# Qilin-Med: Multi-stage Knowledge Injection Advanced Medical Large Language Model

arXiv: https://arxiv.org/abs/2310.09089 · HTML: https://mlsanity.com/paper/2310.09089/

## Key facts

- Cited by 24 papers in the map (data through 14 Oct 2026).
- Builds on 39 of its 72 references that are in the map.
- First posted on arXiv 13 Oct 2023.

## Builds on (most cited first, 30 of 39)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Exploring the Limits of Transfer Learning with a Unified Text-to-Text Transformer](https://mlsanity.com/paper/1910.10683/) (2019)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [Llama 2: Open Foundation and Fine-Tuned Chat Models](https://mlsanity.com/paper/2307.09288/) (2023)
- [Direct Preference Optimization: Your Language Model is Secretly a Reward Model](https://mlsanity.com/paper/2305.18290/) (2023)
- [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)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [GLM: General Language Model Pretraining with Autoregressive Blank Infilling](https://mlsanity.com/paper/2103.10360/) (2021)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [GLM-130B: An Open Bilingual Pre-trained Model](https://mlsanity.com/paper/2210.02414/) (2022)
- [Deduplicating Training Data Makes Language Models Better](https://mlsanity.com/paper/2107.06499/) (2021)
- [C-Eval: A Multi-Level Multi-Discipline Chinese Evaluation Suite for Foundation Models](https://mlsanity.com/paper/2305.08322/) (2023)
- [P-Tuning v2: Prompt Tuning Can Be Comparable to Fine-tuning Universally Across Scales and Tasks](https://mlsanity.com/paper/2110.07602/) (2021)
- [Instruction Tuning with GPT-4](https://mlsanity.com/paper/2304.03277/) (2023)
- [An Empirical Study of Catastrophic Forgetting in Large Language Models During Continual Fine-tuning](https://mlsanity.com/paper/2308.08747/) (2023)
- [How Close is ChatGPT to Human Experts? Comparison Corpus, Evaluation, and Detection](https://mlsanity.com/paper/2301.07597/) (2023)
- [Towards Expert-Level Medical Question Answering with Large Language Models](https://mlsanity.com/paper/2305.09617/) (2023)
- [ZeRO-Offload: Democratizing Billion-Scale Model Training](https://mlsanity.com/paper/2101.06840/) (2021)
- [ChatDoctor: A Medical Chat Model Fine-Tuned on a Large Language Model Meta-AI (LLaMA) Using Medical Domain Knowledge](https://mlsanity.com/paper/2303.14070/) (2023)
- [Efficient and Effective Text Encoding for Chinese LLaMA and Alpaca](https://mlsanity.com/paper/2304.08177/) (2023)
- [MedAlpaca -- An Open-Source Collection of Medical Conversational AI Models and Training Data](https://mlsanity.com/paper/2304.08247/) (2023)
- [HuaTuo: Tuning LLaMA Model with Chinese Medical Knowledge](https://mlsanity.com/paper/2304.06975/) (2023)
- [MedDialog: Two Large-scale Medical Dialogue Datasets](https://mlsanity.com/paper/2004.03329/) (2020)
- [DoctorGLM: Fine-tuning your Chinese Doctor is not a Herculean Task](https://mlsanity.com/paper/2304.01097/) (2023)
- [Zhongjing: Enhancing the Chinese Medical Capabilities of Large Language Model through Expert Feedback and Real-world Multi-turn Dialogue](https://mlsanity.com/paper/2308.03549/) (2023)
- [Benchmarking Large Language Models on CMExam -- A Comprehensive Chinese Medical Exam Dataset](https://mlsanity.com/paper/2306.03030/) (2023)

## Built on by (most cited first, 24 of 24)

- [A Survey of Large Language Models in Medicine: Progress, Application, and Challenge](https://mlsanity.com/paper/2311.05112/) (2023)
- [UltraMedical: Building Specialized Generalists in Biomedicine](https://mlsanity.com/paper/2406.03949/) (2024)
- [Qilin-Med-VL: Towards Chinese Large Vision-Language Model for General Healthcare](https://mlsanity.com/paper/2310.17956/) (2023)
- [A Comprehensive Survey of Large Language Models and Multimodal Large Language Models in Medicine](https://mlsanity.com/paper/2405.08603/) (2024)
- [A Survey of Scientific Large Language Models: From Data Foundations to Agent Frontiers](https://mlsanity.com/paper/2508.21148/) (2025)
- [Large Language Models in Mental Health Care: a Scoping Review](https://mlsanity.com/paper/2401.02984/) (2024)
- [A Survey on Medical Large Language Models: Technology, Application, Trustworthiness, and Future Directions](https://mlsanity.com/paper/2406.03712/) (2024)
- [Efficient Knowledge Injection in LLMs via Self-Distillation](https://mlsanity.com/paper/2412.14964/) (2024)
- [PhysGame: Uncovering Physical Commonsense Violations in Gameplay Videos](https://mlsanity.com/paper/2412.01800/) (2024)
- [Large Language Model Benchmarks in Medical Tasks](https://mlsanity.com/paper/2410.21348/) (2024)
- [A Survey on Large Language Models from General Purpose to Medical Applications: Datasets, Methodologies, and Evaluations](https://mlsanity.com/paper/2406.10303/) (2024)
- [Citrus: Leveraging Expert Cognitive Pathways in a Medical Language Model for Advanced Medical Decision Support](https://mlsanity.com/paper/2502.18274/) (2025)
- [Multimodal Large Language Models for Medicine: A Comprehensive Survey](https://mlsanity.com/paper/2504.21051/) (2025)
- [EndoBench: A Comprehensive Evaluation of Multi-Modal Large Language Models for Endoscopy Analysis](https://mlsanity.com/paper/2505.23601/) (2025)
- [Exploring Recommendation Capabilities of GPT-4V(ision): A Preliminary Case Study](https://mlsanity.com/paper/2311.04199/) (2023)
- [Elicit and Enhance: Advancing Multimodal Reasoning in Medical Scenarios](https://mlsanity.com/paper/2505.23118/) (2025)
- [TrumorGPT: Graph-Based Retrieval-Augmented Large Language Model for Fact-Checking](https://mlsanity.com/paper/2505.07891/) (2025)
- [Thinking with Drafts: Speculative Temporal Reasoning for Efficient Long Video Understanding](https://mlsanity.com/paper/2512.00805/) (2025)
- [Opportunities and challenges in the application of large artificial intelligence models in radiology](https://mlsanity.com/paper/2403.16112/) (2024)
- [A Survey for Large Language Models in Biomedicine](https://mlsanity.com/paper/2409.00133/) (2024)
- [Improving TCM Question Answering through Tree-Organized Self-Reflective Retrieval with LLMs](https://mlsanity.com/paper/2502.09156/) (2025)
- [Reviewing Clinical Knowledge in Medical Large Language Models: Training and Beyond](https://mlsanity.com/paper/2502.20988/) (2025)
- [Advances in Large Language Models for Medicine](https://mlsanity.com/paper/2509.18690/) (2025)
- [TCM-DiffRAG: Personalized Syndrome Differentiation Reasoning Method for Traditional Chinese Medicine based on Knowledge Graph and Chain of Thought](https://mlsanity.com/paper/2602.22828/) (2026)

## Abstract (arXiv)

Integrating large language models (LLMs) into healthcare holds great potential but faces challenges. Pre-training LLMs from scratch for domains like medicine is resource-heavy and often unfeasible. On the other hand, sole reliance on Supervised Fine-tuning (SFT) can result in overconfident predictions and may not tap into domain-specific insights. In response, we present a multi-stage training method combining Domain-specific Continued Pre-training (DCPT), SFT, and Direct Preference Optimization (DPO). In addition, we publish a 3Gb Chinese Medicine (ChiMed) dataset, encompassing medical question answering, plain texts, knowledge graphs, and dialogues, segmented into three training stages. The medical LLM trained with our pipeline, Qilin-Med, shows substantial performance improvement. In the CPT and SFT phases, Qilin-Med achieved 38.4% and 40.0% accuracy on the CMExam test set, respectively. It outperformed the basemodel Baichuan-7B (accuracy: 33.5%), by 7.5%. In the DPO phase, it scored 16.66 in BLEU-1 and 27.44 in ROUGE-1 on the Huatuo-26M test set, bringing further improvement to the SFT phase (12.69 in BLEU-1 and 24.21 in ROUGE-1). Additionally, we have further enhanced the model's performance through the Retrieval Augmented Generation (RAG) approach. Experiments demonstrate that Qilin-Med-RAG achieves an accuracy rate of 42.8% on CMExam. These results highlight the contribution of our novel training approach in building LLMs for medical applications.