Abstract:The practical deployment of medical vision-language models (Med-VLMs) necessitates seamless integration of textual data with diverse visual modalities, including 2D/3D images and videos, yet existing models typically employ separate encoders for different modalities. To address this limitation, we present OmniV-Med, a unified framework for multimodal medical understanding. Our technical contributions are threefold: First, we construct OmniV-Med-Instruct, a comprehensive multimodal medical dataset containing 252K instructional samples spanning 14 medical image modalities and 11 clinical tasks. Second, we devise a rotary position-adaptive encoder that processes multi-resolution 2D/3D images and videos within a unified architecture, diverging from conventional modality-specific encoders. Third, we introduce a medical-aware token pruning mechanism that exploits spatial-temporal redundancy in volumetric data (e.g., consecutive CT slices) and medical videos, effectively reducing 60\% of visual tokens without performance degradation. Empirical evaluations demonstrate that OmniV-Med-7B achieves state-of-the-art performance on 7 benchmarks spanning 2D/3D medical imaging and video understanding tasks. Notably, our lightweight variant (OmniV-Med-1.5B) attains comparable performance while requiring only 8 RTX3090 GPUs for training and supporting efficient long-video inference. Data, code and model will be released.