# Deep Reprogramming Distillation for Medical Foundation Models

arXiv: https://arxiv.org/abs/2605.04447 · HTML: https://mlsanity.com/paper/2605.04447/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 62 of its 85 references that are in the map.
- First posted on arXiv 6 May 2026.

## Builds on (most cited first, 30 of 62)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Distilling the Knowledge in a Neural Network](https://mlsanity.com/paper/1503.02531/) (2015)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [MobileNetV2: Inverted Residuals and Linear Bottlenecks](https://mlsanity.com/paper/1801.04381/) (2018)
- [Training data-efficient image transformers & distillation through attention](https://mlsanity.com/paper/2012.12877/) (2020)
- [Parameter-Efficient Transfer Learning for NLP](https://mlsanity.com/paper/1902.00751/) (2019)
- [Prefix-Tuning: Optimizing Continuous Prompts for Generation](https://mlsanity.com/paper/2101.00190/) (2021)
- [The Power of Scale for Parameter-Efficient Prompt Tuning](https://mlsanity.com/paper/2104.08691/) (2021)
- [Similarity of Neural Network Representations Revisited](https://mlsanity.com/paper/1905.00414/) (2019)
- [Visual Prompt Tuning](https://mlsanity.com/paper/2203.12119/) (2022)
- [FitNets: Hints for Thin Deep Nets](https://mlsanity.com/paper/1412.6550/) (2014)
- [BitFit: Simple Parameter-efficient Fine-tuning for Transformer-based Masked Language-models](https://mlsanity.com/paper/2106.10199/) (2021)
- [ShuffleNet V2: Practical Guidelines for Efficient CNN Architecture Design](https://mlsanity.com/paper/1807.11164/) (2018)
- [Paying More Attention to Attention: Improving the Performance of Convolutional Neural Networks via Attention Transfer](https://mlsanity.com/paper/1612.03928/) (2016)
- [Relational Knowledge Distillation](https://mlsanity.com/paper/1904.05068/) (2019)
- [Towards a Unified View of Parameter-Efficient Transfer Learning](https://mlsanity.com/paper/2110.04366/) (2021)
- [DoRA: Weight-Decomposed Low-Rank Adaptation](https://mlsanity.com/paper/2402.09353/) (2024)
- [Contrastive Representation Distillation](https://mlsanity.com/paper/1910.10699/) (2019)
- [AdaptFormer: Adapting Vision Transformers for Scalable Visual Recognition](https://mlsanity.com/paper/2205.13535/) (2022)
- [The Medical Segmentation Decathlon](https://mlsanity.com/paper/2106.05735/) (2021)
- [Similarity-Preserving Knowledge Distillation](https://mlsanity.com/paper/1907.09682/) (2019)
- [Medical SAM Adapter: Adapting Segment Anything Model for Medical Image Segmentation](https://mlsanity.com/paper/2304.12620/) (2023)
- [Compacter: Efficient Low-Rank Hypercomplex Adapter Layers](https://mlsanity.com/paper/2106.04647/) (2021)
- [Faster Segment Anything: Towards Lightweight SAM for Mobile Applications](https://mlsanity.com/paper/2306.14289/) (2023)
- [UNet 3+: A Full-Scale Connected UNet for Medical Image Segmentation](https://mlsanity.com/paper/2004.08790/) (2020)
- [Variational Information Distillation for Knowledge Transfer](https://mlsanity.com/paper/1904.05835/) (2019)
- [Parameter-efficient Multi-task Fine-tuning for Transformers via Shared Hypernetworks](https://mlsanity.com/paper/2106.04489/) (2021)
- [Do Wide and Deep Networks Learn the Same Things? Uncovering How Neural Network Representations Vary with Width and Depth](https://mlsanity.com/paper/2010.15327/) (2020)
- [PMC-CLIP: Contrastive Language-Image Pre-training using Biomedical Documents](https://mlsanity.com/paper/2303.07240/) (2023)

## Abstract (arXiv)

Medical foundation models pre-trained on large-scale datasets have shown powerful versatile performance. However, when adapting medical foundation models for specific medical scenarios, it remains the inevitable challenge due to the gap induced by the discrepancy between pre-training and downstream tasks, the real-world computation, and speed constraints. Relevant techniques that probably handle this challenge more or less suffer from some intrinsic limitations. For example, knowledge distillation (KD) assumes that teacher and student models share the same task, training strategy, and model structure family, while prevalent parameter-efficient fine-tuning (PEFT) fails to achieve personalized and lightweight deployment. Even the combination of PEFT and KD still struggles to resolve model structures and training strategies inconsistencies between teacher and student models, leading to inefficient knowledge transfer. In this study, we propose a novel framework called Deep Reprogramming Distillation (DRD) to combat the general adaptation challenge. Specifically, DRD introduces the novel reprogramming module that on the one side overcomes the domain and task discrepancy between pretraining and downstream scenarios, and on the other side builds the student-friendly efficient distillation from foundation models to lightweight downstream models. Furthermore, to mitigate variability under different training conditions, we design a centered kernel alignment (CKA) distillation method to promote robust knowledge transfer. Empirical results show that DRD surpasses previous PEFT and KD methods across 18 medical downstream tasks under different foundation models, covering various scenarios including 2D/3D classification and 2D/3D segmentation.