# Evaluating Large Language Models on the Spanish Medical Intern Resident (MIR) Examination 2024/2025:A Comparative Analysis of Clinical Reasoning and Knowledge Application

arXiv: https://arxiv.org/abs/2503.00025 · HTML: https://mlsanity.com/paper/2503.00025/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 4 of its 12 references that are in the map.
- First posted on arXiv 24 Feb 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)

## Builds on (most cited first, 4 of 4)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Foundation Metrics for Evaluating Effectiveness of Healthcare Conversations Powered by Generative AI](https://mlsanity.com/paper/2309.12444/) (2023)
- [Early External Safety Testing of OpenAI's o3-mini: Insights from the Pre-Deployment Evaluation](https://mlsanity.com/paper/2501.17749/) (2025)
- [Applications of Generative AI in Healthcare: algorithmic, ethical, legal and societal considerations](https://mlsanity.com/paper/2406.10632/) (2024)

## Abstract (arXiv)

This study presents a comparative evaluation of 22 large language models LLMs on the Spanish Medical Intern Resident MIR examinations for 2024 and 2025 with a focus on clinical reasoning domain specific expertise and multimodal processing capabilities The MIR exam consisting of 210 multiple choice questions some requiring image interpretation serves as a stringent benchmark for assessing both factual recall and complex clinical problem solving skills Our investigation encompasses general purpose models such as GPT4 Claude LLaMA and Gemini as well as specialized fine tuned systems like Miri Pro which leverages proprietary Spanish healthcare data to excel in medical contexts Recent market entries Deepseek and Grok have further enriched the evaluation landscape particularly for tasks that demand advanced visual and semantic analysis The findings indicate that while general purpose LLMs perform robustly overall fine tuned models consistently achieve superior accuracy especially in addressing nuanced domain specific challenges A modest performance decline observed between the two exam cycles appears attributable to the implementation of modified questions designed to mitigate reliance on memorization The results underscore the transformative potential of domain specific fine tuning and multimodal integration in advancing medical AI applications They also highlight critical implications for the future integration of LLMs into medical education training and clinical decision making emphasizing the importance of balancing automated reasoning with ethical and context aware judgment