Recent advancements in Large Language Models (LLMs) and Large Multi-modal Models (LMMs) have shown potential in various medical applications, such as Intelligent Medical Diagnosis. Although impressive results have been achieved, we find that existing benchmarks do not reflect the complexity of real medical reports and specialized in-depth reasoning capabilities. In this work, we establish a comprehensive benchmark in the field of medical specialization and introduced RJUA-MedDQA, which contains 2000 real-world Chinese medical report images poses several challenges: comprehensively interpreting imgage content across a wide variety of challenging layouts, possessing the numerical reasoning ability to identify abnormal indicators and demonstrating robust clinical reasoning ability to provide the statement of disease diagnosis, status and advice based on a collection of medical contexts. We carefully design the data generation pipeline and proposed the Efficient Structural Restoration Annotation (ESRA) Method, aimed at restoring textual and tabular content in medical report images. This method substantially enhances annotation efficiency, doubling the productivity of each annotator, and yields a 26.8% improvement in accuracy. We conduct extensive evaluations, including few-shot assessments of 5 LMMs which are capable of solving Chinese medical QA tasks. To further investigate the limitations and potential of current LMMs, we conduct comparative experiments on a set of strong LLMs by using image-text generated by ESRA method. We report the performance of baselines and offer several observations: (1) The overall performance of existing LMMs is still limited; however LMMs more robust to low-quality and diverse-structured images compared to LLMs. (3) Reasoning across context and image content present significant challenges. We hope this benchmark helps the community make progress on these challenging tasks in multi-modal medical document understanding and facilitate its application in healthcare. Our dataset will be publicly available for noncommercial use at https://github.com/Alipay-Med/medDQA_benchmark.git