# Can Generalist Vision Language Models (VLMs) Rival Specialist Medical VLMs? Benchmarking and Strategic Insights

arXiv: https://arxiv.org/abs/2506.17337 · HTML: https://mlsanity.com/paper/2506.17337/

## Key facts

- Cited by 4 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 39 of its 73 references that are in the map.
- First posted on arXiv 19 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 39)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Microsoft COCO: Common Objects in Context](https://mlsanity.com/paper/1405.0312/) (2014)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [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)
- [Qwen2.5-VL Technical Report](https://mlsanity.com/paper/2502.13923/) (2025)
- [Qwen2-VL: Enhancing Vision-Language Model's Perception of the World at Any Resolution](https://mlsanity.com/paper/2409.12191/) (2024)
- [On the Opportunities and Risks of Foundation Models](https://mlsanity.com/paper/2108.07258/) (2021)
- [Sigmoid Loss for Language Image Pre-Training](https://mlsanity.com/paper/2303.15343/) (2023)
- [Visual Genome: Connecting Language and Vision Using Crowdsourced Dense Image Annotations](https://mlsanity.com/paper/1602.07332/) (2016)
- [InternVL3: Exploring Advanced Training and Test-Time Recipes for Open-Source Multimodal Models](https://mlsanity.com/paper/2504.10479/) (2025)
- [Gemma 3 Technical Report](https://mlsanity.com/paper/2503.19786/) (2025)
- [LAION-400M: Open Dataset of CLIP-Filtered 400 Million Image-Text Pairs](https://mlsanity.com/paper/2111.02114/) (2021)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [Conceptual 12M: Pushing Web-Scale Image-Text Pre-Training To Recognize Long-Tail Visual Concepts](https://mlsanity.com/paper/2102.08981/) (2021)
- [PaLI: A Jointly-Scaled Multilingual Language-Image Model](https://mlsanity.com/paper/2209.06794/) (2022)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [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)
- [HealthBench: Evaluating Large Language Models Towards Improved Human Health](https://mlsanity.com/paper/2505.08775/) (2025)
- [Lingshu: A Generalist Foundation Model for Unified Multimodal Medical Understanding and Reasoning](https://mlsanity.com/paper/2506.07044/) (2025)
- [MedXpertQA: Benchmarking Expert-Level Medical Reasoning and Understanding](https://mlsanity.com/paper/2501.18362/) (2025)
- [BiomedGPT: A Generalist Vision-Language Foundation Model for Diverse Biomedical Tasks](https://mlsanity.com/paper/2305.17100/) (2023)
- [Causality matters in medical imaging](https://mlsanity.com/paper/1912.08142/) (2019)
- [OmniMedVQA: A New Large-Scale Comprehensive Evaluation Benchmark for Medical LVLM](https://mlsanity.com/paper/2402.09181/) (2024)
- [MDAgents: An Adaptive Collaboration of LLMs for Medical Decision-Making](https://mlsanity.com/paper/2404.15155/) (2024)
- [FairCLIP: Harnessing Fairness in Vision-Language Learning](https://mlsanity.com/paper/2403.19949/) (2024)
- [Overtrained Language Models Are Harder to Fine-Tune](https://mlsanity.com/paper/2503.19206/) (2025)

## Built on by (most cited first, 4 of 4)

- [Verification Mirage: Mapping the Reliability Boundary of Self-Verification in Medical VQA](https://mlsanity.com/paper/2605.10850/) (2026)
- [EG-ARSA: An Expert-Grounded Open Model for Visual Road Safety Auditing in Low-Resource Settings](https://mlsanity.com/paper/2608.23563/) (2026)
- [MedProb: Probing Internal Representations of Vision-Language Models for Medical Question Answering](https://mlsanity.com/paper/2609.04336/) (2026)
- [Multimodal Medical Image Parsing with Task-Specific Low-Rank Adapters](https://mlsanity.com/paper/2610.19901/) (2026)

## Abstract (arXiv)

Vision Language Models (VLMs) have shown promise in automating image diagnosis and interpretation in clinical settings. However, developing specialist medical VLMs requires substantial computational resources and carefully curated datasets, and it remains unclear under which conditions generalist and specialist medical VLMs each perform best. This study highlights the complementary strengths of specialist medical and generalist VLMs. Specialists remain valuable in modality-aligned use cases, but we find that efficiently fine-tuned generalist VLMs can achieve comparable or even superior performance in most tasks, particularly when transferring to unseen or rare OOD medical modalities. These results suggest that generalist VLMs, rather than being constrained by their lack of specialist medical pretraining, may offer a scalable and cost-effective pathway for advancing clinical AI development.