# Optimizing Medical Question-Answering Systems: A Comparative Study of Fine-Tuned and Zero-Shot Large Language Models with RAG Framework

arXiv: https://arxiv.org/abs/2512.05863 · HTML: https://mlsanity.com/paper/2512.05863/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical and biomedical RAG, one of 15 directions in Retrieval-augmented generation.
- Builds on 16 of its 18 references that are in the map.
- First posted on arXiv 5 Dec 2025.

## Placed in

- Retrieval-augmented generation / [Medical and biomedical RAG](https://mlsanity.com/rag/medical-and-biomedical-rag/)

## Builds on (most cited first, 16 of 16)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Llama 2: Open Foundation and Fine-Tuned Chat Models](https://mlsanity.com/paper/2307.09288/) (2023)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Dense Passage Retrieval for Open-Domain Question Answering](https://mlsanity.com/paper/2004.04906/) (2020)
- [A Survey of Large Language Models](https://mlsanity.com/paper/2303.18223/) (2023)
- [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)
- [Atlas: Few-shot Learning with Retrieval Augmented Language Models](https://mlsanity.com/paper/2208.03299/) (2022)
- [Reading Wikipedia to Answer Open-Domain Questions](https://mlsanity.com/paper/1704.00051/) (2017)
- [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)
- [BioGPT: Generative Pre-trained Transformer for Biomedical Text Generation and Mining](https://mlsanity.com/paper/2210.10341/) (2022)
- [The Falcon Series of Open Language Models](https://mlsanity.com/paper/2311.16867/) (2023)
- [Towards Expert-Level Medical Question Answering with Large Language Models](https://mlsanity.com/paper/2305.09617/) (2023)
- [A Survey of Large Language Models in Medicine: Progress, Application, and Challenge](https://mlsanity.com/paper/2311.05112/) (2023)

## Abstract (arXiv)

Medical question-answering (QA) systems can benefit from advances in large language models (LLMs), but directly applying LLMs to the clinical domain poses challenges such as maintaining factual accuracy and avoiding hallucinations. In this paper, we present a retrieval-augmented generation (RAG) based medical QA system that combines domain-specific knowledge retrieval with open-source LLMs to answer medical questions. We fine-tune two state-of-the-art open LLMs (LLaMA~2 and Falcon) using Low-Rank Adaptation (LoRA) for efficient domain specialization. The system retrieves relevant medical literature to ground the LLM's answers, thereby improving factual correctness and reducing hallucinations. We evaluate the approach on benchmark datasets (PubMedQA and MedMCQA) and show that retrieval augmentation yields measurable improvements in answer accuracy compared to using LLMs alone. Our fine-tuned LLaMA~2 model achieves 71.8% accuracy on PubMedQA, substantially improving over the 55.4% zero-shot baseline, while maintaining transparency by providing source references. We also detail the system design and fine-tuning methodology, demonstrating that grounding answers in retrieved evidence reduces unsupported content by approximately 60%. These results highlight the potential of RAG-augmented open-source LLMs for reliable biomedical QA, pointing toward practical clinical informatics applications.