# Process-Supervised Multi-Agent Reinforcement Learning for Reliable Clinical Reasoning

arXiv: https://arxiv.org/abs/2602.14160 · HTML: https://mlsanity.com/paper/2602.14160/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 24 of its 35 references that are in the map.
- First posted on arXiv 15 Feb 2026.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 24 of 24)

- [DeepSeekMath: Pushing the Limits of Mathematical Reasoning in Open Language Models](https://mlsanity.com/paper/2402.03300/) (2024)
- [Qwen3 Technical Report](https://mlsanity.com/paper/2505.09388/) (2025)
- [ReAct: Synergizing Reasoning and Acting in Language Models](https://mlsanity.com/paper/2210.03629/) (2022)
- [Reflexion: Language Agents with Verbal Reinforcement Learning](https://mlsanity.com/paper/2303.11366/) (2023)
- [Toolformer: Language Models Can Teach Themselves to Use Tools](https://mlsanity.com/paper/2302.04761/) (2023)
- [AutoGen: Enabling Next-Gen LLM Applications via Multi-Agent Conversation](https://mlsanity.com/paper/2308.08155/) (2023)
- [Search-R1: Training LLMs to Reason and Leverage Search Engines with Reinforcement Learning](https://mlsanity.com/paper/2503.09516/) (2025)
- [DeepSeek-V3.2: Pushing the Frontier of Open Large Language Models](https://mlsanity.com/paper/2512.02556/) (2025)
- [ToolRL: Reward is All Tool Learning Needs](https://mlsanity.com/paper/2504.13958/) (2025)
- [AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments](https://mlsanity.com/paper/2405.07960/) (2024)
- [Agent Hospital: A Simulacrum of Hospital with Evolvable Medical Agents](https://mlsanity.com/paper/2405.02957/) (2024)
- [MDAgents: An Adaptive Collaboration of LLMs for Medical Decision-Making](https://mlsanity.com/paper/2404.15155/) (2024)
- [Med-R1: Reinforcement Learning for Generalizable Medical Reasoning in Vision-Language Models](https://mlsanity.com/paper/2503.13939/) (2025)
- [MMedAgent: Learning to Use Medical Tools with Multi-modal Agent](https://mlsanity.com/paper/2407.02483/) (2024)
- [AI Hospital: Benchmarking Large Language Models in a Multi-agent Medical Interaction Simulator](https://mlsanity.com/paper/2402.09742/) (2024)
- [AgentNet: Decentralized Evolutionary Coordination for LLM-based Multi-Agent Systems](https://mlsanity.com/paper/2504.00587/) (2025)
- [MedAgent-Pro: Towards Evidence-based Multi-modal Medical Diagnosis via Reasoning Agentic Workflow](https://mlsanity.com/paper/2503.18968/) (2025)
- [TxAgent: An AI Agent for Therapeutic Reasoning Across a Universe of Tools](https://mlsanity.com/paper/2503.10970/) (2025)
- [SiriuS: Self-improving Multi-agent Systems via Bootstrapped Reasoning](https://mlsanity.com/paper/2502.04780/) (2025)
- [AgentMD: Empowering Language Agents for Risk Prediction with Large-Scale Clinical Tool Learning](https://mlsanity.com/paper/2402.13225/) (2024)
- [CoMM: Collaborative Multi-Agent, Multi-Reasoning-Path Prompting for Complex Problem Solving](https://mlsanity.com/paper/2404.17729/) (2024)
- [Real-World Doctor Agent with Proactive Consultation through Multi-Agent Reinforcement Learning](https://mlsanity.com/paper/2505.19630/) (2025)
- [MEDDxAgent: A Unified Modular Agent Framework for Explainable Automatic Differential Diagnosis](https://mlsanity.com/paper/2502.19175/) (2025)
- [MedAide: Information Fusion and Anatomy of Medical Intents via LLM-based Agent Collaboration](https://mlsanity.com/paper/2410.12532/) (2024)

## Abstract (arXiv)

Clinical decision-making requires nuanced reasoning over heterogeneous evidence and traceable justifications. While recent LLM multi-agent systems (MAS) show promise, they largely optimise for outcome accuracy while overlooking process-grounded reasoning aligned with clinical standards. One critical real-world case of this is gene-disease validity curation, where experts must determine whether a gene is causally implicated in a disease by synthesising diverse biomedical evidence. We introduce an agent-as-tool reinforcement learning framework for this task with two objectives: (i) process-level supervision to ensure reasoning follows valid clinical pathways, and (ii) efficient coordination via a hierarchical multi-agent system. Our evaluation on the ClinGen dataset shows that with outcome-only rewards, MAS with a GRPO-trained Qwen3-4B supervisor agent substantially improves final outcome accuracy from 0.195 with a base model supervisor to 0.732, but results in poor process alignment (0.392 F1). Conversely, with process + outcome rewards, MAS with GRPO-trained supervisor achieves higher outcome accuracy (0.750) while significantly improving process fidelity to 0.520 F1. Our code is available at https://github.com/chaeeunlee-io/GeneDiseaseCurationAgents.