Vision-language models (VLMs) have achieved impressive progress in natural image reasoning, yet their potential in medical imaging remains underexplored. Medical vision-language tasks demand precise understanding and clinically coherent answers, which are difficult to achieve due to complexity of medical data and the scarcity of high-quality expert annotations. These challenges limit the effectiveness of conventional supervised fine-tuning (SFT) and Chain-of-Thought (CoT) strategies that work well in general domains. To address these challenges, we propose Med-R1, a reinforcement learning (RL)-enhanced VLM designed to improve generalization and reliability in medical reasoning. Med-R1 adopts Group Relative Policy Optimization (GRPO) to encourage reward-guided learning beyond static annotations. We comprehensively evaluate Med-R1 across eight distinct medical imaging modalities. Med-R1 achieves a 29.94% improvement in average accuracy over its base model Qwen2-VL-2B, and even outperforms Qwen2-VL-72B-a model with $36\times $ more parameters. To assess cross-task generalization, we further evaluate Med-R1 on five question types. Med-R1 outperforms Qwen2-VL-2B by 32.06% in question-type generalization, also surpassing Qwen2-VL-72B. We further explore the thinking process in Med-R1, a crucial component of Deepseek-R1. Our results show that omitting intermediate rationales (No-Thinking Med-R1) not only improves cross-domain generalization with less training, but also challenges the common assumption that more reasoning always helps. Nevertheless, we also find that the Think-After Med-R1 variant further improves performance while maintaining interpretability. These findings suggest that, in medical VQA, the mere presence of explicit reasoning does not guarantee better performance. Instead, performance depends on the quality of the reasoning and the position where the reasoning is generated.

Computed tomography (CT) is extensively used for accurate visualization and segmentation of organs and lesions. While deep learning models such as convolutional neural networks (CNNs) and vision transformers (ViTs) have significantly improved CT image analysis, their performance often declines when applied to diverse, real-world clinical data. Although foundation models offer a broader and more adaptable solution, their potential is limited due to the challenge of obtaining large-scale, voxel-level annotations for medical images. In response to these challenges, prompting-based models using visual or text prompts have emerged. Visual-prompting methods, such as the Segment Anything Model (SAM), still require significant manual input and can introduce ambiguity when applied to clinical scenarios. Instead, foundation models that use text prompts offer a more versatile and clinically relevant approach. Notably, current text-prompt models, such as the CLIP-Driven Universal Model, are limited to text prompts already encountered during training and struggle to process the complex and diverse scenarios of real-world clinical applications. Instead of fine-tuning models trained from natural imaging, we propose OpenVocabCT, a vision-language model pretrained on large-scale 3D CT images for universal text-driven segmentation. Using the large-scale CT-RATE dataset, we decompose the diagnostic reports into fine-grained, organ-level descriptions using large language models for multi-granular contrastive learning. We evaluate our OpenVocabCT on downstream segmentation tasks across 14 public datasets and 1 institutional dataset for organ and tumor segmentation, demonstrating the superior performance of our model compared to existing methods. All code, datasets, and models will be publicly released at https://github.com/ricklisz/OpenVocabCT.

Recent studies on large language models (LLMs) and large multimodal models (LMMs) have demonstrated promising skills in various domains including science and mathematics. However, their capability in more challenging and real-world related scenarios like engineering has not been systematically studied. To bridge this gap, we propose EEE-Bench, a multimodal benchmark aimed at assessing LMMs’ capabilities in solving practical engineering tasks, using electrical and electronics engineering (EEE) as the testbed. Our benchmark consists of 2860 hand-picked and carefully curated problems spanning 10 essential subdomains such as analog circuits, control systems, etc. Compared to other domains, engineering problems are intrinsically 1) more visually complex and versatile and 2) less deterministic in solutions. Successful solutions to these problems often demand more-than-usual rigorous integration of visual and textual information as models need to understand intricate images like abstract circuits and system diagrams while taking professional instructions. Alongside EEE-Bench, we provide extensive quantitative evaluations, fine-grained analysis, and improvement methods using 17 widely-used open-and closed-sourced LLMs and LMMs and 7 popular prompting techniques. Our results reveal notable deficiencies in current foundation models for EEE, including an average performance ranging from 19.48% to 46.78% and a tendency toward "laziness" in overlooking essential visual context. In summary, we believe EEE-Bench not only reveals some noteworthy limitations of LMMs but also provides a valuable resource for advancing research on their application in practical engineering tasks, driving future improvements in their capability to handle complex, real-world scenarios. The EEE-Bench is publicly released on this link.

This paper investigates the role of explicit thinking process in rule-based reinforcement fine-tuning (RFT) for multi-modal large language models (MLLMs). We first extend \textit{Thinking-RFT} to image classification task, using verifiable rewards for fine-tuning~(FT). Experiments show {Thinking-RFT} significantly outperforms supervised FT and yields a cross-dataset generalization effect. We then rethink and question whether explicit thinking in RFT is always necessary and beneficial. Challenging the convention that explicit thinking is crucial for the success of RFT, we introduce \textit{No-Thinking-RFT}, exploring RFT without thinking by introducing a simple equality accuracy reward. We evaluate No-Thinking-RFT on six diverse tasks across different model sizes and types. Experiment results reveal four key findings: \textbf{(1).} Visual perception tasks do not require thinking during RFT, as No-Thinking-RFT consistently outperforms or matches Thinking-RFT across model sizes and types. \textbf{(2).} Models with limited capabilities struggle to generate high-quality CoT for RFT, making Thinking-RFT less effective than No-Thinking-RFT. \textbf{(3).} There are inconsistencies between the answers in the thinking tags and answer tags for some responses of Thinking-RFT, which show lower average accuracy than the overall accuracy. \textbf{(4).} The performance gain of No-Thinking-RFT mainly stems from improved learning during no thinking FT and the avoidance of inference overthinking, as evidenced by the partial gains from appending empty thinking tags at inference time of Thinking-RFT. We hypothesize that explicit thinking before verifiable answers may hinder reward convergence and reduce performance in certain scenarios. To test this, we propose \textit{Think-After-Answer}, which places thinking after the answer to mitigate this effect for experimental verification. Lastly, we conduct a pilot study to explore whether MLLMs can learn when to think during RFT, introducing an \textit{Adaptive-Thinking} method. Experiments show that model converges to either thinking or not depending on model capability, achieving comparable or better performance than both Thinking and No-Thinking-RFT. Our findings suggest MLLMs can adaptively decide to think or not based on their capabilities and task complexity, offering insights into the thinking process in RFT.

Universal domain adaptation aims to align the classes and reduce the feature gap between the same category of the source and target domains. The target private category is set as the unknown class during the adaptation process, as it is not included in the source domain. However, most existing methods overlook the intra-class structure within a category, especially in cases where there exists significant concept shift between the samples belonging to the same category. When samples with large concept shift are forced to be pushed together, it may negatively affect the adaptation performance. Moreover, from the interpretability aspect, it is unreasonable to align visual features with significant differences, such as fighter jets and civil aircraft, into the same category. Unfortunately, due to such semantic ambiguity and annotation cost, categories are not always classified in detail, making it difficult for the model to perform precise adaptation. To address these issues, we propose a novel Memory-Assisted Sub-Prototype Mining (MemSPM) method that can learn the differences between samples belonging to the same category and mine sub-classes when there exists significant concept shift between them. By doing so, our model learns a more reasonable feature space that enhances the transferability and reflects the inherent differences among samples annotated as the same category. We evaluate the effectiveness of our MemSPM method over multiple scenarios, including UniDA, OSDA, and PDA. Our method achieves state-of-the-art performance on four benchmarks in most cases.