# Enhancing the Medical Context-Awareness Ability of LLMs via Multifaceted Self-Refinement Learning

arXiv: https://arxiv.org/abs/2511.10067 · HTML: https://mlsanity.com/paper/2511.10067/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 34 of its 60 references that are in the map.
- First posted on arXiv 13 Nov 2025.

## Builds on (most cited first, 30 of 34)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [Distilling the Knowledge in a Neural Network](https://mlsanity.com/paper/1503.02531/) (2015)
- [Qwen3 Technical Report](https://mlsanity.com/paper/2505.09388/) (2025)
- [DeepSeek-R1: Incentivizing Reasoning Capability in LLMs via Reinforcement Learning](https://mlsanity.com/paper/2501.12948/) (2025)
- [DistilBERT, a distilled version of BERT: smaller, faster, cheaper and lighter](https://mlsanity.com/paper/1910.01108/) (2019)
- [Gemini 2.5: Pushing the Frontier with Advanced Reasoning, Multimodality, Long Context, and Next Generation Agentic Capabilities](https://mlsanity.com/paper/2507.06261/) (2025)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [TinyBERT: Distilling BERT for Natural Language Understanding](https://mlsanity.com/paper/1909.10351/) (2019)
- [Phi-4 Technical Report](https://mlsanity.com/paper/2412.08905/) (2024)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [HealthBench: Evaluating Large Language Models Towards Improved Human Health](https://mlsanity.com/paper/2505.08775/) (2025)
- [Towards Expert-Level Medical Question Answering with Large Language Models](https://mlsanity.com/paper/2305.09617/) (2023)
- [Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine](https://mlsanity.com/paper/2311.16452/) (2023)
- [MEDITRON-70B: Scaling Medical Pretraining for Large Language Models](https://mlsanity.com/paper/2311.16079/) (2023)
- [HuatuoGPT, towards Taming Language Model to Be a Doctor](https://mlsanity.com/paper/2305.15075/) (2023)
- [BiomedGPT: A Generalist Vision-Language Foundation Model for Diverse Biomedical Tasks](https://mlsanity.com/paper/2305.17100/) (2023)
- [CMB: A Comprehensive Medical Benchmark in Chinese](https://mlsanity.com/paper/2308.08833/) (2023)
- [HEAD-QA: A Healthcare Dataset for Complex Reasoning](https://mlsanity.com/paper/1906.04701/) (2019)
- [HuatuoGPT-II, One-stage Training for Medical Adaption of LLMs](https://mlsanity.com/paper/2311.09774/) (2023)
- [Towards Building Multilingual Language Model for Medicine](https://mlsanity.com/paper/2402.13963/) (2024)
- [Med42-v2: A Suite of Clinical LLMs](https://mlsanity.com/paper/2408.06142/) (2024)
- [Clinical Camel: An Open Expert-Level Medical Language Model with Dialogue-Based Knowledge Encoding](https://mlsanity.com/paper/2305.12031/) (2023)
- [Pangu Embedded: An Efficient Dual-system LLM Reasoner with Metacognition](https://mlsanity.com/paper/2505.22375/) (2025)
- [Baichuan-M2: Scaling Medical Capability with Large Verifier System](https://mlsanity.com/paper/2509.02208/) (2025)
- [Med42 -- Evaluating Fine-Tuning Strategies for Medical LLMs: Full-Parameter vs. Parameter-Efficient Approaches](https://mlsanity.com/paper/2404.14779/) (2024)
- [MedBench: A Large-Scale Chinese Benchmark for Evaluating Medical Large Language Models](https://mlsanity.com/paper/2312.12806/) (2023)

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

- [ClinAlign: Scaling Healthcare Alignment from Clinician Preference](https://mlsanity.com/paper/2602.09653/) (2026)
- [DeCode: Decoupling Content and Delivery for Medical QA](https://mlsanity.com/paper/2601.02123/) (2026)
- [LLM-Guided Evolution for Medical Decision Pipelines](https://mlsanity.com/paper/2606.07342/) (2026)
- [The Rise of Verbal Reinforcement Learning](https://mlsanity.com/paper/2609.01597/) (2026)

## Abstract (arXiv)

Large language models (LLMs) have shown great promise in the medical domain, achieving strong performance on several benchmarks. However, they continue to underperform in real-world medical scenarios, which often demand stronger context-awareness, i.e., the ability to recognize missing or critical details (e.g., user identity, medical history, risk factors) and provide safe, helpful, and contextually appropriate responses. To address this issue, we propose Multifaceted Self-Refinement (MuSeR), a data-driven approach that enhances LLMs' context-awareness along three key facets (decision-making, communication, and safety) through self-evaluation and refinement. Specifically, we first design a attribute-conditioned query generator that simulates diverse real-world user contexts by varying attributes such as role, geographic region, intent, and degree of information ambiguity. An LLM then responds to these queries, self-evaluates its answers along three key facets, and refines its responses to better align with the requirements of each facet. Finally, the queries and refined responses are used for supervised fine-tuning to reinforce the model's context-awareness ability. Evaluation results on the latest HealthBench dataset demonstrate that our method significantly improves LLM performance across multiple aspects, with particularly notable gains in the context-awareness axis. Furthermore, by incorporating knowledge distillation with the proposed method, the performance of a smaller backbone LLM (e.g., Qwen3-32B) surpasses its teacher model, achieving a new SOTA across all open-source LLMs on HealthBench (63.8%) and its hard subset (43.1%). Code and dataset will be released at https://muser-llm.github.io.