Few-shot Adaptation of Medical Vision-Language Models
On the map: Multimodal LLMs / vision-language models → Medical vision-language models
Abstract (arXiv)
Integrating image and text data through multi-modal learning has emerged as a new approach in medical imaging research, following its successful deployment in computer vision. While considerable efforts have been dedicated to establishing medical foundation models and their zero-shot transfer to downstream tasks, the popular few-shot setting remains relatively unexplored. Following on from the currently strong emergence of this setting in computer vision, we introduce the first structured benchmark for adapting medical vision-language models (VLMs) in a strict few-shot regime and investigate various adaptation strategies commonly used in the context of natural images. Furthermore, we evaluate a simple generalization of the linear-probe adaptation baseline, which seeks an optimal blending of the visual prototypes and text embeddings via learnable class-wise multipliers. Surprisingly, such a text-informed linear probe yields competitive performances in comparison to convoluted prompt-learning and adapter-based strategies, while running considerably faster and accommodating the black-box setting. Our extensive experiments span three different medical modalities and specialized foundation models, nine downstream tasks, and several state-of-the-art few-shot adaptation methods. We made our benchmark and code publicly available to trigger further developments in this emergent subject: urlhttps://github.com/FereshteShakeri/few-shot-MedVLMs.
Key facts. Cited by 24 papers in the map (data through 13 Oct 2026). Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models. Builds on 26 of its 36 references that are in the map. First posted on arXiv 5 Sep 2024.
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Other references · 25
- 2021Learning Transferable Visual Models From Natural Language Supervisioncited by 33,588
- 2021Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervisioncited by 3,855
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- 2022Conditional Prompt Learning for Vision-Language Modelscited by 1,431
- 2019CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparisoncited by 1,419
- 2017A Survey on Deep Learning in Medical Image Analysiscited by 1,183
- 2021CLIP-Adapter: Better Vision-Language Models with Feature Adapterscited by 1,023
- 2019How Can We Know What Language Models Know?cited by 958
- 2020Contrastive Learning of Medical Visual Representations from Paired Images and Textcited by 639
- 2022MedCLIP: Contrastive Learning from Unpaired Medical Images and Textcited by 567
- 2019Transfusion: Understanding Transfer Learning for Medical Imagingcited by 367
- 2022Tip-Adapter: Training-free Adaption of CLIP for Few-shot Classificationcited by 358
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- 2023Quilt-1M: One Million Image-Text Pairs for Histopathologycited by 192
- 2017Machine Learning Models that Remember Too Muchcited by 169
- 2023MedKLIP: Medical Knowledge Enhanced Language-Image Pre-Training in Radiologycited by 149
- 2021Recent advances and clinical applications of deep learning in medical image analysiscited by 104
- 2023Multimodality Helps Unimodality: Cross-Modal Few-Shot Learning with Multimodal Modelscited by 91
- 2021Going Deeper through the Gleason Scoring Scale: An Automatic end-to-end System for Histology Prostate Grading and Cribriform Pattern Detectioncited by 67
- 2022PLOT: Prompt Learning with Optimal Transport for Vision-Language Modelscited by 64
- 2024LP++: A Surprisingly Strong Linear Probe for Few-Shot CLIPcited by 60
- 2022Prompt Tuning for Parameter-efficient Medical Image Segmentationcited by 21
- 2022Clinical Prompt Learning with Frozen Language Modelscited by 19
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Citing papers per year: 2024: 1; 2025: 14; 2026: 9.
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- 2025Conformal Prediction for Zero-Shot Modelscited by 15
- 2025Full Conformal Adaptation of Medical Vision-Language Modelscited by 9
- 2025Trustworthy Few-Shot Transfer of Medical VLMs through Split Conformal Predictioncited by 8
- 2025Few-Shot, Now for Real: Medical VLMs Adaptation without Balanced Sets or Validationcited by 7
- 2025Medical Knowledge Intervention Prompt Tuning for Medical Image Classificationcited by 5
- 2025Recognizing Surgical Phases Anywhere: Few-Shot Test-time Adaptation and Task-graph Guided Refinementcited by 4
- 2025X-Ray-CoT: Interpretable Chest X-ray Diagnosis with Vision-Language Models via Chain-of-Thought Reasoningcited by 4
- 2026Histopath-C: Towards Realistic Domain Shifts for Histopathology Vision-Language Adaptationcited by 4
- 2024BayesAdapter: enhanced uncertainty estimation in CLIP few-shot adaptationcited by 3
- 2025Fine-tuning Vision Language Models with Graph-based Knowledge for Explainable Medical Image Analysiscited by 3
- 2025Decoupling Clinical and Class-Agnostic Features for Reliable Few-Shot Adaptation under Shiftcited by 3
- 2025A Reality Check of Vision-Language Pre-training in Radiology: Have We Progressed Using Text?cited by 2
12 more
- 2025TransUNet-GradCAM: A Hybrid Transformer-U-Net with Self-Attention and Explainable Visualizations for Foot Ulcer Segmentationcited by 2
- 2026Large-Small Model Collaboration for Zero-Shot Surgical Phase Recognitioncited by 1
- 2025Adapting Foundation Vision-Language Models to Medical Diagnosis via Query-Driven Expert Bridgingcited by 0
- 2025Prompt Triage: Structured Optimization Enhances Vision-Language Model Performance on Medical Imaging Benchmarkscited by 0
- 2025All Centers Are at most a Few Tokens Apart: Knowledge Distillation with Domain Invariant Prompt Tuningcited by 0
- 2026Semi-Supervised Few-Shot Adaptation of Vision-Language Modelscited by 0
- 2026BiomedAP: A Vision-Informed Dual-Anchor Framework with Gated Cross-Modal Fusion for Robust Medical Vision-Language Adaptationcited by 0
- 2026TCLA: Training-Free Class-wise Logit Adaptation for Medical Vision-Language Modelscited by 0
- 2026Example-based Robust Abnormality Detection with Minimal Annotations using Exemplar Med-DETRcited by 0
- 2026Exploiting Spatial Structure for Transductive Few-Shot Classification of Whole-Slide Imagescited by 0
- 2026Image-Based Breast Implant Detection for Mammography Dataset Curation and Near-Real-Time Deployment: Comparing Foundation Models and Task-Specific Convolutional Modelscited by 0
- 2026Localization Lens for Improving Medical Vision-Language Modelscited by 0
- 2026Localization Lens for Improving Medical Vision-Language Models3 Oct 2026
- 2026Image-Based Breast Implant Detection for Mammography Dataset Curation and Near-Real-Time Deployment: Comparing Foundation Models and Task-Specific Convolutional Models1 Oct 2026
- 2026Exploiting Spatial Structure for Transductive Few-Shot Classification of Whole-Slide Images25 Sep 2026
- 2026Example-based Robust Abnormality Detection with Minimal Annotations using Exemplar Med-DETR25 Aug 2026
- 2026Large-Small Model Collaboration for Zero-Shot Surgical Phase Recognition24 Aug 2026
- 2026TCLA: Training-Free Class-wise Logit Adaptation for Medical Vision-Language Models10 Jul 2026
- 2026BiomedAP: A Vision-Informed Dual-Anchor Framework with Gated Cross-Modal Fusion for Robust Medical Vision-Language Adaptation15 May 2026
- 2026Semi-Supervised Few-Shot Adaptation of Vision-Language Models3 Mar 2026
- 2026Histopath-C: Towards Realistic Domain Shifts for Histopathology Vision-Language Adaptation18 Jan 2026
- 2025All Centers Are at most a Few Tokens Apart: Knowledge Distillation with Domain Invariant Prompt Tuning27 Nov 2025
- 2025Medical Knowledge Intervention Prompt Tuning for Medical Image Classification16 Nov 2025
- 2025Prompt Triage: Structured Optimization Enhances Vision-Language Model Performance on Medical Imaging Benchmarks14 Nov 2025
12 more
- 2025Decoupling Clinical and Class-Agnostic Features for Reliable Few-Shot Adaptation under Shift11 Sep 2025
- 2025X-Ray-CoT: Interpretable Chest X-ray Diagnosis with Vision-Language Models via Chain-of-Thought Reasoning17 Aug 2025
- 2025TransUNet-GradCAM: A Hybrid Transformer-U-Net with Self-Attention and Explainable Visualizations for Foot Ulcer Segmentation4 Aug 2025
- 2025Recognizing Surgical Phases Anywhere: Few-Shot Test-time Adaptation and Task-graph Guided Refinement25 Jun 2025
- 2025Trustworthy Few-Shot Transfer of Medical VLMs through Split Conformal Prediction20 Jun 2025
- 2025Few-Shot, Now for Real: Medical VLMs Adaptation without Balanced Sets or Validation20 Jun 2025
- 2025Full Conformal Adaptation of Medical Vision-Language Models6 Jun 2025
- 2025Conformal Prediction for Zero-Shot Models30 May 2025
- 2025Adapting Foundation Vision-Language Models to Medical Diagnosis via Query-Driven Expert Bridging27 May 2025
- 2025A Reality Check of Vision-Language Pre-training in Radiology: Have We Progressed Using Text?7 Apr 2025
- 2025Fine-tuning Vision Language Models with Graph-based Knowledge for Explainable Medical Image Analysis12 Mar 2025
- 2024BayesAdapter: enhanced uncertainty estimation in CLIP few-shot adaptation12 Dec 2024
- 2025Conformal Prediction for Zero-Shot Modelscited by 15
- 2025Full Conformal Adaptation of Medical Vision-Language Modelscited by 9
- 2025Trustworthy Few-Shot Transfer of Medical VLMs through Split Conformal Predictioncited by 8
- 2025Few-Shot, Now for Real: Medical VLMs Adaptation without Balanced Sets or Validationcited by 7
- 2025Medical Knowledge Intervention Prompt Tuning for Medical Image Classificationcited by 5
- 2026Histopath-C: Towards Realistic Domain Shifts for Histopathology Vision-Language Adaptationcited by 4
- 2024BayesAdapter: enhanced uncertainty estimation in CLIP few-shot adaptationcited by 3
- 2025Fine-tuning Vision Language Models with Graph-based Knowledge for Explainable Medical Image Analysiscited by 3
- 2025Decoupling Clinical and Class-Agnostic Features for Reliable Few-Shot Adaptation under Shiftcited by 3
- 2025A Reality Check of Vision-Language Pre-training in Radiology: Have We Progressed Using Text?cited by 2
- 2025Adapting Foundation Vision-Language Models to Medical Diagnosis via Query-Driven Expert Bridgingcited by 0
- 2025Prompt Triage: Structured Optimization Enhances Vision-Language Model Performance on Medical Imaging Benchmarkscited by 0
12 most cited of 15 All 15 (JSON)
- 2026Localization Lens for Improving Medical Vision-Language Models3 Oct 2026
- 2026TCLA: Training-Free Class-wise Logit Adaptation for Medical Vision-Language Models10 Jul 2026
- 2026Semi-Supervised Few-Shot Adaptation of Vision-Language Models3 Mar 2026
- 2026Histopath-C: Towards Realistic Domain Shifts for Histopathology Vision-Language Adaptation18 Jan 2026
- 2025Medical Knowledge Intervention Prompt Tuning for Medical Image Classification16 Nov 2025
- 2025Prompt Triage: Structured Optimization Enhances Vision-Language Model Performance on Medical Imaging Benchmarks14 Nov 2025
- 2025Decoupling Clinical and Class-Agnostic Features for Reliable Few-Shot Adaptation under Shift11 Sep 2025
- 2025Trustworthy Few-Shot Transfer of Medical VLMs through Split Conformal Prediction20 Jun 2025
- 2025Few-Shot, Now for Real: Medical VLMs Adaptation without Balanced Sets or Validation20 Jun 2025
- 2025Full Conformal Adaptation of Medical Vision-Language Models6 Jun 2025
- 2025Conformal Prediction for Zero-Shot Models30 May 2025
- 2025Adapting Foundation Vision-Language Models to Medical Diagnosis via Query-Driven Expert Bridging27 May 2025
12 newest of 15 All 15 (JSON)
- 2025Recognizing Surgical Phases Anywhere: Few-Shot Test-time Adaptation and Task-graph Guided Refinementcited by 4
- 2025TransUNet-GradCAM: A Hybrid Transformer-U-Net with Self-Attention and Explainable Visualizations for Foot Ulcer Segmentationcited by 2
- 2026Large-Small Model Collaboration for Zero-Shot Surgical Phase Recognitioncited by 1
- 2026BiomedAP: A Vision-Informed Dual-Anchor Framework with Gated Cross-Modal Fusion for Robust Medical Vision-Language Adaptationcited by 0
- 2026Example-based Robust Abnormality Detection with Minimal Annotations using Exemplar Med-DETRcited by 0
- 2026Exploiting Spatial Structure for Transductive Few-Shot Classification of Whole-Slide Imagescited by 0
- 2026Image-Based Breast Implant Detection for Mammography Dataset Curation and Near-Real-Time Deployment: Comparing Foundation Models and Task-Specific Convolutional Modelscited by 0
- 2026Image-Based Breast Implant Detection for Mammography Dataset Curation and Near-Real-Time Deployment: Comparing Foundation Models and Task-Specific Convolutional Models1 Oct 2026
- 2026Exploiting Spatial Structure for Transductive Few-Shot Classification of Whole-Slide Images25 Sep 2026
- 2026Example-based Robust Abnormality Detection with Minimal Annotations using Exemplar Med-DETR25 Aug 2026
- 2026Large-Small Model Collaboration for Zero-Shot Surgical Phase Recognition24 Aug 2026
- 2026BiomedAP: A Vision-Informed Dual-Anchor Framework with Gated Cross-Modal Fusion for Robust Medical Vision-Language Adaptation15 May 2026
- 2025TransUNet-GradCAM: A Hybrid Transformer-U-Net with Self-Attention and Explainable Visualizations for Foot Ulcer Segmentation4 Aug 2025
- 2025Recognizing Surgical Phases Anywhere: Few-Shot Test-time Adaptation and Task-graph Guided Refinement25 Jun 2025
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