MedScope: Incentivizing "Think with Videos" for Clinical Reasoning via Coarse-to-Fine Tool Calling

Long-form clinical videos are central to visual evidence-based decision-making, with growing importance for applications such as surgical robotics and related settings. However, current multimodal large language models typically process videos with passive sampling or weakly grounded inspection, which limits their ability to iteratively locate, verify, and justify predictions with temporally targeted evidence. To close this gap, we propose MedScope, a tool-using clinical video reasoning model that performs coarse-to-fine evidence seeking over long-form procedures. By interleaving intermediate reasoning with targeted tool calls and verification on retrieved observations, MedScope produces more accurate and trustworthy predictions that are explicitly grounded in temporally localized visual evidence. To address the lack of high-fidelity supervision, we build ClinVideoSuite, an evidence-centric, fine-grained clinical video suite. We then optimize MedScope with Grounding-Aware Group Relative Policy Optimization (GA-GRPO), which directly reinforces tool use with grounding-aligned rewards and evidence-weighted advantages. On full and fine-grained video understanding benchmarks, MedScope achieves state-of-the-art performance in both in-domain and out-of-domain evaluations. Our approach illuminates a path toward medical AI agents that can genuinely "think with videos" through tool-integrated reasoning. We will release our code, models, and data.

RSAgent: Learning to Reason and Act for Text-Guided Segmentation via Multi-Turn Tool Invocations

Text-guided object segmentation requires both cross-modal reasoning and pixel grounding abilities. Most recent methods treat text-guided segmentation as one-shot grounding, where the model predicts pixel prompts in a single forward pass to drive an external segmentor, which limits verification, refocusing and refinement when initial localization is wrong. To address this limitation, we propose RSAgent, an agentic Multimodal Large Language Model (MLLM) which interleaves reasoning and action for segmentation via multi-turn tool invocations. RSAgent queries a segmentation toolbox, observes visual feedback, and revises its spatial hypothesis using historical observations to re-localize targets and iteratively refine masks. We further build a data pipeline to synthesize multi-turn reasoning segmentation trajectories, and train RSAgent with a two-stage framework: cold-start supervised fine-tuning followed by agentic reinforcement learning with fine-grained, task-specific rewards. Extensive experiments show that RSAgent achieves a zero-shot performance of 66.5% gIoU on ReasonSeg test, improving over Seg-Zero-7B by 9%, and reaches 81.5% cIoU on RefCOCOg, demonstrating state-of-the-art performance on both in-domain and out-of-domain benchmarks.