# Benchmarking Large Language Models on Answering and Explaining Challenging Medical Questions

arXiv: https://arxiv.org/abs/2402.18060 · HTML: https://mlsanity.com/paper/2402.18060/

## Key facts

- Cited by 109 papers in the map (data through 14 Oct 2026).
- Builds on 41 of its 82 references that are in the map.
- First posted on arXiv 28 Feb 2024.

## Builds on (most cited first, 30 of 41)

- [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)
- [RoBERTa: A Robustly Optimized BERT Pretraining Approach](https://mlsanity.com/paper/1907.11692/) (2019)
- [Llama 2: Open Foundation and Fine-Tuned Chat Models](https://mlsanity.com/paper/2307.09288/) (2023)
- [Measuring Massive Multitask Language Understanding](https://mlsanity.com/paper/2009.03300/) (2020)
- [BART: Denoising Sequence-to-Sequence Pre-training for Natural Language Generation, Translation, and Comprehension](https://mlsanity.com/paper/1910.13461/) (2019)
- [Self-Consistency Improves Chain of Thought Reasoning in Language Models](https://mlsanity.com/paper/2203.11171/) (2022)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [PaLM: Scaling Language Modeling with Pathways](https://mlsanity.com/paper/2204.02311/) (2022)
- [Large Language Models are Zero-Shot Reasoners](https://mlsanity.com/paper/2205.11916/) (2022)
- [G-Eval: NLG Evaluation using GPT-4 with Better Human Alignment](https://mlsanity.com/paper/2303.16634/) (2023)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Rethinking the Role of Demonstrations: What Makes In-Context Learning Work?](https://mlsanity.com/paper/2202.12837/) (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)
- [BLEURT: Learning Robust Metrics for Text Generation](https://mlsanity.com/paper/2004.04696/) (2020)
- [Teaching Machines to Read and Comprehend](https://mlsanity.com/paper/1506.03340/) (2015)
- [BARTScore: Evaluating Generated Text as Text Generation](https://mlsanity.com/paper/2106.11520/) (2021)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [The Falcon Series of Open Language Models](https://mlsanity.com/paper/2311.16867/) (2023)
- [NLP Evaluation in trouble: On the Need to Measure LLM Data Contamination for each Benchmark](https://mlsanity.com/paper/2310.18018/) (2023)
- [Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine](https://mlsanity.com/paper/2311.16452/) (2023)
- [MedAlpaca -- An Open-Source Collection of Medical Conversational AI Models and Training Data](https://mlsanity.com/paper/2304.08247/) (2023)
- [Data Contamination: From Memorization to Exploitation](https://mlsanity.com/paper/2203.08242/) (2022)
- [HuatuoGPT, towards Taming Language Model to Be a Doctor](https://mlsanity.com/paper/2305.15075/) (2023)
- [Can large language models reason about medical questions?](https://mlsanity.com/paper/2207.08143/) (2022)
- [Meta-learning via Language Model In-context Tuning](https://mlsanity.com/paper/2110.07814/) (2021)
- [A Study of Generative Large Language Model for Medical Research and Healthcare](https://mlsanity.com/paper/2305.13523/) (2023)
- [When Benchmarks are Targets: Revealing the Sensitivity of Large Language Model Leaderboards](https://mlsanity.com/paper/2402.01781/) (2024)
- [emrQA: A Large Corpus for Question Answering on Electronic Medical Records](https://mlsanity.com/paper/1809.00732/) (2018)

## Built on by (most cited first, 30 of 109)

- [Towards Reasoning Era: A Survey of Long Chain-of-Thought for Reasoning Large Language Models](https://mlsanity.com/paper/2503.09567/) (2025)
- [From System 1 to System 2: A Survey of Reasoning Large Language Models](https://mlsanity.com/paper/2502.17419/) (2025)
- [Lingshu: A Generalist Foundation Model for Unified Multimodal Medical Understanding and Reasoning](https://mlsanity.com/paper/2506.07044/) (2025)
- [A Survey on Test-Time Scaling in Large Language Models: What, How, Where, and How Well?](https://mlsanity.com/paper/2503.24235/) (2025)
- [MDAgents: An Adaptive Collaboration of LLMs for Medical Decision-Making](https://mlsanity.com/paper/2404.15155/) (2024)
- [MedReason: Eliciting Factual Medical Reasoning Steps in LLMs via Knowledge Graphs](https://mlsanity.com/paper/2504.00993/) (2025)
- [m1: Unleash the Potential of Test-Time Scaling for Medical Reasoning with Large Language Models](https://mlsanity.com/paper/2504.00869/) (2025)
- [Baichuan-M1: Pushing the Medical Capability of Large Language Models](https://mlsanity.com/paper/2502.12671/) (2025)
- [MedicalAgentsBench for Complex Medical Reasoning: Comparing Internalized Reasoning Models versus Externalized Agent-based Frameworks](https://mlsanity.com/paper/2503.07459/) (2025)
- [A Survey of Scientific Large Language Models: From Data Foundations to Agent Frontiers](https://mlsanity.com/paper/2508.21148/) (2025)
- [O1 Replication Journey -- Part 3: Inference-time Scaling for Medical Reasoning](https://mlsanity.com/paper/2501.06458/) (2025)
- [A Preliminary Study of o1 in Medicine: Are We Closer to an AI Doctor?](https://mlsanity.com/paper/2409.15277/) (2024)
- [ClinicalBench: Can LLMs Beat Traditional ML Models in Clinical Prediction?](https://mlsanity.com/paper/2411.06469/) (2024)
- [Small Language Models Learn Enhanced Reasoning Skills from Medical Textbooks](https://mlsanity.com/paper/2404.00376/) (2024)
- [AfriMed-QA: A Pan-African, Multi-Specialty, Medical Question-Answering Benchmark Dataset](https://mlsanity.com/paper/2411.15640/) (2024)
- [Automating Expert-Level Medical Reasoning Evaluation of Large Language Models](https://mlsanity.com/paper/2507.07988/) (2025)
- [DiagnosisArena: Benchmarking Diagnostic Reasoning for Large Language Models](https://mlsanity.com/paper/2505.14107/) (2025)
- [Disentangling Reasoning and Knowledge in Medical Large Language Models](https://mlsanity.com/paper/2505.11462/) (2025)
- [Large language models provide unsafe answers to patient-posed medical questions](https://mlsanity.com/paper/2507.18905/) (2025)
- [Beyond Log Likelihood: Probability-Based Objectives for Supervised Fine-Tuning across the Model Capability Continuum](https://mlsanity.com/paper/2510.00526/) (2025)
- [Medchain: Bridging the Gap Between LLM Agents and Clinical Practice with Interactive Sequence](https://mlsanity.com/paper/2412.01605/) (2024)
- [Citrus: Leveraging Expert Cognitive Pathways in a Medical Language Model for Advanced Medical Decision Support](https://mlsanity.com/paper/2502.18274/) (2025)
- [Cancer-Myth: Evaluating Large Language Models on Patient Questions with False Presuppositions](https://mlsanity.com/paper/2504.11373/) (2025)
- [MedArabiQ: Benchmarking Large Language Models on Arabic Medical Tasks](https://mlsanity.com/paper/2505.03427/) (2025)
- [DiReCT: Diagnostic Reasoning for Clinical Notes via Large Language Models](https://mlsanity.com/paper/2408.01933/) (2024)
- [MultiFinBen: Benchmarking Large Language Models for Multilingual and Multimodal Financial Application](https://mlsanity.com/paper/2506.14028/) (2025)
- [Does Biomedical Training Lead to Better Medical Performance?](https://mlsanity.com/paper/2404.04067/) (2024)
- [Explainability in Practice: A Survey of Explainable NLP Across Various Domains](https://mlsanity.com/paper/2502.00837/) (2025)
- [Recursive Multi-Agent Systems](https://mlsanity.com/paper/2604.25917/) (2026)
- [Evaluating Reasoning Faithfulness in Medical Vision-Language Models using Multimodal Perturbations](https://mlsanity.com/paper/2510.11196/) (2025)

## Abstract (arXiv)

LLMs have demonstrated impressive performance in answering medical questions, such as achieving passing scores on medical licensing examinations. However, medical board exams or general clinical questions do not capture the complexity of realistic clinical cases. Moreover, the lack of reference explanations means we cannot easily evaluate the reasoning of model decisions, a crucial component of supporting doctors in making complex medical decisions. To address these challenges, we construct two new datasets: JAMA Clinical Challenge and Medbullets. Datasets and code are available at https://github.com/HanjieChen/ChallengeClinicalQA. JAMA Clinical Challenge consists of questions based on challenging clinical cases, while Medbullets comprises simulated clinical questions. Both datasets are structured as multiple-choice question-answering tasks, accompanied by expert-written explanations. We evaluate seven LLMs on the two datasets using various prompts. Experiments demonstrate that our datasets are harder than previous benchmarks. In-depth automatic and human evaluations of model-generated explanations provide insights into the promise and deficiency of LLMs for explainable medical QA.