Clinical-R1: Empowering Large Language Models for Faithful and Comprehensive Reasoning with Clinical Objective Relative Policy Optimization
On the map: LLM reasoning → Clinical and biomedical applications
Abstract (arXiv)
Recent advances in large language models (LLMs) have shown strong reasoning capabilities through large-scale pretraining and post-training reinforcement learning, demonstrated by DeepSeek-R1. However, current post-training methods, such as Grouped Relative Policy Optimization (GRPO), mainly reward correctness, which is not aligned with the multi-dimensional objectives required in high-stakes fields such as medicine, where reasoning must also be faithful and comprehensive. We introduce Clinical-Objective Relative Policy Optimization (CRPO), a scalable, multi-objective, verifiable reinforcement learning method designed to align LLM post-training with clinical reasoning principles. CRPO integrates rule-based and verifiable reward signals that jointly optimize accuracy, faithfulness, and comprehensiveness without relying on human annotation. To demonstrate its effectiveness, we train Clinical-R1-3B, a 3B-parameter model for clinical reasoning. The experiments on three benchmarks demonstrate that our CRPO substantially improves reasoning on truthfulness and completeness over standard GRPO while maintaining comfortable accuracy enhancements. This framework provides a scalable pathway to align LLM reasoning with clinical objectives, enabling safer and more collaborative AI systems for healthcare while also highlighting the potential of multi-objective, verifiable RL methods in post-training scaling of LLMs for medical domains.
Key facts. Cited by 7 papers in the map (data through 14 Oct 2026). Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning. Builds on 27 of its 37 references that are in the map. First posted on arXiv 29 Nov 2025.
Builds on
27 of 37 references.
Closest ancestors · 4
Same direction, newest first
- 2024HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs25 Dec
- 2024MedAdapter: Efficient Test-Time Adaptation of Large Language Models towards Medical Reasoning5 May
- 2024JMLR: Joint Medical LLM and Retrieval Training for Enhancing Reasoning and Professional Question Answering Capability27 Feb
- 2023MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoning16 Nov
Other references · 23
- 2023GPT-4 Technical Reportcited by 18,396
- 2024The Llama 3 Herd of Modelscited by 14,715
- 2023LLaMA: Open and Efficient Foundation Language Modelscited by 14,132
- 2023Llama 2: Open Foundation and Fine-Tuned Chat Modelscited by 13,028
- 2024DeepSeekMath: Pushing the Limits of Mathematical Reasoning in Open Language Modelscited by 9,379
- 2025DeepSeek-R1: Incentivizing Reasoning Capability in LLMs via Reinforcement Learningcited by 6,330
- 2022PaLM: Scaling Language Modeling with Pathwayscited by 5,326
- 2024Qwen2.5 Technical Reportcited by 4,942
- 2024GPT-4o System Cardcited by 4,588
- 2024HybridFlow: A Flexible and Efficient RLHF Frameworkcited by 2,057
- 2024OpenAI o1 System Cardcited by 1,244
- 2023Towards Expert-Level Medical Question Answering with Large Language Modelscited by 384
11 more
- 2025Cognitive Behaviors that Enable Self-Improving Reasoners, or, Four Habits of Highly Effective STaRscited by 377
- 2025rStar-Math: Small LLMs Can Master Math Reasoning with Self-Evolved Deep Thinkingcited by 313
- 2024BioMistral: A Collection of Open-Source Pretrained Large Language Models for Medical Domainscited by 301
- 2023MEDITRON-70B: Scaling Medical Pretraining for Large Language Modelscited by 274
- 2024Is DPO Superior to PPO for LLM Alignment? A Comprehensive Studycited by 262
- 2024Capabilities of Gemini Models in Medicinecited by 237
- 2025MedXpertQA: Benchmarking Expert-Level Medical Reasoning and Understandingcited by 224
- 2024Mutual Reasoning Makes Smaller LLMs Stronger Problem-Solverscited by 138
- 2024Reinforcement Learning for LLM Post-Training: A Surveycited by 92
- 2024Advancing Multimodal Medical Capabilities of Geminicited by 90
- 2023Clinical Camel: An Open Expert-Level Medical Language Model with Dialogue-Based Knowledge Encodingcited by 71
Built on by
Citing papers per year: 2026: 7.
7 papers.
- 2026RadAgent: A tool-using AI agent for stepwise interpretation of chest computed tomographycited by 6
- 2026MedGuideX: Internalizing Decision Logic from Executable Guidelines into Large Language Models for Clinical Reasoningcited by 4
- 2026CLR-voyance: Reinforcing Open-Ended Reasoning for Inpatient Clinical Decision Support with Outcome-Aware Rubricscited by 3
- 2026The Path to Self-Evolving Clinical Systems: Scaling Medical Agents from Assistance to Autonomycited by 2
- 2026Thinking Like a Clinician: A Cognitive AI Agent for Clinical Diagnosis via Panoramic Profiling and Adversarial Debatecited by 1
- 2026Reinforcement Learning over Patient Trajectories for Clinical Reasoning in EHR Foundation Modelscited by 0
- 2026Reinforcement Learning In Partially Verifiable Environments for Colon Cancer Treatment Planningcited by 0
- 2026Reinforcement Learning In Partially Verifiable Environments for Colon Cancer Treatment Planning12 Oct 2026
- 2026Reinforcement Learning over Patient Trajectories for Clinical Reasoning in EHR Foundation Models10 Sep 2026
- 2026The Path to Self-Evolving Clinical Systems: Scaling Medical Agents from Assistance to Autonomy13 Jul 2026
- 2026MedGuideX: Internalizing Decision Logic from Executable Guidelines into Large Language Models for Clinical Reasoning26 May 2026
- 2026CLR-voyance: Reinforcing Open-Ended Reasoning for Inpatient Clinical Decision Support with Outcome-Aware Rubrics10 May 2026
- 2026Thinking Like a Clinician: A Cognitive AI Agent for Clinical Diagnosis via Panoramic Profiling and Adversarial Debate26 Apr 2026
- 2026RadAgent: A tool-using AI agent for stepwise interpretation of chest computed tomography16 Apr 2026
Similar, not cited
Close in wording, no citation either way
- 2026MCPO: Mastery-Consolidated Policy Optimization for Large Reasoning Models
- 2025QoQ-Med: Building Multimodal Clinical Foundation Models with Domain-Aware GRPO Training
- 2025Toward Effective Reinforcement Learning Fine-Tuning for Medical VQA in Vision-Language Models
- 2025EQPO: Equitable Group Relative Policy Optimization for Clinical Reasoning
- 2025Fleming-R1: Toward Expert-Level Medical Reasoning via Reinforcement Learning
- 2025Stepwise Guided Policy Optimization: Coloring your Incorrect Reasoning in GRPO
- 2025Med-R1: Reinforcement Learning for Generalizable Medical Reasoning in Vision-Language Models
- 2025Open-Medical-R1: How to Choose Data for RLVR Training at Medicine Domain