# Agent Hospital: A Simulacrum of Hospital with Evolvable Medical Agents

arXiv: https://arxiv.org/abs/2405.02957 · HTML: https://mlsanity.com/paper/2405.02957/

## Key facts

- Cited by 218 papers in the map (data through 14 Oct 2026).
- Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use.
- Builds on 19 of its 34 references that are in the map.
- First posted on arXiv 5 May 2024.

## Placed in

- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 19 of 19)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [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)
- [Reflexion: Language Agents with Verbal Reinforcement Learning](https://mlsanity.com/paper/2303.11366/) (2023)
- [Generative Agents: Interactive Simulacra of Human Behavior](https://mlsanity.com/paper/2304.03442/) (2023)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [Enhancing Chat Language Models by Scaling High-quality Instructional Conversations](https://mlsanity.com/paper/2305.14233/) (2023)
- [Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine](https://mlsanity.com/paper/2311.16452/) (2023)
- [Principle-Driven Self-Alignment of Language Models from Scratch with Minimal Human Supervision](https://mlsanity.com/paper/2305.03047/) (2023)
- [MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoning](https://mlsanity.com/paper/2311.10537/) (2023)
- [Exploring Large Language Models for Communication Games: An Empirical Study on Werewolf](https://mlsanity.com/paper/2309.04658/) (2023)
- [S3: Social-network Simulation System with Large Language Model-Empowered Agents](https://mlsanity.com/paper/2307.14984/) (2023)
- [Can large language models reason about medical questions?](https://mlsanity.com/paper/2207.08143/) (2022)
- [EconAgent: Large Language Model-Empowered Agents for Simulating Macroeconomic Activities](https://mlsanity.com/paper/2310.10436/) (2023)
- [War and Peace (WarAgent): Large Language Model-based Multi-Agent Simulation of World Wars](https://mlsanity.com/paper/2311.17227/) (2023)
- [AgentCF: Collaborative Learning with Autonomous Language Agents for Recommender Systems](https://mlsanity.com/paper/2310.09233/) (2023)
- [MetaAgents: Large Language Model Based Agents for Decision-Making on Teaming](https://mlsanity.com/paper/2310.06500/) (2023)
- [In-Context Principle Learning from Mistakes](https://mlsanity.com/paper/2402.05403/) (2024)
- [Self-seeding and Multi-intent Self-instructing LLMs for Generating Intent-aware Information-Seeking dialogs](https://mlsanity.com/paper/2402.11633/) (2024)

## Built on by (most cited first, 30 of 218)

- [HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs](https://mlsanity.com/paper/2412.18925/) (2024)
- [Scaling Large Language Model-based Multi-Agent Collaboration](https://mlsanity.com/paper/2406.07155/) (2024)
- [AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments](https://mlsanity.com/paper/2405.07960/) (2024)
- [Lingshu: A Generalist Foundation Model for Unified Multimodal Medical Understanding and Reasoning](https://mlsanity.com/paper/2506.07044/) (2025)
- [Large Language Model Agent: A Survey on Methodology, Applications and Challenges](https://mlsanity.com/paper/2503.21460/) (2025)
- [A Survey of Self-Evolving Agents: What, When, How, and Where to Evolve on the Path to Artificial Super Intelligence](https://mlsanity.com/paper/2507.21046/) (2025)
- [AgentSquare: Automatic LLM Agent Search in Modular Design Space](https://mlsanity.com/paper/2410.06153/) (2024)
- [From LLM Reasoning to Autonomous AI Agents: A Comprehensive Review](https://mlsanity.com/paper/2504.19678/) (2025)
- [Simulating Classroom Education with LLM-Empowered Agents](https://mlsanity.com/paper/2406.19226/) (2024)
- [Advances and Challenges in Foundation Agents: From Brain-Inspired Intelligence to Evolutionary, Collaborative, and Safe Systems](https://mlsanity.com/paper/2504.01990/) (2025)
- [Adaptive Attacks Break Defenses Against Indirect Prompt Injection Attacks on LLM Agents](https://mlsanity.com/paper/2503.00061/) (2025)
- [GuardAgent: Safeguard LLM Agents by a Guard Agent via Knowledge-Enabled Reasoning](https://mlsanity.com/paper/2406.09187/) (2024)
- [FinCon: A Synthesized LLM Multi-Agent System with Conceptual Verbal Reinforcement for Enhanced Financial Decision Making](https://mlsanity.com/paper/2407.06567/) (2024)
- [MMedAgent: Learning to Use Medical Tools with Multi-modal Agent](https://mlsanity.com/paper/2407.02483/) (2024)
- [Multi-Agent Collaboration via Evolving Orchestration](https://mlsanity.com/paper/2505.19591/) (2025)
- [On the Resilience of LLM-Based Multi-Agent Collaboration with Faulty Agents](https://mlsanity.com/paper/2408.00989/) (2024)
- [AGrail: A Lifelong Agent Guardrail with Effective and Adaptive Safety Detection](https://mlsanity.com/paper/2502.11448/) (2025)
- [A Survey of LLM-based Agents in Medicine: How far are we from Baymax?](https://mlsanity.com/paper/2502.11211/) (2025)
- [From Individual to Society: A Survey on Social Simulation Driven by Large Language Model-based Agents](https://mlsanity.com/paper/2412.03563/) (2024)
- [From AI for Science to Agentic Science: A Survey on Autonomous Scientific Discovery](https://mlsanity.com/paper/2508.14111/) (2025)
- [Self-Evolving Multi-Agent Collaboration Networks for Software Development](https://mlsanity.com/paper/2410.16946/) (2024)
- [AgentRxiv: Towards Collaborative Autonomous Research](https://mlsanity.com/paper/2503.18102/) (2025)
- [Preble: Efficient Distributed Prompt Scheduling for LLM Serving](https://mlsanity.com/paper/2407.00023/) (2024)
- [Retrieval Augmented Generation (RAG) and Beyond: A Comprehensive Survey on How to Make your LLMs use External Data More Wisely](https://mlsanity.com/paper/2409.14924/) (2024)
- [Ask-before-Plan: Proactive Language Agents for Real-World Planning](https://mlsanity.com/paper/2406.12639/) (2024)
- [Baichuan-M2: Scaling Medical Capability with Large Verifier System](https://mlsanity.com/paper/2509.02208/) (2025)
- [A Survey on LLM-based Multi-Agent System: Recent Advances and New Frontiers in Application](https://mlsanity.com/paper/2412.17481/) (2024)
- [Do as We Do, Not as You Think: the Conformity of Large Language Models](https://mlsanity.com/paper/2501.13381/) (2025)
- [SeRL: Self-Play Reinforcement Learning for Large Language Models with Limited Data](https://mlsanity.com/paper/2505.20347/) (2025)
- [GenSim: A General Social Simulation Platform with Large Language Model based Agents](https://mlsanity.com/paper/2410.04360/) (2024)

## Abstract (arXiv)

The recent rapid development of large language models (LLMs) has sparked a new wave of technological revolution in medical artificial intelligence (AI). While LLMs are designed to understand and generate text like a human, autonomous agents that utilize LLMs as their "brain" have exhibited capabilities beyond text processing such as planning, reflection, and using tools by enabling their "bodies" to interact with the environment. We introduce a simulacrum of hospital called Agent Hospital that simulates the entire process of treating illness, in which all patients, nurses, and doctors are LLM-powered autonomous agents. Within the simulacrum, doctor agents are able to evolve by treating a large number of patient agents without the need to label training data manually. After treating tens of thousands of patient agents in the simulacrum (human doctors may take several years in the real world), the evolved doctor agents outperform state-of-the-art medical agent methods on the MedQA benchmark comprising US Medical Licensing Examination (USMLE) test questions. Our methods of simulacrum construction and agent evolution have the potential in benefiting a broad range of applications beyond medical AI.