MedS3: Towards Medical Slow Thinking with Self-Evolved Soft Dual-sided Process Supervision
On the map: LLM reasoning → Clinical and biomedical applications
Abstract (arXiv)
Medical language models face critical barriers to real-world clinical reasoning applications. However, mainstream efforts, which fall short in task coverage, lack fine-grained supervision for intermediate reasoning steps, and rely on proprietary systems, are still far from a versatile, credible and efficient language model for clinical reasoning usage. To this end, we propose MedS3, a self-evolving framework that imparts robust reasoning capabilities to small, deployable models. Starting with 8,000 curated instances sampled via a curriculum strategy across five medical domains and 16 datasets, we use a small base policy model to conduct Monte Carlo Tree Search (MCTS) for constructing rule-verifiable reasoning trajectories. Self-explored reasoning trajectories ranked by node values are used to bootstrap the policy model via reinforcement fine-tuning and preference learning. Moreover, we introduce a soft dual process reward model that incorporates value dynamics: steps that degrade node value are penalized, enabling fine-grained identification of reasoning errors even when the final answer is correct. Experiments on eleven benchmarks show that MedS3 outperforms the previous state-of-the-art medical model by +6.45 accuracy points and surpasses 32B-scale general-purpose reasoning models by +8.57 points. Additional empirical analysis further demonstrates that MedS3 achieves robust and faithful reasoning behavior.
Key facts. Cited by 24 papers in the map (data through 14 Oct 2026). Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning. Builds on 33 of its 60 references that are in the map. First posted on arXiv 21 Jan 2025.
Builds on
33 of 60 references.
Closest ancestors · 2
Same direction, newest first
- 2025O1 Replication Journey -- Part 3: Inference-time Scaling for Medical Reasoning11 Jan
- 2024HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs25 Dec
Other references · 31
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- 2022Large Language Models Encode Clinical Knowledgecited by 1,830
- 2020What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Examscited by 1,356
- 2019ZeRO: Memory Optimizations Toward Training Trillion Parameter Modelscited by 1,301
- 2019PubMedQA: A Dataset for Biomedical Research Question Answeringcited by 1,288
- 2023Math-Shepherd: Verify and Reinforce LLMs Step-by-step without Human Annotationscited by 928
- 2023Capabilities of GPT-4 on Medical Challenge Problemscited by 638
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- 2025The Lessons of Developing Process Reward Models in Mathematical Reasoningcited by 415
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- 2020Explainable Automated Fact-Checking for Public Health Claimscited by 211
- 2019HEAD-QA: A Healthcare Dataset for Complex Reasoningcited by 101
- 2024Med42-v2: A Suite of Clinical LLMscited by 90
- 2024MedCalc-Bench: Evaluating Large Language Models for Medical Calculationscited by 70
- 2024UltraMedical: Building Specialized Generalists in Biomedicinecited by 67
- 2020Effective Transfer Learning for Identifying Similar Questions: Matching User Questions to COVID-19 FAQscited by 48
- 2020Evidence Inference 2.0: More Data, Better Modelscited by 40
- 2024Towards Evaluating and Building Versatile Large Language Models for Medicinecited by 40
- 2024Automatic Interactive Evaluation for Large Language Models with State Aware Patient Simulatorcited by 39
- 2024A Preliminary Study of o1 in Medicine: Are We Closer to an AI Doctor?cited by 33
- 2024From Medprompt to o1: Exploration of Run-Time Strategies for Medical Challenge Problems and Beyondcited by 24
- 2024Intelligent Clinical Documentation: Harnessing Generative AI for Patient-Centric Clinical Note Generationcited by 20
- 2020Multilingual Stance Detection: The Catalonia Independence Corpuscited by 16
- 2024Enhancing Clinical Efficiency through LLM: Discharge Note Generation for Cardiac Patientscited by 14
- 2024Towards Next-Generation Medical Agent: How o1 is Reshaping Decision-Making in Medical Scenarioscited by 10
- 2024MedCare: Advancing Medical LLMs through Decoupling Clinical Alignment and Knowledge Aggregationcited by 4
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Citing papers per year: 2025: 10; 2026: 14.
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- 2025Towards Reasoning Era: A Survey of Long Chain-of-Thought for Reasoning Large Language Modelscited by 384
- 2025GenPRM: Scaling Test-Time Compute of Process Reward Models via Generative Reasoningcited by 97
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- 2025MedVLThinker: Simple Baselines for Multimodal Medical Reasoningcited by 27
- 2025Med-PRM: Medical Reasoning Models with Stepwise, Guideline-verified Process Rewardscited by 24
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12 more
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- 2025Enhancing Reasoning Skills in Small Persian Medical Language Models Can Outperform Large-Scale Data Trainingcited by 2
- 2026MedPRMBench: A Fine-grained Benchmark for Process Reward Models in Medical Reasoningcited by 2
- 2026Eliciting Medical Reasoning with Knowledge-enhanced Data Synthesis: A Semi-Supervised Reinforcement Learning Approachcited by 1
- 2026Aligning Clinical Needs and AI Capabilities: A Survey on LLMs for Medical Reasoningcited by 1
- 2026FaithMed: Training LLMs For Faithful Evidence-Based Medical Reasoningcited by 0
- 2026Reinforcement Learning for Evidence-Seeking Diagnostic Reasoning with Large Language Modelscited by 0
- 2026Gaokerena: A Small Persian Medical Language Model Familycited by 0
- 2026When LLM Meets Tree Search: A Systematic View of Inference as Search in Large Language Modelscited by 0
- 2026MedAgent-R1: Faithfulness-Aware Reinforcement Learning for Evidence-Grounded Medical Reasoningcited by 0
- 2026MedAgent-R1: Faithfulness-Aware Reinforcement Learning for Evidence-Grounded Medical Reasoning31 Aug 2026
- 2026When LLM Meets Tree Search: A Systematic View of Inference as Search in Large Language Models31 Aug 2026
- 2026Gaokerena: A Small Persian Medical Language Model Family2 Aug 2026
- 2026Aligning Clinical Needs and AI Capabilities: A Survey on LLMs for Medical Reasoning8 Jul 2026
- 2026Reinforcement Learning for Evidence-Seeking Diagnostic Reasoning with Large Language Models3 Jul 2026
- 2026FaithMed: Training LLMs For Faithful Evidence-Based Medical Reasoning1 Jul 2026
- 2026MedPRMBench: A Fine-grained Benchmark for Process Reward Models in Medical Reasoning19 Apr 2026
- 2026Eliciting Medical Reasoning with Knowledge-enhanced Data Synthesis: A Semi-Supervised Reinforcement Learning Approach13 Apr 2026
- 2026Automatic Configuration of LLM Post-Training Pipelines19 Mar 2026
- 2026Medical Reasoning with Large Language Models: A Survey and MR-Bench17 Mar 2026
- 2026Guideline-Grounded Evidence Accumulation for High-Stakes Agent Verification3 Mar 2026
- 2026Reward Modeling for Reinforcement Learning-Based LLM Reasoning: Design, Challenges, and Evaluation10 Feb 2026
12 more
- 2026From Conflict to Consensus: Boosting Medical Reasoning via Multi-Round Agentic RAG6 Feb 2026
- 2026Scaling Medical Reasoning Verification via Tool-Integrated Reinforcement Learning28 Jan 2026
- 2025MedCEG: Reinforcing Verifiable Medical Reasoning with Critical Evidence Graph15 Dec 2025
- 2025Enhancing Reasoning Skills in Small Persian Medical Language Models Can Outperform Large-Scale Data Training22 Oct 2025
- 2025A Survey of Process Reward Models: From Outcome Signals to Process Supervisions for Large Language Models9 Oct 2025
- 2025MedVLThinker: Simple Baselines for Multimodal Medical Reasoning4 Aug 2025
- 2025Med-R3: Enhancing Medical Retrieval-Augmented Reasoning of LLMs via Progressive Reinforcement Learning31 Jul 2025
- 2025Rethinking Test-Time Scaling for Medical AI: Model and Task-Aware Strategies for LLMs and VLMs16 Jun 2025
- 2025Med-PRM: Medical Reasoning Models with Stepwise, Guideline-verified Process Rewards13 Jun 2025
- 2025DiagnosisArena: Benchmarking Diagnostic Reasoning for Large Language Models20 May 2025
- 2025GenPRM: Scaling Test-Time Compute of Process Reward Models via Generative Reasoning1 Apr 2025
- 2025Towards Reasoning Era: A Survey of Long Chain-of-Thought for Reasoning Large Language Models12 Mar 2025
- 2025Towards Reasoning Era: A Survey of Long Chain-of-Thought for Reasoning Large Language Modelscited by 384
- 2025GenPRM: Scaling Test-Time Compute of Process Reward Models via Generative Reasoningcited by 97
- 2025A Survey of Process Reward Models: From Outcome Signals to Process Supervisions for Large Language Modelscited by 38
- 2025MedVLThinker: Simple Baselines for Multimodal Medical Reasoningcited by 27
- 2025Med-PRM: Medical Reasoning Models with Stepwise, Guideline-verified Process Rewardscited by 24
- 2025DiagnosisArena: Benchmarking Diagnostic Reasoning for Large Language Modelscited by 21
- 2026Reward Modeling for Reinforcement Learning-Based LLM Reasoning: Design, Challenges, and Evaluationcited by 7
- 2026From Conflict to Consensus: Boosting Medical Reasoning via Multi-Round Agentic RAGcited by 7
- 2025MedCEG: Reinforcing Verifiable Medical Reasoning with Critical Evidence Graphcited by 4
- 2026Medical Reasoning with Large Language Models: A Survey and MR-Benchcited by 4
- 2025Rethinking Test-Time Scaling for Medical AI: Model and Task-Aware Strategies for LLMs and VLMscited by 3
- 2026Scaling Medical Reasoning Verification via Tool-Integrated Reinforcement Learningcited by 3
12 most cited of 20 All 20 (JSON)
- 2026When LLM Meets Tree Search: A Systematic View of Inference as Search in Large Language Models31 Aug 2026
- 2026Aligning Clinical Needs and AI Capabilities: A Survey on LLMs for Medical Reasoning8 Jul 2026
- 2026Reinforcement Learning for Evidence-Seeking Diagnostic Reasoning with Large Language Models3 Jul 2026
- 2026FaithMed: Training LLMs For Faithful Evidence-Based Medical Reasoning1 Jul 2026
- 2026MedPRMBench: A Fine-grained Benchmark for Process Reward Models in Medical Reasoning19 Apr 2026
- 2026Eliciting Medical Reasoning with Knowledge-enhanced Data Synthesis: A Semi-Supervised Reinforcement Learning Approach13 Apr 2026
- 2026Medical Reasoning with Large Language Models: A Survey and MR-Bench17 Mar 2026
- 2026Reward Modeling for Reinforcement Learning-Based LLM Reasoning: Design, Challenges, and Evaluation10 Feb 2026
- 2026From Conflict to Consensus: Boosting Medical Reasoning via Multi-Round Agentic RAG6 Feb 2026
- 2026Scaling Medical Reasoning Verification via Tool-Integrated Reinforcement Learning28 Jan 2026
- 2025MedCEG: Reinforcing Verifiable Medical Reasoning with Critical Evidence Graph15 Dec 2025
- 2025Enhancing Reasoning Skills in Small Persian Medical Language Models Can Outperform Large-Scale Data Training22 Oct 2025
12 newest of 20 All 20 (JSON)
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