Recent advances in medical multi-modal models focus on specialized image analysis like dermatology, pathology, or radiology. However, they do not fully capture the complexity of real-world clinical diagnostics, which involve heterogeneous inputs and require ongoing contextual understanding during patient-physician interactions. To bridge this gap, we introduce PulseMind, a new family of multi-modal diagnostic models that integrates a systematically curated dataset, a comprehensive evaluation benchmark, and a tailored training framework. Specifically, we first construct a diagnostic dataset, MediScope, which comprises 98,000 real-world multi-turn consultations and 601,500 medical images, spanning over 10 major clinical departments and more than 200 sub-specialties. Then, to better reflect the requirements of real-world clinical diagnosis, we develop the PulseMind Benchmark, a multi-turn diagnostic consultation benchmark with a four-dimensional evaluation protocol comprising proactiveness, accuracy, usefulness, and language quality. Finally, we design a training framework tailored for multi-modal clinical diagnostics, centered around a core component named Comparison-based Reinforcement Policy Optimization (CRPO). Compared to absolute score rewards, CRPO uses relative preference signals from multi-dimensional comparisons to provide stable and human-aligned training guidance. Extensive experiments demonstrate that PulseMind achieves competitive performance on both the diagnostic consultation benchmark and public medical benchmarks.

Modular and composable transfer learning is an emerging direction in the field of Parameter Efficient Fine-Tuning, as it enables neural networks to better organize various aspects of knowledge, leading to improved cross-task generalization. In this paper, we introduce a novel approach Customized Polytropon ($\texttt{C-Poly}$) that combines task-common skills and task-specific skills, while the skill parameters being highly parameterized using low-rank techniques. Each task is associated with a customizable number of exclusive specialized skills and also benefits from skills shared with peer tasks. A skill assignment matrix is jointly learned. To evaluate our approach, we conducted extensive experiments on the Super-NaturalInstructions and the SuperGLUE benchmarks. Our findings demonstrate that $\texttt{C-Poly}$ outperforms fully-shared, task-specific, and skill-indistinguishable baselines, significantly enhancing the sample efficiency in multi-task learning scenarios.

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