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
MultiViewDx is a physician‑validated multimodal instruction dataset that links medical imaging studies with patient context and normalizes heterogeneous reports into an evidence‑linked workflow (evidence → findings → differential discussion → diagnosis). The dataset covers a wide range of imaging modalities and uses a unified image‑text retriever to ensure that instruction synthesis is grounded in source‑supported evidence. Fine‑tuned models on MultiViewDx achieve the highest average accuracy on four MedVQA benchmarks and receive the strongest overall rating on JAMA Clinical Challenge cases, with ablations confirming the importance of case‑level multi‑view organization and evidence‑linked reasoning.
By Junda Wang, Zonghai Yao, Yujan Ting, Eric Z. Chen, Hieu Tran, Hong Yu, Weijing Huang, Terrence 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: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
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: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:2609.36838v1 Announce Type: cross
Abstract: Visual agents solve problems by interleaving reasoning with image operations, and on-policy distillation (OPD) provides guidance from a strong teache...
By Shaohang Wei, Feifan Song, Guangyue Peng, Wenhao Yu, Wei Li, Wen Luo, Yang Xu, Yufan Shen, Luke Mao, Yang Du, Asher Qin, Houfeng Wang
arXiv:2607. 27304v1 Announce Type: new Abstract: Medical vision-language models (VLMs) generate chain-of-thought (CoT) reasoning before answering clinical questions, but whether this reasoning causally influences predictions remains unclear.
By Supratik Bhowal, Subhrajyoti Basu, Aritra Gir Mahanta, Anik Pal Chowdhury
arXiv:2601.06847v2 Announce Type: replace-cross
Abstract: Vision-Language Models (VLMs) can generate convincing clinical narratives, yet frequently struggle to visually ground their statements. We po...
By Mengmeng Zhang, Xiaoping Wu, Hao Luo, Fan Wang, Yisheng Lv
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: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
arXiv:2512. 14157v2 Announce Type: replace Abstract: Recent medical MLLMs have made significant progress in generating step-by-step textual reasoning chains.
By Yankai Jiang, Yujie Zhang, Peng Zhang, Wenjie Li, Yichen Li, Jintai Chen, Xiaoming Shi, Shihui Zhen