# Enhancing Small Medical Learners with Privacy-preserving Contextual Prompting

arXiv: https://arxiv.org/abs/2305.12723 · HTML: https://mlsanity.com/paper/2305.12723/

## Key facts

- Cited by 11 papers in the map (data through 14 Oct 2026).
- Builds on 52 of its 80 references that are in the map.
- First posted on arXiv 22 May 2023.

## Builds on (most cited first, 30 of 52)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Exploring the Limits of Transfer Learning with a Unified Text-to-Text Transformer](https://mlsanity.com/paper/1910.10683/) (2019)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Distilling the Knowledge in a Neural Network](https://mlsanity.com/paper/1503.02531/) (2015)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Measuring Massive Multitask Language Understanding](https://mlsanity.com/paper/2009.03300/) (2020)
- [PaLM: Scaling Language Modeling with Pathways](https://mlsanity.com/paper/2204.02311/) (2022)
- [Dense Passage Retrieval for Open-Domain Question Answering](https://mlsanity.com/paper/2004.04906/) (2020)
- [Deep Learning with Differential Privacy](https://mlsanity.com/paper/1607.00133/) (2016)
- [Can a Suit of Armor Conduct Electricity? A New Dataset for Open Book Question Answering](https://mlsanity.com/paper/1809.02789/) (2018)
- [REALM: Retrieval-Augmented Language Model Pre-Training](https://mlsanity.com/paper/2002.08909/) (2020)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Language Models as Knowledge Bases?](https://mlsanity.com/paper/1909.01066/) (2019)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [CommonsenseQA: A Question Answering Challenge Targeting Commonsense Knowledge](https://mlsanity.com/paper/1811.00937/) (2018)
- [Don't Stop Pretraining: Adapt Language Models to Domains and Tasks](https://mlsanity.com/paper/2004.10964/) (2020)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [Leveraging Passage Retrieval with Generative Models for Open Domain Question Answering](https://mlsanity.com/paper/2007.01282/) (2020)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [Reading Wikipedia to Answer Open-Domain Questions](https://mlsanity.com/paper/1704.00051/) (2017)
- [How Much Knowledge Can You Pack Into the Parameters of a Language Model?](https://mlsanity.com/paper/2002.08910/) (2020)
- [Latent Retrieval for Weakly Supervised Open Domain Question Answering](https://mlsanity.com/paper/1906.00300/) (2019)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [RocketQA: An Optimized Training Approach to Dense Passage Retrieval for Open-Domain Question Answering](https://mlsanity.com/paper/2010.08191/) (2020)
- [QA-GNN: Reasoning with Language Models and Knowledge Graphs for Question Answering](https://mlsanity.com/paper/2104.06378/) (2021)
- [Large Language Models Are Reasoning Teachers](https://mlsanity.com/paper/2212.10071/) (2022)
- [Generate rather than Retrieve: Large Language Models are Strong Context Generators](https://mlsanity.com/paper/2209.10063/) (2022)

## Built on by (most cited first, 11 of 11)

- [AlpaCare:Instruction-tuned Large Language Models for Medical Application](https://mlsanity.com/paper/2310.14558/) (2023)
- [Health-LLM: Large Language Models for Health Prediction via Wearable Sensor Data](https://mlsanity.com/paper/2401.06866/) (2024)
- [Unveiling the Impact of Coding Data Instruction Fine-Tuning on Large Language Models Reasoning](https://mlsanity.com/paper/2405.20535/) (2024)
- [Instruction-following Evaluation through Verbalizer Manipulation](https://mlsanity.com/paper/2307.10558/) (2023)
- [PrivacyMind: Large Language Models Can Be Contextual Privacy Protection Learners](https://mlsanity.com/paper/2310.02469/) (2023)
- [LLM Sensitivity Evaluation Framework for Clinical Diagnosis](https://mlsanity.com/paper/2504.13475/) (2025)
- [A Survey on Collaborating Small and Large Language Models for Performance, Cost-effectiveness, Cloud-edge Privacy, and Trustworthiness](https://mlsanity.com/paper/2510.13890/) (2025)
- [Retrieval Augmented Thought Process for Private Data Handling in Healthcare](https://mlsanity.com/paper/2402.07812/) (2024)
- [FedCoT: Communication-Efficient Federated Reasoning Enhancement for Large Language Models](https://mlsanity.com/paper/2508.10020/) (2025)
- [Continual Pretraining on Encrypted Synthetic Data for Privacy-Preserving LLMs](https://mlsanity.com/paper/2601.05635/) (2026)
- [Applying Language Models in Clinical Medicine: Recent Trends and Perspectives](https://mlsanity.com/paper/2609.34780/) (2026)

## Abstract (arXiv)

Large language models (LLMs) demonstrate remarkable medical expertise, but data privacy concerns impede their direct use in healthcare environments. Although offering improved data privacy protection, domain-specific small language models (SLMs) often underperform LLMs, emphasizing the need for methods that reduce this performance gap while alleviating privacy concerns. In this paper, we present a simple yet effective method that harnesses LLMs' medical proficiency to boost SLM performance in medical tasks under privacy-restricted scenarios. Specifically, we mitigate patient privacy issues by extracting keywords from medical data and prompting the LLM to generate a medical knowledge-intensive context by simulating clinicians' thought processes. This context serves as additional input for SLMs, augmenting their decision-making capabilities. Our method significantly enhances performance in both few-shot and full training settings across three medical knowledge-intensive tasks, achieving up to a 22.57% increase in absolute accuracy compared to SLM fine-tuning without context, and sets new state-of-the-art results in two medical tasks within privacy-restricted scenarios. Further out-of-domain testing and experiments in two general domain datasets showcase its generalizability and broad applicability. Our code can be found at https://github.com/XZhang97666/PrivacyBoost-SLM.