# Investigating LLM Capabilities on Long Context Comprehension for Medical Question Answering

arXiv: https://arxiv.org/abs/2510.18691 · HTML: https://mlsanity.com/paper/2510.18691/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 97 of its 127 references that are in the map.
- First posted on arXiv 21 Oct 2025.

## Builds on (most cited first, 30 of 97)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
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- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Measuring Massive Multitask Language Understanding](https://mlsanity.com/paper/2009.03300/) (2020)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [Qwen2.5 Technical Report](https://mlsanity.com/paper/2412.15115/) (2024)
- [RoFormer: Enhanced Transformer with Rotary Position Embedding](https://mlsanity.com/paper/2104.09864/) (2021)
- [GPT-4o System Card](https://mlsanity.com/paper/2410.21276/) (2024)
- [Lost in the Middle: How Language Models Use Long Contexts](https://mlsanity.com/paper/2307.03172/) (2023)
- [Gemini 1.5: Unlocking multimodal understanding across millions of tokens of context](https://mlsanity.com/paper/2403.05530/) (2024)
- [Efficient Streaming Language Models with Attention Sinks](https://mlsanity.com/paper/2309.17453/) (2023)
- [Self-RAG: Learning to Retrieve, Generate, and Critique through Self-Reflection](https://mlsanity.com/paper/2310.11511/) (2023)
- [LongBench: A Bilingual, Multitask Benchmark for Long Context Understanding](https://mlsanity.com/paper/2308.14508/) (2023)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [RULER: What's the Real Context Size of Your Long-Context Language Models?](https://mlsanity.com/paper/2404.06654/) (2024)
- [Improving language models by retrieving from trillions of tokens](https://mlsanity.com/paper/2112.04426/) (2021)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [Qwen3 Embedding: Advancing Text Embedding and Reranking Through Foundation Models](https://mlsanity.com/paper/2506.05176/) (2025)
- [Text Embeddings by Weakly-Supervised Contrastive Pre-training](https://mlsanity.com/paper/2212.03533/) (2022)
- [Unsupervised Dense Information Retrieval with Contrastive Learning](https://mlsanity.com/paper/2112.09118/) (2021)
- [ColBERT: Efficient and Effective Passage Search via Contextualized Late Interaction over BERT](https://mlsanity.com/paper/2004.12832/) (2020)
- [M3-Embedding: Multi-Linguality, Multi-Functionality, Multi-Granularity Text Embeddings Through Self-Knowledge Distillation](https://mlsanity.com/paper/2402.03216/) (2024)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [Atlas: Few-shot Learning with Retrieval Augmented Language Models](https://mlsanity.com/paper/2208.03299/) (2022)
- [Extending Context Window of Large Language Models via Positional Interpolation](https://mlsanity.com/paper/2306.15595/) (2023)
- [MTEB: Massive Text Embedding Benchmark](https://mlsanity.com/paper/2210.07316/) (2022)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [YaRN: Efficient Context Window Extension of Large Language Models](https://mlsanity.com/paper/2309.00071/) (2023)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)

## Abstract (arXiv)

This study is the first to investigate LLM comprehension capabilities over long-context (LC), clinically relevant medical Question Answering (QA) beyond MCQA. Our comprehensive approach considers a range of settings based on content inclusion of varying size and relevance, LLM models of different capabilities and a variety of datasets across task formulations. We reveal insights on model size effects and their limitations, underlying memorization issues and the benefits of reasoning models, while demonstrating the value and challenges of leveraging the full long patient's context. Importantly, we examine the effect of Retrieval Augmented Generation (RAG) on medical LC comprehension, showcasing best settings in single versus multi-document QA datasets. We shed light into some of the evaluation aspects using a multi-faceted approach uncovering common metric challenges. Our quantitative analysis reveals challenging cases where RAG excels while still showing limitations in cases requiring temporal reasoning.