VITAL: Visual-Semantic Dual Supervision for Enhanced and Interpretable Latent Reasoning in Medical MLLMs

VITAL introduces a visual‑semantic dual supervision framework for latent reasoning in medical multimodal large language models. It uses an auxiliary text decoder to reconstruct reasoning chains from latent states and a visual projector to regress ROI features from a frozen medical vision encoder, both discarded during inference to avoid overhead. The approach yields a 61K dataset across nine imaging modalities and achieves state‑of‑the‑art performance on seven benchmarks, outperforming existing latent reasoning baselines and large medical MLLMs.

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