LiteMedCoT-VL is a parameter‑efficient pipeline that transfers chain‑of‑thought reasoning from a 235B teacher model to a 2B student model using LoRA fine‑tuning on explanation‑enriched data. The approach enables a compact vision‑language model to perform medical visual question answering without relying on image captions, achieving 64.9% accuracy on the PMC‑VQA benchmark—an 11‑point improvement over the zero‑shot Qwen3‑VL‑4B baseline. Visual grounding analysis confirms that the model bases its predictions on image content rather than textual priors.
By Runze Ma, Shunbo Jia, Haonan Lyu, Guo Liu, Caizhi Liao
arXiv:2511.22232v2 Announce Type: replace-cross
Abstract: Multimodal large language models (MLLMs) are increasingly capable in medical imaging, yet most focus on single-image settings. Clinical inter...
By Zhen Chen, Yihang Fu, Rong Zhou, Serina Applebaum, Min Kyu Kim, Aidan Gilson, Morten Lee, Salahudeen Mirza, Gabriel Madera, Mauro Giuffre, Yuanting Pan, Roy Jiang, Hyunjae Kim, Hua Xu, Qingyu Chen
arXiv:2606. 12169v1 Announce Type: cross Abstract: High-stakes clinical use of large vision-language models (LVLMs) requires reasoning that is grounded in visual evidence and clinical knowledge, not just correct final answers.
By Negin Baghbanzadeh, Pritam Sarkar, Michael Colacci, Abeer Badawi, Adibvafa Fallahpour, Arash Afkanpour, Leonid Sigal, Ali Etemad, Elham Dolatabadi
arXiv:2608.28623v1 Announce Type: cross
Abstract: Large multimodal reasoning models (LMRMs) are getting increasingly capable, primarily through generating explicit chain-of-thought reasoning before a...
By Mahir Numayeer Islam, Gakuto Okuyama, Nikolaus Siauw, Shivank Garg, Madhur Panwar, Vasu Sharma
arXiv:2608.22323v1 Announce Type: new
Abstract: The application of Large Language Models (LLMs) to diagnostic decision-making has garnered growing interest. However, existing benchmarks largely focus...
By Lai Wei, Yuchao Chen, Zhenbiao Cao, Xiaojin Zhang, Zhongyu Wei, Bangting Wang, Wei Chen, Xiang Bai
arXiv:2606. 31825v1 Announce Type: cross Abstract: Recent multimodal large language models have shown great promise in clinical image reasoning, but existing post-training pipelines remain predominantly outcome-centric, relying on final answer correctness or sequence-level preferences.
By Junha Jung, Minbyul Jeong, Suhyeon Lim, Sungwook Jung, Jaehoon Yun, Taeyun Roh, Mujeen Sung, Jaewoo Kang
arXiv:2508. 16129v3 Announce Type: replace Abstract: Multimodal large language models (MLLMs) have recently demonstrated remarkable reasoning abilities with reinforcement learning paradigm.
By Ruiqi Wu, Yuang Yao, Tengfei Ma, Chenran Zhang, Na Su, Tao Zhou, Geng Chen, Wen Fan, Yi Zhou
The paper introduces MedREAL, a unified framework that aligns linguistic reasoning with spatial grounding for medical visual question answering and segmentation. MedREAL employs Seg Anchored Reasoning Pooling (SARP) to extract semantic evidence from segmentation tokens and a Reasoning-to-Visual (R2V) fusion mechanism to integrate these features into a segmentation pipeline. Using the newly created MedRAVS-13K dataset, MedREAL achieves superior performance, reporting 68.49% gIoU and 70.47% cIoU, and generates evidence masks that consistently match textual diagnoses.
By Haowen Gu, Gensheng Pei, Junzhu Mao, Qiong Wang, Mingwu Ren, Yazhou Yao
arXiv:2609.32352v2 Announce Type: replace-cross
Abstract: Vision-language models (VLMs) have shown increasing potential for medical image understanding, yet their capabilities in ophthalmic imaging r...
By Gujie Shao, Zixun Xie, Xuechun Xing, Ruixiang Wang, Ziyun Lan, Yanlin Qi, Gangyi Zhang, Yuxin Yang, Dawei Li, Haiming Tang
arXiv:2604. 09757v2 Announce Type: replace-cross Abstract: Medical vision--language models (VLMs) have shown strong potential for medical visual question answering (VQA), yet their reasoning remains largely text-centric: images are encoded once as static context, and subsequent inference is dominated by language.
By Suyang Xi, Songtao Hu, Yuxiang Lai, Wangyun Dan, Yaqi Liu, Shansong Wang, Xiaofeng Yang
arXiv:2606. 28556v1 Announce Type: new Abstract: Recent advances in large language models and vision-language models have enabled reasoning over multimodal data, offering opportunities for clinical applications such as decision support and triaging.
By Maria Xenochristou, Ashutosh Joshi, Korosh Vatanparvar, Mohammad Abuzar Hashemi, Prasad Kasu, Deepak Bansal, Anchal Nema, Nivedita Wadhwa, Prashams S Jain, Rebecca Abraham, Will Kimbrough, Dilek Hakkani-Tur, Wilko Schulz-Mahlendorf
The paper introduces VIG (Visual Information Gain), an information‑theoretic reward that evaluates each token in a multimodal chain‑of‑thought by measuring how much the image reduces its predictive uncertainty. VIG is computed online using two forward passes—one with and one without the image—eliminating the need for reference chains or external annotations. Experiments on six multimodal reasoning benchmarks and multiple Qwen3‑VL‑Thinking model sizes show that VIG consistently improves the accuracy–efficiency trade‑off, demonstrating that efficient multimodal reasoning arises from increasing visual information density rather than merely limiting chain length.
By Wen Luo, Xiaohan Yi, Xiaotao Huang, Liqun Huang