# Prompt-Aware Adaptive Elastic Weight Consolidation for Continual Learning in Medical Vision-Language Models

arXiv: https://arxiv.org/abs/2511.20732 · HTML: https://mlsanity.com/paper/2511.20732/

## Key facts

- Cited by 1 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 23 of its 28 references that are in the map.
- First posted on arXiv 25 Nov 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, 23 of 23)

- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Model-Agnostic Meta-Learning for Fast Adaptation of Deep Networks](https://mlsanity.com/paper/1703.03400/) (2017)
- [Overcoming catastrophic forgetting in neural networks](https://mlsanity.com/paper/1612.00796/) (2016)
- [Learning without Forgetting](https://mlsanity.com/paper/1606.09282/) (2016)
- [Gradient Episodic Memory for Continual Learning](https://mlsanity.com/paper/1706.08840/) (2017)
- [Visual Prompt Tuning](https://mlsanity.com/paper/2203.12119/) (2022)
- [Progressive Neural Networks](https://mlsanity.com/paper/1606.04671/) (2016)
- [Memory Aware Synapses: Learning what (not) to forget](https://mlsanity.com/paper/1711.09601/) (2017)
- [CLIP-Adapter: Better Vision-Language Models with Feature Adapters](https://mlsanity.com/paper/2110.04544/) (2021)
- [Learning to Prompt for Continual Learning](https://mlsanity.com/paper/2112.08654/) (2021)
- [Dark Experience for General Continual Learning: a Strong, Simple Baseline](https://mlsanity.com/paper/2004.07211/) (2020)
- [PackNet: Adding Multiple Tasks to a Single Network by Iterative Pruning](https://mlsanity.com/paper/1711.05769/) (2017)
- [Skin Lesion Analysis Toward Melanoma Detection 2018: A Challenge Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1902.03368/) (2019)
- [DualPrompt: Complementary Prompting for Rehearsal-free Continual Learning](https://mlsanity.com/paper/2204.04799/) (2022)
- [Kvasir-SEG: A Segmented Polyp Dataset](https://mlsanity.com/paper/1911.07069/) (2019)
- [Image Segmentation Using Text and Image Prompts](https://mlsanity.com/paper/2112.10003/) (2021)
- [CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning](https://mlsanity.com/paper/1711.05225/) (2017)
- [CODA-Prompt: COntinual Decomposed Attention-based Prompting for Rehearsal-Free Continual Learning](https://mlsanity.com/paper/2211.13218/) (2022)
- [Deep Learning for Segmentation using an Open Large-Scale Dataset in 2D Echocardiography](https://mlsanity.com/paper/1908.06948/) (2019)
- [Boosting Continual Learning of Vision-Language Models via Mixture-of-Experts Adapters](https://mlsanity.com/paper/2403.11549/) (2024)
- [Functional Regularisation for Continual Learning with Gaussian Processes](https://mlsanity.com/paper/1901.11356/) (2019)
- [Preventing Zero-Shot Transfer Degradation in Continual Learning of Vision-Language Models](https://mlsanity.com/paper/2303.06628/) (2023)
- [Lung Segmentation from Chest X-rays using Variational Data Imputation](https://mlsanity.com/paper/2005.10052/) (2020)

## Built on by (most cited first, 1 of 1)

- [CADRE: Stable, Parameter Efficient Adaptation of Medical Vision Language Models with Bounded Forgetting and Prior Drift](https://mlsanity.com/paper/2606.23487/) (2026)

## Abstract (arXiv)

Medical AI systems face catastrophic forgetting when deployed in clinical settings, where models must learn new imaging protocols while retaining prior diagnostic capabilities. This challenge is particularly acute for medical vision-language models that must preserve complex cross-modal alignments between medical images and clinical terminology across diverse imaging modalities. We introduce Prompt- Aware Adaptive Elastic Weight Consolidation (PA-EWC), a novel continual learning approach that addresses catastrophic forgetting through prompt-guided parameter specialization. Our method systematically categorizes model parameters based on their functional roles in processing visual-descriptive, spatial-guided, and medical-semantic information, enabling targeted protection of critical knowledge while allowing adaptation to new clinical requirements. PA-EWC incorporates adaptive Fisher Information computation with gradient stability analysis and develops weighted complexity metrics based on medical terminology density. We evaluate our approach across five medical imaging datasets (Kvasir-SEG, ISIC 2018, CheXlocalize, BUSI, CAMUS) representing diverse modalities including endoscopy, dermoscopy, radiography, and ultrasound. Experimental results demonstrate that PA-EWC reduces catastrophic forgetting by up to 17.58% compared to baseline methods, with performance improvements of 4.30% on chest X-ray pathology localization and 6.06% on polyp segmentation.