MEDIC-AD: Towards Medical Vision-Language Model's Clinical Intelligence

Lesion detection, symptom tracking, and visual explainability are central to real-world medical image analysis, yet current medical Vision-Language Models (VLMs) still lack mechanisms that translate their broad knowledge into clinically actionable outputs. To bridge this gap, we present MEDIC-AD, a clinically oriented VLM that strengthens these three capabilities through a stage-wise framework. First, learnable anomaly-aware tokens (<Ano>) encourage the model to focus on abnormal regions and build more discriminative lesion centered representations. Second, inter image difference tokens (<Diff>) explicitly encode temporal changes between studies, allowing the model to distinguish worsening, improvement, and stability in disease burden. Finally, a dedicated explainability stage trains the model to generate heatmaps that highlight lesion-related regions, offering clear visual evidence that is consistent with the model's reasoning. Through our staged design, MEDIC-AD steadily boosts performance across anomaly detection, symptom tracking, and anomaly segmentation, achieving state-of-the-art results compared with both closed source and medical-specialized baselines. Evaluations on real longitudinal clinical data collected from real hospital workflows further show that MEDIC-AD delivers stable predictions and clinically faithful explanations in practical patient-monitoring and decision-support workflows

SECOND: Mitigating Perceptual Hallucination in Vision-Language Models via Selective and Contrastive Decoding

Despite significant advancements in Vision-Language Models (VLMs), the performance of existing VLMs remains hindered by object hallucination, a critical challenge to achieving accurate visual understanding. To address this issue, we propose SECOND: Selective and Contrastive Decoding, a novel approach that enables VLMs to effectively leverage multi-scale visual information with an object-centric manner, closely aligning with human visual perception. SECOND progressively selects and integrates multi-scale visual information, facilitating a more precise interpretation of images. By contrasting these visual information iteratively, SECOND significantly reduces perceptual hallucinations and outperforms a wide range of benchmarks. Our theoretical analysis and experiments highlight the largely unexplored potential of multi-scale application in VLMs, showing that prioritizing and contrasting across scales outperforms existing methods.