Evaluating Counterfactual Sensitivity to Patient Information in Medication-Safety Reasoning

Applying a valid medication-safety rule when its patient-specific conditions are not met can produce an incorrect decision. Existing medical evaluations largely use isolated and fixed scenarios. A model may therefore answer correctly by recalling a drug-risk association without showing that it used patient information to decide whether the rule applies. To address this gap, we introduce MedPIC-Bench, a benchmark of source-verifiable recommendations and expert-validated questions for patient-specific medication-safety reasoning. It combines guideline-following questions with paired counterfactual questions in which a controlled change in patient information changes whether a rule applies. The benchmark contains 467 questions annotated along six clinical and reasoning dimensions. Across 28 medical-specific, general, and proprietary LLMs, every model performs worse on counterfactual questions, with mean accuracy falling from 63.6\% to 45.1\%. Models perform well when an explicit patient attribute directly signals a familiar contraindication, but struggle when patient information must narrow or withdraw a safety warning. Model rationales often acknowledge the changed patient information, yet the final answers retain the previous safety judgment. This vulnerability persists among medical-specific LLMs, whose average CF performance trails that of general LLMs. MedPIC-Bench therefore makes conditional rule application measurable and highlights the limitations of static medication-safety accuracy for assessing patient-specific reliability.

PMC-InterCPT: Rethinking Biomedical Interleaved Data for Multimodal Continued Pretraining

Large-scale biomedical image-text datasets extracted from scientific literature provide valuable resources for medical multimodal model training. These datasets are commonly organized as image-caption pairs; however, figure captions are often short, context-dependent, and only partially informative without the surrounding article text. At the same time, large-scale automatic extraction introduces structural noise such as missing captions, residual markup, duplicated context, and incoherent multi-paragraph figure descriptions. We revisit data construction for medical multimodal continued pretraining (CPT) and present PMC-InterCPT, a context-grounded biomedical interleaved corpus that incorporates figure-referencing body text in addition to captions. Our pipeline recovers missing captions, cleans caption and context text, reconstructs coherent interleaved image-text samples, and applies LLM-supervised medical relevance and quality classifiers to filter noisy records. We further reveal strong modality imbalance in the resulting corpus and introduce a four-bucket evidence taxonomy for modality-aware resampling. Through CPT followed by supervised fine-tuning (SFT) on Qwen3.5-4B-Base, PMC-InterCPT effectively improves medical and general multimodal performance while using fewer CPT tokens than the raw source pool. The experimental results also illustrate the complementarity between the data quality and modality for medical multimodal CPT.

InfiMed-Foundation: Pioneering Advanced Multimodal Medical Models with Compute-Efficient Pre-Training and Multi-Stage Fine-Tuning

Multimodal large language models (MLLMs) have shown remarkable potential in various domains, yet their application in the medical field is hindered by several challenges. General-purpose MLLMs often lack the specialized knowledge required for medical tasks, leading to uncertain or hallucinatory responses. Knowledge distillation from advanced models struggles to capture domain-specific expertise in radiology and pharmacology. Additionally, the computational cost of continual pretraining with large-scale medical data poses significant efficiency challenges. To address these issues, we propose InfiMed-Foundation-1.7B and InfiMed-Foundation-4B, two medical-specific MLLMs designed to deliver state-of-the-art performance in medical applications. We combined high-quality general-purpose and medical multimodal data and proposed a novel five-dimensional quality assessment framework to curate high-quality multimodal medical datasets. We employ low-to-high image resolution and multimodal sequence packing to enhance training efficiency, enabling the integration of extensive medical data. Furthermore, a three-stage supervised fine-tuning process ensures effective knowledge extraction for complex medical tasks. Evaluated on the MedEvalKit framework, InfiMed-Foundation-1.7B outperforms Qwen2.5VL-3B, while InfiMed-Foundation-4B surpasses HuatuoGPT-V-7B and MedGemma-27B-IT, demonstrating superior performance in medical visual question answering and diagnostic tasks. By addressing key challenges in data quality, training efficiency, and domain-specific knowledge extraction, our work paves the way for more reliable and effective AI-driven solutions in healthcare. InfiMed-Foundation-4B model is available at \href{https://huggingface.co/InfiX-ai/InfiMed-Foundation-4B}{InfiMed-Foundation-4B}.

Infi-Med: Low-Resource Medical MLLMs with Robust Reasoning Evaluation

Multimodal large language models (MLLMs) have demonstrated promising prospects in healthcare, particularly for addressing complex medical tasks, supporting multidisciplinary treatment (MDT), and enabling personalized precision medicine. However, their practical deployment faces critical challenges in resource efficiency, diagnostic accuracy, clinical considerations, and ethical privacy. To address these limitations, we propose Infi-Med, a comprehensive framework for medical MLLMs that introduces three key innovations: (1) a resource-efficient approach through curating and constructing high-quality supervised fine-tuning (SFT) datasets with minimal sample requirements, with a forward-looking design that extends to both pretraining and posttraining phases; (2) enhanced multimodal reasoning capabilities for cross-modal integration and clinical task understanding; and (3) a systematic evaluation system that assesses model performance across medical modalities and task types. Our experiments demonstrate that Infi-Med achieves state-of-the-art (SOTA) performance in general medical reasoning while maintaining rapid adaptability to clinical scenarios. The framework establishes a solid foundation for deploying MLLMs in real-world healthcare settings by balancing model effectiveness with operational constraints.