# FMBench: Benchmarking Fairness in Multimodal Large Language Models on Medical Tasks

arXiv: https://arxiv.org/abs/2410.01089 · HTML: https://mlsanity.com/paper/2410.01089/

## Key facts

- Cited by 11 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 21 of its 27 references that are in the map.
- First posted on arXiv 1 Oct 2024.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 21 of 21)

- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [InternVL: Scaling up Vision Foundation Models and Aligning for Generic Visual-Linguistic Tasks](https://mlsanity.com/paper/2312.14238/) (2023)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [MiniCPM-V: A GPT-4V Level MLLM on Your Phone](https://mlsanity.com/paper/2408.01800/) (2024)
- [VisionLLM: Large Language Model is also an Open-Ended Decoder for Vision-Centric Tasks](https://mlsanity.com/paper/2305.11175/) (2023)
- [PathVQA: 30000+ Questions for Medical Visual Question Answering](https://mlsanity.com/paper/2003.10286/) (2020)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [Making the Most of Text Semantics to Improve Biomedical Vision--Language Processing](https://mlsanity.com/paper/2204.09817/) (2022)
- [PMC-VQA: Visual Instruction Tuning for Medical Visual Question Answering](https://mlsanity.com/paper/2305.10415/) (2023)
- [OmniMedVQA: A New Large-Scale Comprehensive Evaluation Benchmark for Medical LVLM](https://mlsanity.com/paper/2402.09181/) (2024)
- [M3D: Advancing 3D Medical Image Analysis with Multi-Modal Large Language Models](https://mlsanity.com/paper/2404.00578/) (2024)
- [CheXclusion: Fairness gaps in deep chest X-ray classifiers](https://mlsanity.com/paper/2003.00827/) (2020)
- [GREEN: Generative Radiology Report Evaluation and Error Notation](https://mlsanity.com/paper/2405.03595/) (2024)
- [Contrastive Attention for Automatic Chest X-ray Report Generation](https://mlsanity.com/paper/2106.06965/) (2021)
- [FairCLIP: Harnessing Fairness in Vision-Language Learning](https://mlsanity.com/paper/2403.19949/) (2024)
- [ECG-QA: A Comprehensive Question Answering Dataset Combined With Electrocardiogram](https://mlsanity.com/paper/2306.15681/) (2023)
- [Deep Learning Predicts Hip Fracture using Confounding Patient and Healthcare Variables](https://mlsanity.com/paper/1811.03695/) (2018)
- [DeepOpht: Medical Report Generation for Retinal Images via Deep Models and Visual Explanation](https://mlsanity.com/paper/2011.00569/) (2020)
- [Social Debiasing for Fair Multi-modal LLMs](https://mlsanity.com/paper/2408.06569/) (2024)

## Built on by (most cited first, 11 of 11)

- [A Survey of State of the Art Large Vision Language Models: Alignment, Benchmark, Evaluations and Challenges](https://mlsanity.com/paper/2501.02189/) (2025)
- [ST-Think: How Multimodal Large Language Models Reason About 4D Worlds from Ego-Centric Videos](https://mlsanity.com/paper/2503.12542/) (2025)
- [UGC-VideoCaptioner: An Omni UGC Video Detail Caption Model and New Benchmarks](https://mlsanity.com/paper/2507.11336/) (2025)
- [FairMedQA: Benchmarking Bias in Large Language Models for Medical Question Answering](https://mlsanity.com/paper/2505.19562/) (2025)
- [M3CoTBench: Benchmark Chain-of-Thought of MLLMs in Medical Image Understanding](https://mlsanity.com/paper/2601.08758/) (2026)
- [BiasICL: In-Context Learning and Demographic Biases of Vision Language Models](https://mlsanity.com/paper/2503.02334/) (2025)
- [Interpreting Social Bias in LVLMs via Information Flow Analysis and Multi-Round Dialogue Evaluation](https://mlsanity.com/paper/2505.21106/) (2025)
- [VSF-Med:A Vulnerability Scoring Framework for Medical Vision-Language Models](https://mlsanity.com/paper/2507.00052/) (2025)
- [Fairness in Multi-modal Medical Diagnosis with Demonstration Selection](https://mlsanity.com/paper/2511.15986/) (2025)
- [DUCX: Decomposing Unfairness in Tool-Using Chest X-ray Agents](https://mlsanity.com/paper/2603.00777/) (2026)
- [MultiFair: Multimodal Balanced Fairness-Aware Medical Classification with Dual-Level Gradient Modulation](https://mlsanity.com/paper/2510.07328/) (2025)

## Abstract (arXiv)

Advancements in Multimodal Large Language Models (MLLMs) have significantly improved medical task performance, such as Visual Question Answering (VQA) and Report Generation (RG). However, the fairness of these models across diverse demographic groups remains underexplored, despite its importance in healthcare. This oversight is partly due to the lack of demographic diversity in existing medical multimodal datasets, which complicates the evaluation of fairness. In response, we propose FMBench, the first benchmark designed to evaluate the fairness of MLLMs performance across diverse demographic attributes. FMBench has the following key features: 1: It includes four demographic attributes: race, ethnicity, language, and gender, across two tasks, VQA and RG, under zero-shot settings. 2: Our VQA task is free-form, enhancing real-world applicability and mitigating the biases associated with predefined choices. 3: We utilize both lexical metrics and LLM-based metrics, aligned with clinical evaluations, to assess models not only for linguistic accuracy but also from a clinical perspective. Furthermore, we introduce a new metric, Fairness-Aware Performance (FAP), to evaluate how fairly MLLMs perform across various demographic attributes. We thoroughly evaluate the performance and fairness of eight state-of-the-art open-source MLLMs, including both general and medical MLLMs, ranging from 7B to 26B parameters on the proposed benchmark. We aim for FMBench to assist the research community in refining model evaluation and driving future advancements in the field. All data and code will be released upon acceptance.