ShizhenGPT: Towards Multimodal LLMs for Traditional Chinese Medicine

Despite the success of large language models (LLMs) in various domains, their potential in Traditional Chinese Medicine (TCM) remains largely underexplored due to two critical barriers: (1) the scarcity of high-quality TCM data and (2) the inherently multimodal nature of TCM diagnostics, which involve looking, listening, smelling, and pulse-taking. These sensory-rich modalities are beyond the scope of conventional LLMs. To address these challenges, we present ShizhenGPT, the first multimodal LLM tailored for TCM. To overcome data scarcity, we curate the largest TCM dataset to date, comprising 100GB+ of text and 200GB+ of multimodal data, including 1.2M images, 200 hours of audio, and physiological signals. ShizhenGPT is pretrained and instruction-tuned to achieve deep TCM knowledge and multimodal reasoning. For evaluation, we collect recent national TCM qualification exams and build a visual benchmark for Medicinal Recognition and Visual Diagnosis. Experiments demonstrate that ShizhenGPT outperforms comparable-scale LLMs and competes with larger proprietary models. Moreover, it leads in TCM visual understanding among existing multimodal LLMs and demonstrates unified perception across modalities like sound, pulse, smell, and vision, paving the way toward holistic multimodal perception and diagnosis in TCM. Datasets, models, and code are publicly available. We hope this work will inspire further exploration in this field.

Large Language Models for Outpatient Referral: Problem Definition, Benchmarking and Challenges

Large language models (LLMs) are increasingly applied to outpatient referral tasks across healthcare systems. However, there is a lack of standardized evaluation criteria to assess their effectiveness, particularly in dynamic, interactive scenarios. In this study, we systematically examine the capabilities and limitations of LLMs in managing tasks within Intelligent Outpatient Referral (IOR) systems and propose a comprehensive evaluation framework specifically designed for such systems. This framework comprises two core tasks: static evaluation, which focuses on evaluating the ability of predefined outpatient referrals, and dynamic evaluation, which evaluates capabilities of refining outpatient referral recommendations through iterative dialogues. Our findings suggest that LLMs offer limited advantages over BERT-like models, but show promise in asking effective questions during interactive dialogues.

The First Few Tokens Are All You Need: An Efficient and Effective Unsupervised Prefix Fine-Tuning Method for Reasoning Models

Improving the reasoning capabilities of large language models (LLMs) typically requires supervised fine-tuning with labeled data or computationally expensive sampling. We introduce Unsupervised Prefix Fine-Tuning (UPFT), which leverages the observation of Prefix Self-Consistency -- the shared initial reasoning steps across diverse solution trajectories -- to enhance LLM reasoning efficiency. By training exclusively on the initial prefix substrings (as few as 8 tokens), UPFT removes the need for labeled data or exhaustive sampling. Experiments on reasoning benchmarks show that UPFT matches the performance of supervised methods such as Rejection Sampling Fine-Tuning, while reducing training time by 75% and sampling cost by 99%. Further analysis reveals that errors tend to appear in later stages of the reasoning process and that prefix-based training preserves the model's structural knowledge. This work demonstrates how minimal unsupervised fine-tuning can unlock substantial reasoning gains in LLMs, offering a scalable and resource-efficient alternative to conventional approaches.

RAG-Instruct: Boosting LLMs with Diverse Retrieval-Augmented Instructions

Retrieval-Augmented Generation (RAG) has emerged as a key paradigm for enhancing large language models (LLMs) by incorporating external knowledge. However, current RAG methods face two limitations: (1) they only cover limited RAG scenarios. (2) They suffer from limited task diversity due to the lack of a general RAG dataset. To address these limitations, we propose RAG-Instruct, a general method for synthesizing diverse and high-quality RAG instruction data based on any source corpus. Our approach leverages (1) five RAG paradigms, which encompass diverse query-document relationships, and (2) instruction simulation, which enhances instruction diversity and quality by utilizing the strengths of existing instruction datasets. Using this method, we construct a 40K instruction dataset from Wikipedia, comprehensively covering diverse RAG scenarios and tasks. Experiments demonstrate that RAG-Instruct effectively enhances LLMs' RAG capabilities, achieving strong zero-shot performance and significantly outperforming various RAG baselines across a diverse set of tasks. RAG-Instruct is publicly available at https://github.com/FreedomIntelligence/RAG-Instruct.

On the Compositional Generalization of Multimodal LLMs for Medical Imaging

Multimodal large language models (MLLMs) hold significant potential in the medical field, but their capabilities are often limited by insufficient data in certain medical domains, highlighting the need for understanding what kinds of images can be used by MLLMs for generalization. Current research suggests that multi-task training outperforms single-task as different tasks can benefit each other, but they often overlook the internal relationships within these tasks, providing limited guidance on selecting datasets to enhance specific tasks. To analyze this phenomenon, we attempted to employ compositional generalization (CG)-the ability of models to understand novel combinations by recombining learned elements-as a guiding framework. Since medical images can be precisely defined by Modality, Anatomical area, and Task, naturally providing an environment for exploring CG. Therefore, we assembled 106 medical datasets to create Med-MAT for comprehensive experiments. The experiments confirmed that MLLMs can use CG to understand unseen medical images and identified CG as one of the main drivers of the generalization observed in multi-task training. Additionally, further studies demonstrated that CG effectively supports datasets with limited data and delivers consistent performance across different backbones, highlighting its versatility and broad applicability. Med-MAT is publicly available at https://github.com/FreedomIntelligence/Med-MAT.

HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs

The breakthrough of OpenAI o1 highlights the potential of enhancing reasoning to improve LLM. Yet, most research in reasoning has focused on mathematical tasks, leaving domains like medicine underexplored. The medical domain, though distinct from mathematics, also demands robust reasoning to provide reliable answers, given the high standards of healthcare. However, verifying medical reasoning is challenging, unlike those in mathematics. To address this, we propose verifiable medical problems with a medical verifier to check the correctness of model outputs. This verifiable nature enables advancements in medical reasoning through a two-stage approach: (1) using the verifier to guide the search for a complex reasoning trajectory for fine-tuning LLMs, (2) applying reinforcement learning (RL) with verifier-based rewards to enhance complex reasoning further. Finally, we introduce HuatuoGPT-o1, a medical LLM capable of complex reasoning, which outperforms general and medical-specific baselines using only 40K verifiable problems. Experiments show complex reasoning improves medical problem-solving and benefits more from RL. We hope our approach inspires advancements in reasoning across medical and other specialized domains.

Second Language (Arabic) Acquisition of LLMs via Progressive Vocabulary Expansion

This paper addresses the critical need for democratizing large language models (LLM) in the Arab world, a region that has seen slower progress in developing models comparable to state-of-the-art offerings like GPT-4 or ChatGPT 3.5, due to a predominant focus on mainstream languages (e.g., English and Chinese). One practical objective for an Arabic LLM is to utilize an Arabic-specific vocabulary for the tokenizer that could speed up decoding. However, using a different vocabulary often leads to a degradation of learned knowledge since many words are initially out-of-vocabulary (OOV) when training starts. Inspired by the vocabulary learning during Second Language (Arabic) Acquisition for humans, the released AraLLaMA employs progressive vocabulary expansion, which is implemented by a modified BPE algorithm that progressively extends the Arabic subwords in its dynamic vocabulary during training, thereby balancing the OOV ratio at every stage. The ablation study demonstrated the effectiveness of Progressive Vocabulary Expansion. Moreover, AraLLaMA achieves decent performance comparable to the best Arabic LLMs across a variety of Arabic benchmarks. Models, training data, benchmarks, and codes will be all open-sourced.

CoD, Towards an Interpretable Medical Agent using Chain of Diagnosis

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.

HuatuoGPT-Vision, Towards Injecting Medical Visual Knowledge into Multimodal LLMs at Scale

The rapid development of multimodal large language models (MLLMs), such as GPT-4V, has led to significant advancements. However, these models still face challenges in medical multimodal capabilities due to limitations in the quantity and quality of medical vision-text data, stemming from data privacy concerns and high annotation costs. While pioneering approaches utilize PubMed's large-scale, de-identified medical image-text pairs to address these limitations, they still fall short due to inherent data noise. To tackle this, we refined medical image-text pairs from PubMed and employed MLLMs (GPT-4V) in an 'unblinded' capacity to denoise and reformat the data, resulting in the creation of the PubMedVision dataset with 1.3 million medical VQA samples. Our validation demonstrates that: (1) PubMedVision can significantly enhance the medical multimodal capabilities of current MLLMs, showing significant improvement in benchmarks including the MMMU Health & Medicine track; (2) manual checks by medical experts and empirical results validate the superior data quality of our dataset compared to other data construction methods. Using PubMedVision, we train a 34B medical MLLM HuatuoGPT-Vision, which shows superior performance in medical multimodal scenarios among open-source MLLMs.

LLMs for Doctors: Leveraging Medical LLMs to Assist Doctors, Not Replace Them

The recent success of Large Language Models (LLMs) has had a significant impact on the healthcare field, providing patients with medical advice, diagnostic information, and more. However, due to a lack of professional medical knowledge, patients are easily misled by generated erroneous information from LLMs, which may result in serious medical problems. To address this issue, we focus on tuning the LLMs to be medical assistants who collaborate with more experienced doctors. We first conduct a two-stage survey by inspiration-feedback to gain a broad understanding of the real needs of doctors for medical assistants. Based on this, we construct a Chinese medical dataset called DoctorFLAN to support the entire workflow of doctors, which includes 92K Q\&A samples from 22 tasks and 27 specialists. Moreover, we evaluate LLMs in doctor-oriented scenarios by constructing the DoctorFLAN-\textit{test} containing 550 single-turn Q\&A and DotaBench containing 74 multi-turn conversations. The evaluation results indicate that being a medical assistant still poses challenges for existing open-source models, but DoctorFLAN can help them significantly. It demonstrates that the doctor-oriented dataset and benchmarks we construct can complement existing patient-oriented work and better promote medical LLMs research.