# One Patient, Many Contexts: Scaling Medical AI with Contextual Intelligence

arXiv: https://arxiv.org/abs/2506.10157 · HTML: https://mlsanity.com/paper/2506.10157/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 49 of its 111 references that are in the map.
- First posted on arXiv 11 Jun 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 49)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [DeepSeek-R1: Incentivizing Reasoning Capability in LLMs via Reinforcement Learning](https://mlsanity.com/paper/2501.12948/) (2025)
- [Self-RAG: Learning to Retrieve, Generate, and Critique through Self-Reflection](https://mlsanity.com/paper/2310.11511/) (2023)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Rethinking the Role of Demonstrations: What Makes In-Context Learning Work?](https://mlsanity.com/paper/2202.12837/) (2022)
- [Conditional Prompt Learning for Vision-Language Models](https://mlsanity.com/paper/2203.05557/) (2022)
- [Few-Shot Parameter-Efficient Fine-Tuning is Better and Cheaper than In-Context Learning](https://mlsanity.com/paper/2205.05638/) (2022)
- [VisionLLM: Large Language Model is also an Open-Ended Decoder for Vision-Centric Tasks](https://mlsanity.com/paper/2305.11175/) (2023)
- [Adaptive-RAG: Learning to Adapt Retrieval-Augmented Large Language Models through Question Complexity](https://mlsanity.com/paper/2403.14403/) (2024)
- [VLMo: Unified Vision-Language Pre-Training with Mixture-of-Modality-Experts](https://mlsanity.com/paper/2111.02358/) (2021)
- [Scaling up Test-Time Compute with Latent Reasoning: A Recurrent Depth Approach](https://mlsanity.com/paper/2502.05171/) (2025)
- [Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine](https://mlsanity.com/paper/2311.16452/) (2023)
- [Diffusion Self-Guidance for Controllable Image Generation](https://mlsanity.com/paper/2306.00986/) (2023)
- [Adapted Large Language Models Can Outperform Medical Experts in Clinical Text Summarization](https://mlsanity.com/paper/2309.07430/) (2023)
- [What In-Context Learning "Learns" In-Context: Disentangling Task Recognition and Task Learning](https://mlsanity.com/paper/2305.09731/) (2023)
- [Turning Up the Heat: Min-p Sampling for Creative and Coherent LLM Outputs](https://mlsanity.com/paper/2407.01082/) (2024)
- [A Survey of Efficient Reasoning for Large Reasoning Models: Language, Multimodality, and Beyond](https://mlsanity.com/paper/2503.21614/) (2025)
- [BIG-Bench Extra Hard](https://mlsanity.com/paper/2502.19187/) (2025)
- [CollabLLM: From Passive Responders to Active Collaborators](https://mlsanity.com/paper/2502.00640/) (2025)
- [MLGym: A New Framework and Benchmark for Advancing AI Research Agents](https://mlsanity.com/paper/2502.14499/) (2025)
- [4M: Massively Multimodal Masked Modeling](https://mlsanity.com/paper/2312.06647/) (2023)
- [Empowering Biomedical Discovery with AI Agents](https://mlsanity.com/paper/2404.02831/) (2024)
- [Towards Accurate Differential Diagnosis with Large Language Models](https://mlsanity.com/paper/2312.00164/) (2023)
- [SycEval: Evaluating LLM Sycophancy](https://mlsanity.com/paper/2502.08177/) (2025)
- [Zero Shot Health Trajectory Prediction Using Transformer](https://mlsanity.com/paper/2407.21124/) (2024)
- [Unleashing the potential of prompt engineering for large language models](https://mlsanity.com/paper/2310.14735/) (2023)
- [Flex-MoE: Modeling Arbitrary Modality Combination via the Flexible Mixture-of-Experts](https://mlsanity.com/paper/2410.08245/) (2024)
- [MedAgentBench: A Realistic Virtual EHR Environment to Benchmark Medical LLM Agents](https://mlsanity.com/paper/2501.14654/) (2025)
- [TxAgent: An AI Agent for Therapeutic Reasoning Across a Universe of Tools](https://mlsanity.com/paper/2503.10970/) (2025)
- [Multitask Vision-Language Prompt Tuning](https://mlsanity.com/paper/2211.11720/) (2022)

## Built on by (most cited first, 2 of 2)

- [A Survey of Context Engineering for Large Language Models](https://mlsanity.com/paper/2507.13334/) (2025)
- [Project Imaging-X: A Survey of 1000+ Open-Access Medical Imaging Datasets for Foundation Model Development](https://mlsanity.com/paper/2603.27460/) (2026)

## Abstract (arXiv)

Medical AI, including clinical language models, vision-language models, and multimodal health record models, already summarizes notes, answers questions, and supports decisions. Their adaptation to new populations, specialties, or care settings often relies on fine-tuning, prompting, or retrieval from external knowledge bases. These strategies can scale poorly and risk contextual errors: outputs that appear plausible but miss critical patient or situational information. We envision context switching as a solution. Context switching adjusts model reasoning at inference without retraining. Generative models can tailor outputs to patient biology, care setting, or disease. Multimodal models can reason on notes, laboratory results, imaging, and genomics, even when some data are missing or delayed. Agent models can coordinate tools and roles based on tasks and users. In each case, context switching enables medical AI to adapt across specialties, populations, and geographies. It requires advances in data design, model architectures, and evaluation frameworks, and establishes a foundation for medical AI that scales to infinitely many contexts while remaining reliable and suited to real-world care.