# MMedAgent-RL: Optimizing Multi-Agent Collaboration for Multimodal Medical Reasoning

arXiv: https://arxiv.org/abs/2506.00555 · HTML: https://mlsanity.com/paper/2506.00555/

## Key facts

- Cited by 40 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 62 of its 77 references that are in the map.
- First posted on arXiv 31 May 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)
- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 30 of 62)

- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Proximal Policy Optimization Algorithms](https://mlsanity.com/paper/1707.06347/) (2017)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [DeepSeek-R1: Incentivizing Reasoning Capability in LLMs via Reinforcement Learning](https://mlsanity.com/paper/2501.12948/) (2025)
- [Efficient Memory Management for Large Language Model Serving with PagedAttention](https://mlsanity.com/paper/2309.06180/) (2023)
- [Self-Consistency Improves Chain of Thought Reasoning in Language Models](https://mlsanity.com/paper/2203.11171/) (2022)
- [Qwen2.5-VL Technical Report](https://mlsanity.com/paper/2502.13923/) (2025)
- [Improved Baselines with Visual Instruction Tuning](https://mlsanity.com/paper/2310.03744/) (2023)
- [Deep reinforcement learning from human preferences](https://mlsanity.com/paper/1706.03741/) (2017)
- [InternVL: Scaling up Vision Foundation Models and Aligning for Generic Visual-Linguistic Tasks](https://mlsanity.com/paper/2312.14238/) (2023)
- [Qwen-VL: A Versatile Vision-Language Model for Understanding, Localization, Text Reading, and Beyond](https://mlsanity.com/paper/2308.12966/) (2023)
- [Fine-Tuning Language Models from Human Preferences](https://mlsanity.com/paper/1909.08593/) (2019)
- [MMMU: A Massive Multi-discipline Multimodal Understanding and Reasoning Benchmark for Expert AGI](https://mlsanity.com/paper/2311.16502/) (2023)
- [AutoGen: Enabling Next-Gen LLM Applications via Multi-Agent Conversation](https://mlsanity.com/paper/2308.08155/) (2023)
- [Scaling LLM Test-Time Compute Optimally can be More Effective than Scaling Model Parameters](https://mlsanity.com/paper/2408.03314/) (2024)
- [MetaGPT: Meta Programming for A Multi-Agent Collaborative Framework](https://mlsanity.com/paper/2308.00352/) (2023)
- [Expanding Performance Boundaries of Open-Source Multimodal Models with Model, Data, and Test-Time Scaling](https://mlsanity.com/paper/2412.05271/) (2024)
- [CAMEL: Communicative Agents for "Mind" Exploration of Large Language Model Society](https://mlsanity.com/paper/2303.17760/) (2023)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [Kimi k1.5: Scaling Reinforcement Learning with LLMs](https://mlsanity.com/paper/2501.12599/) (2025)
- [Yi: Open Foundation Models by 01.AI](https://mlsanity.com/paper/2403.04652/) (2024)
- [VLM-R1: A Stable and Generalizable R1-style Large Vision-Language Model](https://mlsanity.com/paper/2504.07615/) (2025)
- [Visual-RFT: Visual Reinforcement Fine-Tuning](https://mlsanity.com/paper/2503.01785/) (2025)
- [The Entropy Mechanism of Reinforcement Learning for Reasoning Language Models](https://mlsanity.com/paper/2505.22617/) (2025)
- [PathVQA: 30000+ Questions for Medical Visual Question Answering](https://mlsanity.com/paper/2003.10286/) (2020)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [AFlow: Automating Agentic Workflow Generation](https://mlsanity.com/paper/2410.10762/) (2024)
- [Training Language Models to Self-Correct via Reinforcement Learning](https://mlsanity.com/paper/2409.12917/) (2024)
- [Med-Flamingo: a Multimodal Medical Few-shot Learner](https://mlsanity.com/paper/2307.15189/) (2023)
- [Curriculum Learning for Reinforcement Learning Domains: A Framework and Survey](https://mlsanity.com/paper/2003.04960/) (2020)

## Built on by (most cited first, 30 of 40)

- [The Landscape of Agentic Reinforcement Learning for LLMs: A Survey](https://mlsanity.com/paper/2509.02547/) (2025)
- [Thinking with Images for Multimodal Reasoning: Foundations, Methods, and Future Frontiers](https://mlsanity.com/paper/2506.23918/) (2025)
- [A Survey of Reinforcement Learning for Large Reasoning Models](https://mlsanity.com/paper/2509.08827/) (2025)
- [Agent0: Unleashing Self-Evolving Agents from Zero Data via Tool-Integrated Reasoning](https://mlsanity.com/paper/2511.16043/) (2025)
- [When Single-Agent with Skills Replace Multi-Agent Systems and When They Fail](https://mlsanity.com/paper/2601.04748/) (2026)
- [MedAgentGym: A Scalable Agentic Training Environment for Code-Centric Reasoning in Biomedical Data Science](https://mlsanity.com/paper/2506.04405/) (2025)
- [PathAgent: Toward Interpretable Analysis of Whole-slide Pathology Images via Large Language Model-based Agentic Reasoning](https://mlsanity.com/paper/2511.17052/) (2025)
- [PhysUniBench: A Multi-Modal Physics Reasoning Benchmark at Undergraduate Level](https://mlsanity.com/paper/2506.17667/) (2025)
- [Ophiuchus: Incentivizing Tool-augmented "Think with Images" for Joint Medical Segmentation, Understanding and Reasoning](https://mlsanity.com/paper/2512.14157/) (2025)
- [UniShield: An Adaptive Multi-Agent Framework for Unified Forgery Image Detection and Localization](https://mlsanity.com/paper/2510.03161/) (2025)
- [Alignment Tipping Process: How Self-Evolution Pushes LLM Agents Off the Rails](https://mlsanity.com/paper/2510.04860/) (2025)
- [Thinking with Deltas: Incentivizing Reinforcement Learning via Differential Visual Reasoning Policy](https://mlsanity.com/paper/2601.06801/) (2026)
- [3DMedAgent: Unified Perception-to-Understanding for 3D Medical Analysis](https://mlsanity.com/paper/2602.18064/) (2026)
- [A Survey on AgentOps: Categorization, Challenges, and Future Directions](https://mlsanity.com/paper/2508.02121/) (2025)
- [AT-CXR: Uncertainty-Aware Agentic Triage for Chest X-rays](https://mlsanity.com/paper/2508.19322/) (2025)
- [CARE: Towards Clinical Accountability in Multi-Modal Medical Reasoning with an Evidence-Grounded Agentic Framework](https://mlsanity.com/paper/2603.01607/) (2026)
- [E-MRL: Cross-view Aligned Evidence-driven Multimodal Reinforcement Learning for Reliable 3D Tumor Analysis](https://mlsanity.com/paper/2606.23888/) (2026)
- [CogDoc: Towards Unified thinking in Documents](https://mlsanity.com/paper/2512.12658/) (2025)
- [Reasoning over Precedents Alongside Statutes: Case-Augmented Deliberative Alignment for LLM Safety](https://mlsanity.com/paper/2601.08000/) (2026)
- [When Does RL Help Medical VLMs? Disentangling Vision, SFT, and RL Gains](https://mlsanity.com/paper/2603.01301/) (2026)
- [MedInsightBench: Evaluating Medical Analytics Agents Through Multi-Step Insight Discovery in Multimodal Medical Data](https://mlsanity.com/paper/2512.13297/) (2025)
- [GLANCE: A Global-Local Coordination Multi-Agent Framework for Music-Grounded Non-Linear Video Editing](https://mlsanity.com/paper/2604.05076/) (2026)
- [The Path to Self-Evolving Clinical Systems: Scaling Medical Agents from Assistance to Autonomy](https://mlsanity.com/paper/2607.11175/) (2026)
- [TeamMedAgents: Pareto-Efficient Multi-Agent Medical Reasoning Through Teamwork Theory](https://mlsanity.com/paper/2508.08115/) (2025)
- [MedFact-R1: Towards Factual Medical Reasoning via Pseudo-Label Augmentation](https://mlsanity.com/paper/2509.15154/) (2025)
- [UCAgents: Unidirectional Convergence for Visual Evidence Anchored Multi-Agent Medical Decision-Making](https://mlsanity.com/paper/2512.02485/) (2025)
- [MedVerse: Efficient and Reliable Medical Reasoning via DAG-Structured Parallel Execution](https://mlsanity.com/paper/2602.07529/) (2026)
- [TheraAgent: Multi-Agent Framework with Self-Evolving Memory and Evidence-Calibrated Reasoning for PET Theranostics](https://mlsanity.com/paper/2603.13676/) (2026)
- [Beyond English benchmarks: clinical llm evaluation in Brazilian Portuguese](https://mlsanity.com/paper/2606.07853/) (2026)
- [Aligning Clinical Needs and AI Capabilities: A Survey on LLMs for Medical Reasoning](https://mlsanity.com/paper/2607.07761/) (2026)

## Abstract (arXiv)

Medical Large Vision-Language Models (Med-LVLMs) have shown strong potential in multimodal diagnostic tasks. However, existing single-agent models struggle to generalize across diverse medical specialties, limiting their performance. Recent efforts introduce multi-agent collaboration frameworks inspired by clinical workflows, where general practitioners (GPs) and specialists interact in a fixed sequence. Despite improvements, these static pipelines lack flexibility and adaptability in reasoning. To address this, we propose MMedAgent-RL, a reinforcement learning (RL)-based multi-agent framework that enables dynamic, optimized collaboration among medical agents. Specifically, we train two GP agents based on Qwen2.5-VL via RL: the triage doctor learns to assign patients to appropriate specialties, while the attending physician integrates the judgments from multi-specialists and its own knowledge to make final decisions. To address the inconsistency in specialist outputs, we introduce a curriculum learning (CL)-guided RL strategy with dynamic entropy regulation, progressively teaching the attending physician to balance between imitating specialists and correcting their mistakes. Experiments on five medical VQA benchmarks demonstrate that MMedAgent-RL outperforms both open-source and proprietary Med-LVLMs. Notably, it achieves an average performance gain of 23.6% over strong baselines.