The paper reviews how Large Language Models (LLMs) are being adapted for medical reasoning, moving beyond single-step answers to systems that can systematically, transparently, and verifiably reason. It introduces a taxonomy of enhancement techniques, split into training-time methods such as supervised fine‑tuning and reinforcement learning, and test-time methods like prompt engineering and multi‑agent systems. The review examines their application across text, image, and code modalities in key clinical areas—diagnosis, education, and treatment planning—and tracks the shift in evaluation benchmarks from simple accuracy to more nuanced assessments of reasoning quality and visual interpretability.
arXiv:2607. 07761v1 Announce Type: new Abstract: Large language models (LLMs) have emerged as important tools in healthcare, showing growing potential for clinical reasoning and patient care.
arXiv:2606. 01094v1 Announce Type: new Abstract: Clinical order generation serves as a critical bridge between clinical decision-making and real-world practice, translating medical decisions into concrete and executable orders.
arXiv:2505. 02722v2 Announce Type: replace Abstract: Although large language models (LLMs) have demonstrated impressive reasoning capabilities across general domains, their effectiveness in real-world clinical practice remains limited.
arXiv:2606. 28692v1 Announce Type: new Abstract: Treatment reasoning underpins every therapeutic decision, integrating disease context, comorbidities, medications, contraindications, and evolving biomedical knowledge to select an appropriate therapy.
arXiv:2606. 31800v1 Announce Type: new Abstract: Despite recent progress, the reasoning capabilities of large multimodal language models (MLLMs) remain fundamentally constrained by static supervision, where fixed prompts, rules, or reward models provide non-adaptive guidance throughout training.
arXiv:2608.21864v1 Announce Type: cross Abstract: The current progress of Clinical Vision Large Language Models (C-VLLMs) has substantially improved digital diagnostics, still these frameworks often...
arXiv:2608.22622v1 Announce Type: cross Abstract: Clinical decision-making relies on identifying relevant patient information to guide diagnosis and treatment, a challenge that is especially difficul...
arXiv:2608.21810v1 Announce Type: cross Abstract: Clinical decision-making is inherently experience-driven: physicians progressively refine their reasoning by synthesizing patient history, multimodal...
The paper introduces MedTraj, a framework that constructs, evaluates, and optimizes multi‑step reasoning trajectories for medical AI agents. It parses each trajectory into observations, evidence, numbered steps, and a conclusion, scoring them on coherence, evidence support, hallucination, completeness, and traceability. Experiments on CareQA, PubMedQA, and CECMed show that incorporating quality‑weighted trajectory context improves reasoning coherence and correctness while significantly reducing hallucinations.
arXiv:2505. 14107v5 Announce Type: replace-cross Abstract: The emergence of groundbreaking large language models capable of performing complex reasoning tasks holds significant promise for addressing various scientific challenges, including those arising in complex clinical scenarios.
arXiv:2606. 15419v1 Announce Type: cross Abstract: Objective: To enhance the accuracy, interpretability, and robustness of large language models (LLMs) in medical question answering (MedQA).
The paper introduces MACD, a Multi-Agent Clinical Diagnosis framework that enables large language models to self‑learn clinical knowledge through a multi‑agent pipeline of summarization, refinement, and application. MACD is extended into a human‑AI collaborative workflow where multiple diagnostician agents consult iteratively, guided by a judge agent and human oversight. Evaluation on the MIMIC‑MACD cohort shows significant gains in diagnostic accuracy—an average 11.6 percentage‑point improvement over authoritative knowledge for open‑weight LLMs and an 18.3‑percentage‑point boost over physician‑only diagnosis in text‑only vignettes.