mlsanityData to 7 Oct 2026

Scaling Medical Reasoning Verification via Tool-Integrated Reinforcement Learning

arXiv 2601.20221 ↗First posted 28 Jan 2026cs.AI cs.CLcited by 2

On the map: LLM reasoning → Clinical and biomedical applications

Abstract (arXiv)

Large language models have achieved strong performance on medical reasoning benchmarks, yet their deployment in clinical settings demands rigorous verification to ensure factual accuracy. While reward models offer a scalable approach for reasoning trace verification, existing methods face two limitations: they produce only scalar reward values without explicit justification, and they rely on single-pass retrieval that precludes adaptive knowledge access as verification unfolds. We introduce method, an agentic framework that addresses these limitations by training medical reasoning verifiers to iteratively query external medical corpora during evaluation. Our approach combines tool-augmented verification with an iterative reinforcement learning paradigm that requires only trace-level supervision, alongside an adaptive curriculum mechanism that dynamically adjusts training data distribution. Across four medical reasoning benchmarks, method achieves substantial gains over existing methods, improving MedQA accuracy by 23.5% and MedXpertQA by 32.0% relative to the base generator in particular. Crucially, method demonstrates an 8× reduction in sampling budget requirement compared to prior reward model baselines. These findings establish that grounding verification in dynamically retrieved evidence offers a principled path toward more reliable medical reasoning systems.

Key facts. Cited by 2 papers in the map (data through 7 Oct 2026). Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning. Builds on 30 of its 37 references that are in the map. First posted on arXiv 28 Jan 2026.

Builds on

30 of 37 references.

Closest ancestors · 5

Same direction, newest first

  1. 2025Med-PRM: Medical Reasoning Models with Stepwise, Guideline-verified Process Rewards13 Jun
  2. 2025Beyond Distillation: Pushing the Limits of Medical LLM Reasoning with Minimalist Rule-Based RL23 May
  3. 2025MedS3: Towards Medical Slow Thinking with Self-Evolved Soft Dual-sided Process Supervision21 Jan
  4. 2024HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs25 Dec
  5. 2024MedAdapter: Efficient Test-Time Adaptation of Large Language Models towards Medical Reasoning5 May

Other references · 25

  1. 2024The Llama 3 Herd of Modelscited by 14,192
  2. 2020Measuring Massive Multitask Language Understandingcited by 7,768
  3. 2024GPT-4o System Cardcited by 4,467
  4. 2024Scaling LLM Test-Time Compute Optimally can be More Effective than Scaling Model Parameterscited by 1,928
  5. 2025Search-R1: Training LLMs to Reason and Leverage Search Engines with Reinforcement Learningcited by 1,371
  6. 2020What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Examscited by 1,324
  7. 2025Understanding R1-Zero-Like Training: A Critical Perspectivecited by 1,276
  8. 2022MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answeringcited by 525
  9. 2023MEDITRON-70B: Scaling Medical Pretraining for Large Language Modelscited by 272
  10. 2025Inference-Time Scaling for Generalist Reward Modelingcited by 233
  11. 2025MedXpertQA: Benchmarking Expert-Level Medical Reasoning and Understandingcited by 212
  12. 2025VerlTool: Towards Holistic Agentic Reinforcement Learning with Tool Usecited by 92
13 more
  1. 2025The Art of Scaling Reinforcement Learning Compute for LLMscited by 91
  2. 2023PMC-LLaMA: Towards Building Open-source Language Models for Medicinecited by 87
  3. 2025MedRAG: Enhancing Retrieval-augmented Generation with Knowledge Graph-Elicited Reasoning for Healthcare Copilotcited by 83
  4. 2024UltraMedical: Building Specialized Generalists in Biomedicinecited by 67
  5. 2025StepWiser: Stepwise Generative Judges for Wiser Reasoningcited by 28
  6. 2023Tool-Augmented Reward Modelingcited by 20
  7. 2025Incentivizing Agentic Reasoning in LLM Judges via Tool-Integrated Reinforcement Learningcited by 16
  8. 2026Agent-as-a-Judgecited by 15
  9. 2025Towards Safe AI Clinicians: A Comprehensive Study on Large Language Model Jailbreaking in Healthcarecited by 10
  10. 2025TIM-PRM: Verifying multimodal reasoning with Tool-Integrated PRMcited by 8
  11. 2025Bias Evaluation and Mitigation in Retrieval-Augmented Medical Question-Answering Systemscited by 6
  12. 2025Parallelism Meets Adaptiveness: Scalable Documents Understanding in Multi-Agent LLM Systemscited by 4
  13. 2025Digital Voices of Survival: From Social Media Disclosures to Support Provisions for Domestic Violence Victimscited by 3

Built on by

Cited by year (2026 to 7 Oct)

Citing papers per year: 2026: 2.

2 papers.

Similar, not cited

Close in wording, no citation either way

  1. 2026Reinforcement Learning for Evidence-Seeking Diagnostic Reasoning with Large Language Models
  2. 2026MAPLE: Elevating Medical Reasoning from Statistical Consensus to Process-Led Alignment
  3. 2026Eliciting Medical Reasoning with Knowledge-enhanced Data Synthesis: A Semi-Supervised Reinforcement Learning Approach
  4. 2025MedCEG: Reinforcing Verifiable Medical Reasoning with Critical Evidence Graph
  5. 2025Fleming-R1: Toward Expert-Level Medical Reasoning via Reinforcement Learning
  6. 2025Improving Medical Reasoning with Curriculum-Aware Reinforcement Learning
  7. 2025Adaptive Reinforcement for Open-ended Medical Reasoning via Semantic-Guided Reward Collapse Mitigation
  8. 2026MedAgent-R1: Faithfulness-Aware Reinforcement Learning for Evidence-Grounded Medical Reasoning