# Towards Democratizing Multilingual Large Language Models For Medicine Through A Two-Stage Instruction Fine-tuning Approach

arXiv: https://arxiv.org/abs/2409.05732 · HTML: https://mlsanity.com/paper/2409.05732/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 27 of its 33 references that are in the map.
- First posted on arXiv 9 Sep 2024.

## Builds on (most cited first, 27 of 27)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [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)
- [Direct Preference Optimization: Your Language Model is Secretly a Reward Model](https://mlsanity.com/paper/2305.18290/) (2023)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [QLoRA: Efficient Finetuning of Quantized LLMs](https://mlsanity.com/paper/2305.14314/) (2023)
- [Gemini 1.5: Unlocking multimodal understanding across millions of tokens of context](https://mlsanity.com/paper/2403.05530/) (2024)
- [Mistral 7B](https://mlsanity.com/paper/2310.06825/) (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)
- [DoRA: Weight-Decomposed Low-Rank Adaptation](https://mlsanity.com/paper/2402.09353/) (2024)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [Towards Expert-Level Medical Question Answering with Large Language Models](https://mlsanity.com/paper/2305.09617/) (2023)
- [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)
- [MedAlpaca -- An Open-Source Collection of Medical Conversational AI Models and Training Data](https://mlsanity.com/paper/2304.08247/) (2023)
- [MEDITRON-70B: Scaling Medical Pretraining for Large Language Models](https://mlsanity.com/paper/2311.16079/) (2023)
- [HuatuoGPT-II, One-stage Training for Medical Adaption of LLMs](https://mlsanity.com/paper/2311.09774/) (2023)
- [Towards Building Multilingual Language Model for Medicine](https://mlsanity.com/paper/2402.13963/) (2024)
- [AlpaCare:Instruction-tuned Large Language Models for Medical Application](https://mlsanity.com/paper/2310.14558/) (2023)
- [Med42-v2: A Suite of Clinical LLMs](https://mlsanity.com/paper/2408.06142/) (2024)
- [Clinical Camel: An Open Expert-Level Medical Language Model with Dialogue-Based Knowledge Encoding](https://mlsanity.com/paper/2305.12031/) (2023)
- [Huatuo-26M, a Large-scale Chinese Medical QA Dataset](https://mlsanity.com/paper/2305.01526/) (2023)
- [Apollo: A Lightweight Multilingual Medical LLM towards Democratizing Medical AI to 6B People](https://mlsanity.com/paper/2403.03640/) (2024)
- [Taiyi: A Bilingual Fine-Tuned Large Language Model for Diverse Biomedical Tasks](https://mlsanity.com/paper/2311.11608/) (2023)
- [KorMedMCQA: Multi-Choice Question Answering Benchmark for Korean Healthcare Professional Licensing Examinations](https://mlsanity.com/paper/2403.01469/) (2024)
- [BiMediX: Bilingual Medical Mixture of Experts LLM](https://mlsanity.com/paper/2402.13253/) (2024)
- [CrossIn: An Efficient Instruction Tuning Approach for Cross-Lingual Knowledge Alignment](https://mlsanity.com/paper/2404.11932/) (2024)

## Abstract (arXiv)

Open-source, multilingual medical large language models (LLMs) have the potential to serve linguistically diverse populations across different regions. Adapting generic LLMs for healthcare often requires continual pretraining, but this approach is computationally expensive and sometimes impractical. Instruction fine-tuning on a specific task may not always guarantee optimal performance due to the lack of broader domain knowledge that the model needs to understand and reason effectively in diverse scenarios. To address these challenges, we introduce two multilingual instruction fine-tuning datasets, MMed-IFT and MMed-IFT-MC, containing over 200k high-quality medical samples in six languages. We propose a two-stage training paradigm: the first stage injects general medical knowledge using MMed-IFT, while the second stage fine-tunes task-specific multiple-choice questions with MMed-IFT-MC. Our method achieves competitive results on both English and multilingual benchmarks, striking a balance between computational efficiency and performance. We plan to make our dataset and model weights public at urlhttps://github.com/SpassMed/Med-Llama3 in the future.