# Real-World Doctor Agent with Proactive Consultation through Multi-Agent Reinforcement Learning

arXiv: https://arxiv.org/abs/2505.19630 · HTML: https://mlsanity.com/paper/2505.19630/

## Key facts

- Cited by 27 papers in the map (data through 14 Oct 2026).
- Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use.
- Builds on 28 of its 47 references that are in the map.
- First posted on arXiv 26 May 2025.

## Placed in

- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 28 of 28)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Proximal Policy Optimization Algorithms](https://mlsanity.com/paper/1707.06347/) (2017)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [DeepSeekMath: Pushing the Limits of Mathematical Reasoning in Open Language Models](https://mlsanity.com/paper/2402.03300/) (2024)
- [GPT-4o System Card](https://mlsanity.com/paper/2410.21276/) (2024)
- [Mistral 7B](https://mlsanity.com/paper/2310.06825/) (2023)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [ChatGLM: A Family of Large Language Models from GLM-130B to GLM-4 All Tools](https://mlsanity.com/paper/2406.12793/) (2024)
- [DialoGPT: Large-Scale Generative Pre-training for Conversational Response Generation](https://mlsanity.com/paper/1911.00536/) (2019)
- [Qwen2.5-Omni Technical Report](https://mlsanity.com/paper/2503.20215/) (2025)
- [LLMs Get Lost In Multi-Turn Conversation](https://mlsanity.com/paper/2505.06120/) (2025)
- [HealthBench: Evaluating Large Language Models Towards Improved Human Health](https://mlsanity.com/paper/2505.08775/) (2025)
- [BioMistral: A Collection of Open-Source Pretrained Large Language Models for Medical Domains](https://mlsanity.com/paper/2402.10373/) (2024)
- [MedAlpaca -- An Open-Source Collection of Medical Conversational AI Models and Training Data](https://mlsanity.com/paper/2304.08247/) (2023)
- [HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs](https://mlsanity.com/paper/2412.18925/) (2024)
- [Agent Hospital: A Simulacrum of Hospital with Evolvable Medical Agents](https://mlsanity.com/paper/2405.02957/) (2024)
- [MedVLM-R1: Incentivizing Medical Reasoning Capability of Vision-Language Models (VLMs) via Reinforcement Learning](https://mlsanity.com/paper/2502.19634/) (2025)
- [HuaTuo: Tuning LLaMA Model with Chinese Medical Knowledge](https://mlsanity.com/paper/2304.06975/) (2023)
- [Med-R1: Reinforcement Learning for Generalizable Medical Reasoning in Vision-Language Models](https://mlsanity.com/paper/2503.13939/) (2025)
- [CBLUE: A Chinese Biomedical Language Understanding Evaluation Benchmark](https://mlsanity.com/paper/2106.08087/) (2021)
- [AI Hospital: Benchmarking Large Language Models in a Multi-agent Medical Interaction Simulator](https://mlsanity.com/paper/2402.09742/) (2024)
- [UltraMedical: Building Specialized Generalists in Biomedicine](https://mlsanity.com/paper/2406.03949/) (2024)
- [BianQue: Balancing the Questioning and Suggestion Ability of Health LLMs with Multi-turn Health Conversations Polished by ChatGPT](https://mlsanity.com/paper/2310.15896/) (2023)
- [MedDG: An Entity-Centric Medical Consultation Dataset for Entity-Aware Medical Dialogue Generation](https://mlsanity.com/paper/2010.07497/) (2020)
- [A Benchmark for Automatic Medical Consultation System: Frameworks, Tasks and Datasets](https://mlsanity.com/paper/2204.08997/) (2022)
- [Towards Evaluating and Building Versatile Large Language Models for Medicine](https://mlsanity.com/paper/2408.12547/) (2024)
- [Improving Interactive Diagnostic Ability of a Large Language Model Agent Through Clinical Experience Learning](https://mlsanity.com/paper/2503.16463/) (2025)

## Built on by (most cited first, 27 of 27)

- [A Survey of Self-Evolving Agents: What, When, How, and Where to Evolve on the Path to Artificial Super Intelligence](https://mlsanity.com/paper/2507.21046/) (2025)
- [The Invisible Leash: Why RLVR May or May Not Escape Its Origin](https://mlsanity.com/paper/2507.14843/) (2025)
- [A Survey of Agentic Reasoning for Large Language Models: Towards Recursively Self-Improving and Collective Agents](https://mlsanity.com/paper/2601.12538/) (2026)
- [MMedAgent-RL: Optimizing Multi-Agent Collaboration for Multimodal Medical Reasoning](https://mlsanity.com/paper/2506.00555/) (2025)
- [Doctor-R1: Mastering Clinical Inquiry with Experiential Agentic Reinforcement Learning](https://mlsanity.com/paper/2510.04284/) (2025)
- [InfiMed-ORBIT: Aligning LLMs on Open-Ended Complex Tasks via Rubric-Based Incremental Training](https://mlsanity.com/paper/2510.15859/) (2025)
- [End-to-End Agentic RAG System Training for Traceable Diagnostic Reasoning](https://mlsanity.com/paper/2508.15746/) (2025)
- [The Dialogue That Heals: A Comprehensive Evaluation of Doctor Agents' Inquiry Capability](https://mlsanity.com/paper/2509.24958/) (2025)
- [Evolving Interactive Diagnostic Agents in a Virtual Clinical Environment](https://mlsanity.com/paper/2510.24654/) (2025)
- [ATPO: Adaptive Tree Policy Optimization for Multi-Turn Medical Dialogue](https://mlsanity.com/paper/2603.02216/) (2026)
- [CXRAgent: Director-Orchestrated Multi-Stage Reasoning for Chest X-Ray Interpretation](https://mlsanity.com/paper/2510.21324/) (2025)
- [MedKGI: Iterative Differential Diagnosis with Medical Knowledge Graphs and Information-Guided Inquiring](https://mlsanity.com/paper/2512.24181/) (2025)
- [Pentest-R1: Towards Autonomous Penetration Testing Reasoning Optimized via Two-Stage Reinforcement Learning](https://mlsanity.com/paper/2508.07382/) (2025)
- [SycoEval-EM: Sycophancy Evaluation of Large Language Models in Simulated Clinical Encounters for Emergency Care](https://mlsanity.com/paper/2601.16529/) (2026)
- [Implicit Turn-Wise Policy Optimization for Proactive User-LLM Interaction](https://mlsanity.com/paper/2603.23550/) (2026)
- [E-MRL: Cross-view Aligned Evidence-driven Multimodal Reinforcement Learning for Reliable 3D Tumor Analysis](https://mlsanity.com/paper/2606.23888/) (2026)
- [Organ-Agents: Virtual Human Physiology Simulator via LLMs](https://mlsanity.com/paper/2508.14357/) (2025)
- [Note2Chat: Improving LLMs for Multi-Turn Clinical History Taking Using Medical Notes](https://mlsanity.com/paper/2601.21551/) (2026)
- [Agentic AI in Healthcare & Medicine: A Seven-Dimensional Taxonomy for Empirical Evaluation of LLM-based Agents](https://mlsanity.com/paper/2602.04813/) (2026)
- [MedAidDialog: A Multilingual Multi-Turn Medical Dialogue Dataset for Accessible Healthcare](https://mlsanity.com/paper/2603.24132/) (2026)
- [TeamLLM: A Human-Like Team-Oriented Collaboration Framework for Multi-Step Contextualized Tasks](https://mlsanity.com/paper/2604.06765/) (2026)
- [MoBayes: A Modular Bayesian Framework for Separating Reasoning from Language in Conversational Clinical Decision Support](https://mlsanity.com/paper/2604.20022/) (2026)
- [Aligning Clinical Needs and AI Capabilities: A Survey on LLMs for Medical Reasoning](https://mlsanity.com/paper/2607.07761/) (2026)
- [Aligning Medical Conversational AI through Online Reinforcement Learning with Information-Theoretic Rewards](https://mlsanity.com/paper/2601.17828/) (2026)
- [Process-Supervised Multi-Agent Reinforcement Learning for Reliable Clinical Reasoning](https://mlsanity.com/paper/2602.14160/) (2026)
- [TheraAgent: Self-Improving Therapeutic Agent for Precise and Comprehensive Treatment Planning](https://mlsanity.com/paper/2605.05963/) (2026)
- [Can the Environment Speak for Itself? T2-GRPO: A Turn-Trajectory Group Relative Policy Optimization for Caregiver Agents](https://mlsanity.com/paper/2606.08875/) (2026)

## Abstract (arXiv)

Large language models (LLMs) struggle in real-world clinical consultations. Single-turn consultation systems require patients to describe all symptoms at once, which often leads to unclear complaints and vague diagnoses. Traditional dialogue models, constrained by static supervised learning, are limited to superficially imitating existing dialogue patterns and lack the ability to actively construct understanding in dynamic interactions, thus failing to achieve genuine clinical reasoning.To address these challenges, we propose DoctorAgent-RL, a reinforcement learning (RL)-based multi-agent collaborative framework, and train a doctor agent on Qwen2.5-7B-Instruct using this framework. Within this framework, a medical consultation is modeled as a dynamic decision-making process under uncertainty. The core intelligence of the doctor agent is shifted from knowing the answer to learning and mastering a questioning methodology aimed at achieving an optimal diagnosis. Through strategic questioning, it guides the progressive emergence of key patient information in multi-turn dialogues. To support this high-fidelity simulation of the real diagnostic process, we constructed MTMedDialog, a novel English multi-turn medical consultation dataset designed for dynamic, interactive training.To validate its real-world effectiveness, rigorous evaluations including blinded human assessments and trials with real patients were conducted. DoctorAgent-RL outperformed frontier models and achieved a 70% exact diagnostic match rate, confirming its potential as a collaborative tool. By handling initial screenings, it can free clinicians to focus on complex cases, thereby addressing critical issues like physician shortages and misdiagnosis risks while alleviating the strain on healthcare resources.