# Sparse Spectral LoRA: Routed Experts for Medical VLMs

arXiv: https://arxiv.org/abs/2604.01310 · HTML: https://mlsanity.com/paper/2604.01310/

## Key facts

- Cited by 1 papers in the map (data through 7 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 68 of its 89 references that are in the map.
- First posted on arXiv 1 Apr 2026.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)
- Mixture-of-experts / [Medical and biomedical MoE](https://mlsanity.com/moe/medical-and-biomedical-moe/)

## Builds on (most cited first, 30 of 68)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Overcoming catastrophic forgetting in neural networks](https://mlsanity.com/paper/1612.00796/) (2016)
- [Improved Baselines with Visual Instruction Tuning](https://mlsanity.com/paper/2310.03744/) (2023)
- [The Power of Scale for Parameter-Efficient Prompt Tuning](https://mlsanity.com/paper/2104.08691/) (2021)
- [Outrageously Large Neural Networks: The Sparsely-Gated Mixture-of-Experts Layer](https://mlsanity.com/paper/1701.06538/) (2017)
- [Switch Transformers: Scaling to Trillion Parameter Models with Simple and Efficient Sparsity](https://mlsanity.com/paper/2101.03961/) (2021)
- [ViLBERT: Pretraining Task-Agnostic Visiolinguistic Representations for Vision-and-Language Tasks](https://mlsanity.com/paper/1908.02265/) (2019)
- [Mixtral of Experts](https://mlsanity.com/paper/2401.04088/) (2024)
- [Evaluating Object Hallucination in Large Vision-Language Models](https://mlsanity.com/paper/2305.10355/) (2023)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [DoRA: Weight-Decomposed Low-Rank Adaptation](https://mlsanity.com/paper/2402.09353/) (2024)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [Empirical Evaluation of Rectified Activations in Convolutional Network](https://mlsanity.com/paper/1505.00853/) (2015)
- [PathVQA: 30000+ Questions for Medical Visual Question Answering](https://mlsanity.com/paper/2003.10286/) (2020)
- [GaLore: Memory-Efficient LLM Training by Gradient Low-Rank Projection](https://mlsanity.com/paper/2403.03507/) (2024)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [Mitigating Hallucination in Large Multi-Modal Models via Robust Instruction Tuning](https://mlsanity.com/paper/2306.14565/) (2023)
- [Med-Flamingo: a Multimodal Medical Few-shot Learner](https://mlsanity.com/paper/2307.15189/) (2023)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [AdaLoRA: Adaptive Budget Allocation for Parameter-Efficient Fine-Tuning](https://mlsanity.com/paper/2303.10512/) (2023)
- [CheXbert: Combining Automatic Labelers and Expert Annotations for Accurate Radiology Report Labeling Using BERT](https://mlsanity.com/paper/2004.09167/) (2020)
- [LoRA Learns Less and Forgets Less](https://mlsanity.com/paper/2405.09673/) (2024)
- [RadGraph: Extracting Clinical Entities and Relations from Radiology Reports](https://mlsanity.com/paper/2106.14463/) (2021)
- [PiSSA: Principal Singular Values and Singular Vectors Adaptation of Large Language Models](https://mlsanity.com/paper/2404.02948/) (2024)
- [Detecting and Preventing Hallucinations in Large Vision Language Models](https://mlsanity.com/paper/2308.06394/) (2023)
- [SVD-LLM: Truncation-aware Singular Value Decomposition for Large Language Model Compression](https://mlsanity.com/paper/2403.07378/) (2024)
- [PMC-CLIP: Contrastive Language-Image Pre-training using Biomedical Documents](https://mlsanity.com/paper/2303.07240/) (2023)
- [HuatuoGPT-Vision, Towards Injecting Medical Visual Knowledge into Multimodal LLMs at Scale](https://mlsanity.com/paper/2406.19280/) (2024)

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

- [Evi-Steer: Learning to Steer Biomedical Vision-Language Models through Efficient and Generalizable Evidential Tuning](https://mlsanity.com/paper/2605.26292/) (2026)

## Abstract (arXiv)

Large vision-language models (VLMs) excel on general benchmarks but often lack robustness in medical imaging, where heterogeneous supervision induces cross-dataset interference and sensitivity to data regime (i.e., how the supervisory signals are mixed). In realistic clinical workflows, data and tasks arrive sequentially, so naive continual training further leads to catastrophic forgetting. To address these challenges, we propose MedQwen, a parameter-efficient medical VLM that couples a spectrally routed Mixture-of-Experts (MoE) with a theoretically grounded scaling rule that aligns low-rank updates with a full-rank, fully fine-tuned MoE, without changing the base architecture. Concretely, we initialize each expert from non-overlapping singular value decomposition (SVD) segments of the pretrained weight and introduce a residual compensation and scaling scheme to enable stable expert specialization and consistent routing under distribution shift. Across 23 medical datasets covering visual question answering, report generation, radiology classification, and hallucination mitigation, MedQwen achieves strong, reliable performance: it approaches full fine-tuning on zero-shot classification with 339× fewer trainable parameters, and reduces sequential forgetting to ~5% where strong baselines degrade by >20-50%.