# MedCare: Advancing Medical LLMs through Decoupling Clinical Alignment and Knowledge Aggregation

arXiv: https://arxiv.org/abs/2406.17484 · HTML: https://mlsanity.com/paper/2406.17484/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 47 of its 61 references that are in the map.
- First posted on arXiv 25 Jun 2024.

## Builds on (most cited first, 30 of 47)

- [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)
- [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)
- [Parameter-Efficient Transfer Learning for NLP](https://mlsanity.com/paper/1902.00751/) (2019)
- [Prefix-Tuning: Optimizing Continuous Prompts for Generation](https://mlsanity.com/paper/2101.00190/) (2021)
- [The Power of Scale for Parameter-Efficient Prompt Tuning](https://mlsanity.com/paper/2104.08691/) (2021)
- [Finetuned Language Models Are Zero-Shot Learners](https://mlsanity.com/paper/2109.01652/) (2021)
- [Qwen Technical Report](https://mlsanity.com/paper/2309.16609/) (2023)
- [Scaling Instruction-Finetuned Language Models](https://mlsanity.com/paper/2210.11416/) (2022)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Multitask Prompted Training Enables Zero-Shot Task Generalization](https://mlsanity.com/paper/2110.08207/) (2021)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [Transformer Feed-Forward Layers Are Key-Value Memories](https://mlsanity.com/paper/2012.14913/) (2020)
- [Sigmoid-Weighted Linear Units for Neural Network Function Approximation in Reinforcement Learning](https://mlsanity.com/paper/1702.03118/) (2017)
- [DeepSeekMoE: Towards Ultimate Expert Specialization in Mixture-of-Experts Language Models](https://mlsanity.com/paper/2401.06066/) (2024)
- [GLM-130B: An Open Bilingual Pre-trained Model](https://mlsanity.com/paper/2210.02414/) (2022)
- [AdapterFusion: Non-Destructive Task Composition for Transfer Learning](https://mlsanity.com/paper/2005.00247/) (2020)
- [DoRA: Weight-Decomposed Low-Rank Adaptation](https://mlsanity.com/paper/2402.09353/) (2024)
- [C-Eval: A Multi-Level Multi-Discipline Chinese Evaluation Suite for Foundation Models](https://mlsanity.com/paper/2305.08322/) (2023)
- [Baichuan 2: Open Large-scale Language Models](https://mlsanity.com/paper/2309.10305/) (2023)
- [Learning multiple visual domains with residual adapters](https://mlsanity.com/paper/1705.08045/) (2017)
- [CMMLU: Measuring massive multitask language understanding in Chinese](https://mlsanity.com/paper/2306.09212/) (2023)
- [LoRA+: Efficient Low Rank Adaptation of Large Models](https://mlsanity.com/paper/2402.12354/) (2024)
- [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)
- [Orthogonal Subspace Learning for Language Model Continual Learning](https://mlsanity.com/paper/2310.14152/) (2023)
- [BioMistral: A Collection of Open-Source Pretrained Large Language Models for Medical Domains](https://mlsanity.com/paper/2402.10373/) (2024)
- [Adapted Large Language Models Can Outperform Medical Experts in Clinical Text Summarization](https://mlsanity.com/paper/2309.07430/) (2023)
- [Does Fine-Tuning LLMs on New Knowledge Encourage Hallucinations?](https://mlsanity.com/paper/2405.05904/) (2024)

## Built on by (most cited first, 4 of 4)

- [MedS3: Towards Medical Slow Thinking with Self-Evolved Soft Dual-sided Process Supervision](https://mlsanity.com/paper/2501.12051/) (2025)
- [Towards Omni-RAG: Comprehensive Retrieval-Augmented Generation for Large Language Models in Medical Applications](https://mlsanity.com/paper/2501.02460/) (2025)
- [Improving the Safety and Trustworthiness of Medical AI via Multi-Agent Evaluation Loops](https://mlsanity.com/paper/2601.13268/) (2026)
- [FlowPIE: Test-Time Scientific Idea Evolution with Flow-Guided Literature Exploration](https://mlsanity.com/paper/2603.29557/) (2026)

## Abstract (arXiv)

Large language models (LLMs) have shown substantial progress in natural language understanding and generation, proving valuable especially in the medical field. Despite advancements, challenges persist due to the complexity and diversity inherent in medical tasks, which can be categorized as knowledge-intensive tasks and alignment-required tasks. Previous approaches either ignore the latter task or focus on a minority of tasks and hence lose generalization. To address these drawbacks, we propose a progressive fine-tuning pipeline. This pipeline employs a Knowledge Aggregator and a Noise aggregator to encode diverse knowledge in the first stage and filter out detrimental information. In the second stage, we drop the Noise Aggregator to avoid the interference of suboptimal representation and leverage an additional alignment module optimized towards an orthogonal direction to the knowledge space to mitigate knowledge forgetting. Based on this two-stage paradigm, we proposed a Medical LLM through decoupling Clinical Alignment and Knowledge Aggregation (MedCare), which is designed to achieve state-of-the-art (SOTA) performance on over 20 medical tasks, as well as SOTA results on specific medical alignment tasks. Various model sizes of MedCare (1.8B, 7B, 14B) all demonstrate significant improvements over existing models with similar model sizes.