# Forging a Dynamic Memory: Retrieval-Guided Continual Learning for Generalist Medical Foundation Models

arXiv: https://arxiv.org/abs/2512.13072 · HTML: https://mlsanity.com/paper/2512.13072/

## 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 61 of its 91 references that are in the map.
- First posted on arXiv 15 Dec 2025.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)
- Retrieval-augmented generation / [Medical and biomedical RAG](https://mlsanity.com/rag/medical-and-biomedical-rag/)

## Builds on (most cited first, 30 of 61)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Overcoming catastrophic forgetting in neural networks](https://mlsanity.com/paper/1612.00796/) (2016)
- [Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervision](https://mlsanity.com/paper/2102.05918/) (2021)
- [Learning without Forgetting](https://mlsanity.com/paper/1606.09282/) (2016)
- [iCaRL: Incremental Classifier and Representation Learning](https://mlsanity.com/paper/1611.07725/) (2016)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [The Many Faces of Robustness: A Critical Analysis of Out-of-Distribution Generalization](https://mlsanity.com/paper/2006.16241/) (2020)
- [Visual Prompt Tuning](https://mlsanity.com/paper/2203.12119/) (2022)
- [Do ImageNet Classifiers Generalize to ImageNet?](https://mlsanity.com/paper/1902.10811/) (2019)
- [Conditional Prompt Learning for Vision-Language Models](https://mlsanity.com/paper/2203.05557/) (2022)
- [CoCa: Contrastive Captioners are Image-Text Foundation Models](https://mlsanity.com/paper/2205.01917/) (2022)
- [Qwen3 Embedding: Advancing Text Embedding and Reranking Through Foundation Models](https://mlsanity.com/paper/2506.05176/) (2025)
- [How transferable are features in deep neural networks?](https://mlsanity.com/paper/1411.1792/) (2014)
- [Memory Aware Synapses: Learning what (not) to forget](https://mlsanity.com/paper/1711.09601/) (2017)
- [M3-Embedding: Multi-Linguality, Multi-Functionality, Multi-Granularity Text Embeddings Through Self-Knowledge Distillation](https://mlsanity.com/paper/2402.03216/) (2024)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [Dark Experience for General Continual Learning: a Strong, Simple Baseline](https://mlsanity.com/paper/2004.07211/) (2020)
- [Robust fine-tuning of zero-shot models](https://mlsanity.com/paper/2109.01903/) (2021)
- [Riemannian Walk for Incremental Learning: Understanding Forgetting and Intransigence](https://mlsanity.com/paper/1801.10112/) (2018)
- [Large Scale Incremental Learning](https://mlsanity.com/paper/1905.13260/) (2019)
- [DualPrompt: Complementary Prompting for Rehearsal-free Continual Learning](https://mlsanity.com/paper/2204.04799/) (2022)
- [End-to-End Incremental Learning](https://mlsanity.com/paper/1807.09536/) (2018)
- [DAB-DETR: Dynamic Anchor Boxes are Better Queries for DETR](https://mlsanity.com/paper/2201.12329/) (2022)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [DyTox: Transformers for Continual Learning with DYnamic TOken eXpansion](https://mlsanity.com/paper/2111.11326/) (2021)

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

- [Fysiverse-3D-Vision Technical Report: Generating Executable 3D Worlds from Images through Unified Spatial Reasoning](https://mlsanity.com/paper/2609.25741/) (2026)

## Abstract (arXiv)

Multimodal biomedical Vision-Language Models (VLMs) exhibit immense potential in the field of Continual Learning (CL). However, they confront a core dilemma: how to preserve fine-grained intra-modality features while bridging the significant domain gap across different modalities. To address this challenge, we propose a comprehensive framework. Leveraging our 18-million multimodal and comprehensive medical retrieval database derived from PubMed scientific papers, we pioneer the integration of Retrieval-Augmented Generation (RAG) into CL. Specifically, we employ a multi-modal, multi-layer RAG system that provides real-time guidance for model fine-tuning through dynamic, on-demand knowledge retrieval. Building upon this, we introduce a dynamic knowledge distillation framework. This framework precisely resolves the aforementioned core dilemma by dynamically modulating the importance of the parameter space, the granularity of the distilled knowledge, and the data distribution of the reference dataset in accordance with the required level of detail. To thoroughly validate the clinical value of our strategy, we have designed a more rigorous Medical Generalist Task Incremental Learning (MGTIL) benchmark. This benchmark is engineered to simultaneously evaluate the model's capacity for adaptation to significant domain shifts, retention of subtle intra-domain features, and real-time learning of novel and complex medical tasks. Extensive experimental results demonstrate that our proposed method achieves state-of-the-art (SOTA) performance across all metrics. The code is provided in the supplementary materials.