# Adapting Foundation Vision-Language Models to Medical Diagnosis via Query-Driven Expert Bridging

arXiv: https://arxiv.org/abs/2505.21698 · HTML: https://mlsanity.com/paper/2505.21698/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 45 of its 59 references that are in the map.
- First posted on arXiv 27 May 2025.

## Placed in

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

## Builds on (most cited first, 30 of 45)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [BLIP-2: Bootstrapping Language-Image Pre-training with Frozen Image Encoders and Large Language Models](https://mlsanity.com/paper/2301.12597/) (2023)
- [Layer Normalization](https://mlsanity.com/paper/1607.06450/) (2016)
- [Qwen2.5 Technical Report](https://mlsanity.com/paper/2412.15115/) (2024)
- [LAION-5B: An open large-scale dataset for training next generation image-text models](https://mlsanity.com/paper/2210.08402/) (2022)
- [Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervision](https://mlsanity.com/paper/2102.05918/) (2021)
- [Sigmoid Loss for Language Image Pre-Training](https://mlsanity.com/paper/2303.15343/) (2023)
- [Learning to Prompt for Vision-Language Models](https://mlsanity.com/paper/2109.01134/) (2021)
- [Conditional Prompt Learning for Vision-Language Models](https://mlsanity.com/paper/2203.05557/) (2022)
- [Reproducible scaling laws for contrastive language-image learning](https://mlsanity.com/paper/2212.07143/) (2022)
- [CLIP-Adapter: Better Vision-Language Models with Feature Adapters](https://mlsanity.com/paper/2110.04544/) (2021)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [OpenFlamingo: An Open-Source Framework for Training Large Autoregressive Vision-Language Models](https://mlsanity.com/paper/2308.01390/) (2023)
- [Tip-Adapter: Training-free Adaption of CLIP for Few-shot Classification](https://mlsanity.com/paper/2207.09519/) (2022)
- [Prompt-aligned Gradient for Prompt Tuning](https://mlsanity.com/paper/2205.14865/) (2022)
- [Visual-Language Prompt Tuning with Knowledge-guided Context Optimization](https://mlsanity.com/paper/2303.13283/) (2023)
- [Multi-Granularity Cross-modal Alignment for Generalized Medical Visual Representation Learning](https://mlsanity.com/paper/2210.06044/) (2022)
- [MedKLIP: Medical Knowledge Enhanced Language-Image Pre-Training in Radiology](https://mlsanity.com/paper/2301.02228/) (2023)
- [Exploring scalable medical image encoders beyond text supervision](https://mlsanity.com/paper/2401.10815/) (2024)
- [Knowledge-enhanced Visual-Language Pre-training on Chest Radiology Images](https://mlsanity.com/paper/2302.14042/) (2023)
- [CheXpert Plus: Augmenting a Large Chest X-ray Dataset with Text Radiology Reports, Patient Demographics and Additional Image Formats](https://mlsanity.com/paper/2405.19538/) (2024)
- [Low-Rank Few-Shot Adaptation of Vision-Language Models](https://mlsanity.com/paper/2405.18541/) (2024)
- [Adapting Pretrained Vision-Language Foundational Models to Medical Imaging Domains](https://mlsanity.com/paper/2210.04133/) (2022)
- [Adapting Visual-Language Models for Generalizable Anomaly Detection in Medical Images](https://mlsanity.com/paper/2403.12570/) (2024)
- [Medical Image Understanding with Pretrained Vision Language Models: A Comprehensive Study](https://mlsanity.com/paper/2209.15517/) (2022)
- [Med-MoE: Mixture of Domain-Specific Experts for Lightweight Medical Vision-Language Models](https://mlsanity.com/paper/2404.10237/) (2024)

## Abstract (arXiv)

Vision-language foundation models achieve promising performance in natural image classification, yet their direct application to medical imaging is limited by severe domain shifts, resolution mismatches, and the multi-label nature of clinical diagnosis. Training dedicated medical foundation models from scratch, however, is costly and data-intensive. Here, we propose MedBridge, a lightweight adaptation framework that opens a new direction in domain-gap mitigation by jointly combining domain alignment, resolution preservation, and multi-label reasoning via complementary VLM experts for medical image diagnosis. Specifically, MedBridge transforms pretrained VLMs into multi-view query encoders that inject a compact set of learnable query tokens into intermediate layers, enabling non-destructive domain alignment while preserving fine-grained pathological cues via multi-view high-resolution sampling. These query tokens further act as routing signals for a mixture-of-experts, dynamically integrating heterogeneous foundation models for multi-label reasoning without requiring a shared representation space. We evaluated MedBridge on five chest radiograph benchmarks in three key adaptation tasks. MedBridge demonstrates superior performance in both cross-domain generalization (out-of-distribution transfer) and in-domain specialization (same-distribution tuning) settings, yielding a significant 6-15% AUC improvement over state-of-the-art adaptation methods for multi-label thoracic disease diagnosis. Furthermore, MedBridge is model-agnostic and demonstrates broad extensibility across eight diverse VLMs (e.g., CLIP, LLaVA, Qwen-VL, MedGemma), highlighting its ability to flexibly adapt arbitrary foundation models into a powerful medical diagnostic tool. Our code will be released upon acceptance.