mlsanityData to 7 Oct 2026

O1 Replication Journey -- Part 3: Inference-time Scaling for Medical Reasoning

arXiv 2501.06458 ↗First posted 11 Jan 2025cs.CLcited by 34

On the map: LLM reasoning → Clinical and biomedical applications

Abstract (arXiv)

Building upon our previous investigations of O1 replication (Part 1: Journey Learning [Qin et al., 2024] and Part 2: Distillation [Huang et al., 2024]), this work explores the potential of inference-time scaling in large language models (LLMs) for medical reasoning tasks, ranging from diagnostic decision-making to treatment planning. Through extensive experiments on medical benchmarks of varying complexity (MedQA, Medbullets, and JAMA Clinical Challenges), our investigation reveals several key insights: (1) Increasing inference time does lead to improved performance. With a modest training set of 500 samples, our model yields substantial performance improvements of 6%-11%. (2) Task complexity directly correlates with the required length of reasoning chains, confirming the necessity of extended thought processes for challenging problems. (3) The differential diagnoses generated by our model adhere to the principles of the hypothetico-deductive method, producing a list of potential conditions that may explain a patient's symptoms and systematically narrowing these possibilities by evaluating the evidence. These findings demonstrate the promising synergy between inference-time scaling and journey learning in advancing LLMs' real-world clinical reasoning capabilities.

Key facts. Cited by 34 papers in the map (data through 7 Oct 2026). Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning. Builds on 18 of its 26 references that are in the map. First posted on arXiv 11 Jan 2025.

Builds on

18 of 26 references.

References · 18

  1. 2020Language Models are Few-Shot Learnerscited by 32,199
  2. 2021LoRA: Low-Rank Adaptation of Large Language Modelscited by 14,084
  3. 2015Distilling the Knowledge in a Neural Networkcited by 10,076
  4. 2020Scaling Laws for Neural Language Modelscited by 6,411
  5. 2022PaLM: Scaling Language Modeling with Pathwayscited by 5,304
  6. 2024Scaling LLM Test-Time Compute Optimally can be More Effective than Scaling Model Parameterscited by 1,928
  7. 2022Large Language Models Encode Clinical Knowledgecited by 1,807
  8. 2024LlamaFactory: Unified Efficient Fine-Tuning of 100+ Language Modelscited by 1,442
  9. 2020What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Examscited by 1,324
  10. 2023WizardLM: Empowering large pre-trained language models to follow complex instructionscited by 1,116
  11. 2023Textbooks Are All You Needcited by 561
  12. 2024O1 Replication Journey: A Strategic Progress Report -- Part 1cited by 140
6 more
  1. 2024Benchmarking Large Language Models on Answering and Explaining Challenging Medical Questionscited by 106
  2. 2024Towards Building Multilingual Language Model for Medicinecited by 91
  3. 2024LLaMA-Berry: Pairwise Optimization for O1-like Olympiad-Level Mathematical Reasoningcited by 90
  4. 2024O1 Replication Journey -- Part 2: Surpassing O1-preview through Simple Distillation, Big Progress or Bitter Lesson?cited by 90
  5. 2024o1-Coder: an o1 Replication for Codingcited by 77
  6. 2024Enhancing LLM Reasoning with Reward-guided Tree Searchcited by 58

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Cited by year (2026 to 7 Oct)

Citing papers per year: 2025: 31; 2026: 3.

34 papers.

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  1. 2025s1: Simple test-time scalingcited by 1,311
  2. 2025Towards Reasoning Era: A Survey of Long Chain-of-Thought for Reasoning Large Language Modelscited by 381
  3. 2025From System 1 to System 2: A Survey of Reasoning Large Language Modelscited by 319
  4. 2025MedXpertQA: Benchmarking Expert-Level Medical Reasoning and Understandingcited by 212
  5. 2025A Survey of LLM-based Agents in Medicine: How far are we from Baymax?cited by 84
  6. 2025Efficient Inference for Large Reasoning Models: A Surveycited by 58
  7. 2025Training a Scientific Reasoning Model for Chemistrycited by 54
  8. 2025Embodied-Reasoner: Synergizing Visual Search, Reasoning, and Action for Embodied Interactive Taskscited by 43
  9. 2025Nemotron-CrossThink: Scaling Self-Learning beyond Math Reasoningcited by 29
  10. 2025MedS3: Towards Medical Slow Thinking with Self-Evolved Soft Dual-sided Process Supervisioncited by 23
  11. 2025On the Emergence of Thinking in LLMs I: Searching for the Right Intuitioncited by 22
  12. 2025A Comprehensive Survey on Trustworthiness in Reasoning with Large Language Modelscited by 22
22 more
  1. 2025DiagnosisArena: Benchmarking Diagnostic Reasoning for Large Language Modelscited by 19
  2. 2025Incentivizing Reasoning for Advanced Instruction-Following of Large Language Modelscited by 17
  3. 2025Citrus: Leveraging Expert Cognitive Pathways in a Medical Language Model for Advanced Medical Decision Supportcited by 16
  4. 2025Generative AI Act II: Test Time Scaling Drives Cognition Engineeringcited by 14
  5. 2025A Survey of Scaling in Large Language Model Reasoningcited by 10
  6. 2025Medical Reasoning in the Era of LLMs: A Systematic Review of Enhancement Techniques and Applicationscited by 10
  7. 2025Med-U1: Incentivizing Unified Medical Reasoning in LLMs via Large-scale Reinforcement Learningcited by 8
  8. 2025ClinicalGPT-R1: Pushing reasoning capability of generalist disease diagnosis with large language modelcited by 7
  9. 2025Open-Medical-R1: How to Choose Data for RLVR Training at Medicine Domaincited by 7
  10. 2025Elicit and Enhance: Advancing Multimodal Reasoning in Medical Scenarioscited by 6
  11. 2025Decoupling Knowledge and Reasoning in LLMs: An Exploration Using Cognitive Dual-System Theorycited by 4
  12. 2025MedCEG: Reinforcing Verifiable Medical Reasoning with Critical Evidence Graphcited by 4
  13. 2026Medical Reasoning with Large Language Models: A Survey and MR-Benchcited by 4
  14. 2025Rethinking Test-Time Scaling for Medical AI: Model and Task-Aware Strategies for LLMs and VLMscited by 3
  15. 2025Retro-Expert: Collaborative Reasoning for Interpretable Retrosynthesiscited by 3
  16. 2026Better, Faster: Harnessing Self-Improvement in Large Reasoning Modelscited by 2
  17. 2025AnesSuite: A Comprehensive Benchmark and Dataset Suite for Anesthesiology Reasoning in LLMscited by 1
  18. 2025ClinBench-HPB: A Clinical Benchmark for Evaluating LLMs in Hepato-Pancreato-Biliary Diseasescited by 1
  19. 2025Proactive Reasoning-with-Retrieval Framework for Medical Multimodal Large Language Modelscited by 1
  20. 2025Reason-Plan-ReAct: A Reasoner-Planner Supervising a ReAct Executor for Complex Enterprise Taskscited by 1
  21. 2025Benchmarking the Medical Understanding and Reasoning of Large Language Models in Arabic Healthcare Taskscited by 0
  22. 2026Reinforcement Learning for Evidence-Seeking Diagnostic Reasoning with Large Language Modelscited by 0

Similar, not cited

Close in wording, no citation either way

  1. 2025m1: Unleash the Potential of Test-Time Scaling for Medical Reasoning with Large Language Models
  2. 2026MedCoG: Maximizing LLM Inference Density in Medical Reasoning via Meta-Cognitive Regulation
  3. 2025Exploring Efficiency Frontiers of Thinking Budget in Medical Reasoning: Scaling Laws between Computational Resources and Reasoning Quality
  4. 2025Chiron-o1: Igniting Multimodal Large Language Models towards Generalizable Medical Reasoning via Mentor-Intern Collaborative Search
  5. 2024A Preliminary Study of o1 in Medicine: Are We Closer to an AI Doctor?
  6. 2024From Medprompt to o1: Exploration of Run-Time Strategies for Medical Challenge Problems and Beyond
  7. 2025The Knowledge-Reasoning Dissociation: Fundamental Limitations of LLMs in Clinical Natural Language Inference
  8. 2025Automating Expert-Level Medical Reasoning Evaluation of Large Language Models