLIP) and Large Language Models(LLMs), consisting of four modules that identify medical disorders, generate relevant context, filter medical concepts, and craft visually aware summaries. Our comprehensive framework harnesses the power of CLIP, a multimodal foundation model, and various general-purpose LLMs, comprising four main modules: the medical disorder identification module, the relevant context generation module, the context filtration module for distilling relevant medical concepts and knowledge, and finally, a general-purpose LLM to generate visually aware medical question summaries. Leveraging our MMQS dataset, we showcase how visual cues from images enhance the generation of medically nuanced summaries. This multimodal approach not only enhances the decision-making process in healthcare but also fosters a more nuanced understanding of patient queries, laying the groundwork for future research in personalized and responsive medical care

Multimodal large language models (MLLMs) hold significant potential in the medical field, but their capabilities are often limited by insufficient data in certain medical domains, highlighting the need for understanding what kinds of images can be used by MLLMs for generalization. Current research suggests that multi-task training outperforms single-task as different tasks can benefit each other, but they often overlook the internal relationships within these tasks, providing limited guidance on selecting datasets to enhance specific tasks. To analyze this phenomenon, we attempted to employ compositional generalization (CG)-the ability of models to understand novel combinations by recombining learned elements-as a guiding framework. Since medical images can be precisely defined by Modality, Anatomical area, and Task, naturally providing an environment for exploring CG. Therefore, we assembled 106 medical datasets to create Med-MAT for comprehensive experiments. The experiments confirmed that MLLMs can use CG to understand unseen medical images and identified CG as one of the main drivers of the generalization observed in multi-task training. Additionally, further studies demonstrated that CG effectively supports datasets with limited data and delivers consistent performance across different backbones, highlighting its versatility and broad applicability. Med-MAT is publicly available at https://github.com/FreedomIntelligence/Med-MAT.

Medical Image Quality Assessment (IQA) serves as the first-mile safety gate for clinical AI, yet existing approaches remain constrained by scalar, score-based metrics and fail to reflect the descriptive, human-like reasoning process central to expert evaluation. To address this gap, we introduce MedQ-Bench, a comprehensive benchmark that establishes a perception-reasoning paradigm for language-based evaluation of medical image quality with Multi-modal Large Language Models (MLLMs). MedQ-Bench defines two complementary tasks: (1) MedQ-Perception, which probes low-level perceptual capability via human-curated questions on fundamental visual attributes; and (2) MedQ-Reasoning, encompassing both no-reference and comparison reasoning tasks, aligning model evaluation with human-like reasoning on image quality. The benchmark spans five imaging modalities and over forty quality attributes, totaling 2,600 perceptual queries and 708 reasoning assessments, covering diverse image sources including authentic clinical acquisitions, images with simulated degradations via physics-based reconstructions, and AI-generated images. To evaluate reasoning ability, we propose a multi-dimensional judging protocol that assesses model outputs along four complementary axes. We further conduct rigorous human-AI alignment validation by comparing LLM-based judgement with radiologists. Our evaluation of 14 state-of-the-art MLLMs demonstrates that models exhibit preliminary but unstable perceptual and reasoning skills, with insufficient accuracy for reliable clinical use. These findings highlight the need for targeted optimization of MLLMs in medical IQA. We hope that MedQ-Bench will catalyze further exploration and unlock the untapped potential of MLLMs for medical image quality evaluation.