Abstract:Large Language Models (LLMs) perform strongly in English medical tasks but degrade substantially in Arabic, a gap widely attributed to limited training data. We systematically investigate this assumption via tuned lens probing and causal activation patching, and find that Arabic medical knowledge is present in intermediate model representations but fails to surface at the output. This mechanistic insight motivates a targeted adaptation strategy: rather than fine-tuning the full network, we propose Targeted Low-Rank Adaptation (TLoRA), restricted to the layer window where cross-lingual representations diverge, upstream of the output layers where the failure manifests. We evaluate TLoRA on multiple-choice medical QA, where our approach outperforms full-network LoRA, zero-shot, and few-shot baselines. We further evaluate it on short-answer generation and multi-turn clinical dialogue, where it performs competitively without the need for task-specific finetuning. We additionally introduce AraClinicDialog, a clinician-constructed Arabic medical dialogue benchmark in MSA with validated variants across four Arabic dialects. Together, these contributions demonstrate that mechanistic diagnosis can serve as a practical guide for targeted adaptation in underrepresented-language medical LLMs.
Abstract:Inaccuracies in existing or generated clinical text may lead to serious adverse consequences, especially if it is a misdiagnosis or incorrect treatment suggestion. With Large Language Models (LLMs) increasingly being used across diverse healthcare applications, comprehensive evaluation through dedicated benchmarks is crucial. However, such datasets remain scarce, especially across diverse languages and contexts. In this paper, we introduce MedErrBench, the first multilingual benchmark for error detection, localization, and correction, developed under the guidance of experienced clinicians. Based on an expanded taxonomy of ten common error types, MedErrBench covers English, Arabic and Chinese, with natural clinical cases annotated and reviewed by domain experts. We assessed the performance of a range of general-purpose, language-specific, and medical-domain language models across all three tasks. Our results reveal notable performance gaps, particularly in non-English settings, highlighting the need for clinically grounded, language-aware systems. By making MedErrBench and our evaluation protocols publicly-available, we aim to advance multilingual clinical NLP to promote safer and more equitable AI-based healthcare globally. The dataset is available in the supplementary material. An anonymized version of the dataset is available at: https://github.com/congboma/MedErrBench.