The paper introduces MedCBR, a two‑stage alignment framework for medical vision‑language models that improves diagnostic reasoning at the capability boundary. First, it uses Difficulty Weighted Boundary Preference Optimization (DBPO) to focus learning on counterfactual boundary cases, and second, it applies Entropy Gated Grounded Policy Optimization (EGPO) to reward anatomical grounding and reasoning fidelity while mitigating rubric noise. Experiments on six medical benchmarks demonstrate consistent accuracy gains, especially on challenging differential diagnosis tasks, with the combined stages delivering super‑additive improvements.
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...
The paper introduces PRISM, a Compositional Reward Model framework that decomposes image quality into multiple verifier‑grounded stages for conditional medical image generation. By assigning distinct rewards for fine‑to‑coarse properties—such as intensity, texture, structural alignment, and semantic fidelity—and combining them via a Hierarchical Constrained Propagation mechanism, PRISM addresses shortcomings of single‑scalar reward approaches. Experiments on PanNuke, CeDeM, and ISIC datasets show that data generated with PRISM improves downstream model performance, achieving higher mDice, lower MRE, and increased F1 scores compared to baseline methods.
arXiv:2608. 10964v1 Announce Type: cross Abstract: Reinforcement Fine-Tuning (RFT) has enabled medical Multimodal Large Language Models (MLLMs) to produce Chain-of-Thought (CoT) reasoning for visual question answering, yet these models suffer from $\textit{confidence miscalibration}$---a systematic gap between expressed certainty and actual diagnostic accuracy that undermines clinical trust.
arXiv:2608. 03890v1 Announce Type: cross Abstract: A clinically useful chest X-ray system must go beyond fluent report generation: it should classify findings with tunable decision thresholds, localize them spatially, and derive the anatomical measurements upon which many diagnoses depend.
CARE: Causally-Aligned Reasoning Exploration for Medical Large Language Models proposes a new framework to improve medical reasoning in LLMs. It introduces two key conditions—Causal Sufficiency and Proximal Learnability—to curate high-quality training trajectories, using agreement-based self-verification and dynamic entropy bounds. Experiments on medical multimodal and text-only benchmarks show that CARE outperforms competitors, reducing incorrect reasoning and enhancing training stability.
The paper introduces GUIDER, a method that jointly trains a decision flow controller and a reasoning policy to improve clinical guideline reasoning. GUIDER generates multiple plausible decision flows from guideline supervision, computes process rewards across these flows, and gates them on answer correctness to address both path–answer gaps and path multiplicity. Experiments on MedGUIDE and out‑of‑domain benchmarks show that GUIDER outperforms existing reinforcement learning baselines, achieving higher weighted accuracy and guideline adherence.
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.
Medical imaging is a cornerstone of diagnostics, yet automated chest X-ray report generation struggles with structural adherence, anatomical completeness, and semantic faithfulness. We introduce DobicVLM, a vision-language model combining supervised fine-tuning on MedGemma-4B with Group Relative Policy Optimization (GRPO) and clinically-grounded programmatic rewards.
arXiv:2601. 03321v3 Announce Type: replace-cross Abstract: Multimodal Large Language Models (MLLMs) have substantially advanced Radiology Report Generation (RRG), yet aligning them through reinforcement learning (RL) remains challenging due to heterogeneous medical supervision.
arXiv:2609.24480v1 Announce Type: cross Abstract: Deploying Large Language Models (LLMs) in healthcare requires robust performance across two complementary dimensions - diagnostic reasoning: the conv...
arXiv:2609.37283v1 Announce Type: new Abstract: Medical multimodal large language models (MLLMs) are increasingly expected not only to answer clinical questions, but also to localize the visual evide...
arXiv:2505.03380v2 Announce Type: replace Abstract: Accurate delineation of tumors and surrounding organs-at-risk is essential for radiotherapy, surgery and treatment response assessment, yet remains...