# Experience Makes Skillful: Enabling Generalizable Medical Agent Reasoning via Self-Evolving Skill Memory

arXiv: https://arxiv.org/abs/2606.09365 · HTML: https://mlsanity.com/paper/2606.09365/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 41 of its 96 references that are in the map.
- First posted on arXiv 8 Jun 2026.

## Builds on (most cited first, 30 of 41)

- [DeepSeekMath: Pushing the Limits of Mathematical Reasoning in Open Language Models](https://mlsanity.com/paper/2402.03300/) (2024)
- [Gemini 1.5: Unlocking multimodal understanding across millions of tokens of context](https://mlsanity.com/paper/2403.05530/) (2024)
- [Qwen3-VL Technical Report](https://mlsanity.com/paper/2511.21631/) (2025)
- [Voyager: An Open-Ended Embodied Agent with Large Language Models](https://mlsanity.com/paper/2305.16291/) (2023)
- [DeepSeek-V3.2: Pushing the Frontier of Open Large Language Models](https://mlsanity.com/paper/2512.02556/) (2025)
- [CRITIC: Large Language Models Can Self-Correct with Tool-Interactive Critiquing](https://mlsanity.com/paper/2305.11738/) (2023)
- [GLM-5: from Vibe Coding to Agentic Engineering](https://mlsanity.com/paper/2602.15763/) (2026)
- [MedGemma Technical Report](https://mlsanity.com/paper/2507.05201/) (2025)
- [HealthBench: Evaluating Large Language Models Towards Improved Human Health](https://mlsanity.com/paper/2505.08775/) (2025)
- [Agent Workflow Memory](https://mlsanity.com/paper/2409.07429/) (2024)
- [SkillRL: Evolving Agents via Recursive Skill-Augmented Reinforcement Learning](https://mlsanity.com/paper/2602.08234/) (2026)
- [AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments](https://mlsanity.com/paper/2405.07960/) (2024)
- [Lingshu: A Generalist Foundation Model for Unified Multimodal Medical Understanding and Reasoning](https://mlsanity.com/paper/2506.07044/) (2025)
- [MedXpertQA: Benchmarking Expert-Level Medical Reasoning and Understanding](https://mlsanity.com/paper/2501.18362/) (2025)
- [Agent Hospital: A Simulacrum of Hospital with Evolvable Medical Agents](https://mlsanity.com/paper/2405.02957/) (2024)
- [DiLu: A Knowledge-Driven Approach to Autonomous Driving with Large Language Models](https://mlsanity.com/paper/2309.16292/) (2023)
- [SkillWeaver: Web Agents can Self-Improve by Discovering and Honing Skills](https://mlsanity.com/paper/2504.07079/) (2025)
- [Trace2Skill: Distill Trajectory-Local Lessons into Transferable Agent Skills](https://mlsanity.com/paper/2603.25158/) (2026)
- [A Survey of Self-Evolving Agents: What, When, How, and Where to Evolve on the Path to Artificial Super Intelligence](https://mlsanity.com/paper/2507.21046/) (2025)
- [EvolveR: Self-Evolving LLM Agents through an Experience-Driven Lifecycle](https://mlsanity.com/paper/2510.16079/) (2025)
- [Evo-Memory: Benchmarking LLM Agent Test-time Learning with Self-Evolving Memory](https://mlsanity.com/paper/2511.20857/) (2025)
- [Mobile-Agent-E: Self-Evolving Mobile Assistant for Complex Tasks](https://mlsanity.com/paper/2501.11733/) (2025)
- [MemRL: Self-Evolving Agents via Runtime Reinforcement Learning on Episodic Memory](https://mlsanity.com/paper/2601.03192/) (2026)
- [CoEvoSkills: Self-Evolving Agent Skills via Co-Evolutionary Verification](https://mlsanity.com/paper/2604.01687/) (2026)
- [Memento: Fine-tuning LLM Agents without Fine-tuning LLMs](https://mlsanity.com/paper/2508.16153/) (2025)
- [DS-Agent: Automated Data Science by Empowering Large Language Models with Case-Based Reasoning](https://mlsanity.com/paper/2402.17453/) (2024)
- [Memp: Exploring Agent Procedural Memory](https://mlsanity.com/paper/2508.06433/) (2025)
- [Hulu-Med: A Transparent Generalist Model towards Holistic Medical Vision-Language Understanding](https://mlsanity.com/paper/2510.08668/) (2025)
- [MemEvolve: Meta-Evolution of Agent Memory Systems](https://mlsanity.com/paper/2512.18746/) (2025)
- [Agent KB: Leveraging Cross-Domain Experience for Agentic Problem Solving](https://mlsanity.com/paper/2507.06229/) (2025)

## Built on by (most cited first, 4 of 4)

- [The Last AI Built by Humans: Toward Genuine Recursive Self-Improvement](https://mlsanity.com/paper/2609.11873/) (2026)
- [Volumetric Radiology AI in the Era of Multimodal Large Language Models](https://mlsanity.com/paper/2608.20549/) (2026)
- [Grounded Skill Synthesis from Code at Scale for Agentic Intelligence](https://mlsanity.com/paper/2609.05571/) (2026)
- [MammoClaw: Towards Skill-Evolving Agent Harness for Breast Cancer Mammography Analysis](https://mlsanity.com/paper/2609.31789/) (2026)

## Abstract (arXiv)

Medical agent systems are increasingly expected to support interactive clinical decision making rather than only static question answering. In such settings, effective agents must reuse prior experience across evolving cases, yet existing memory mechanisms often retain raw historical traces that are redundant, noisy, and difficult to govern. More importantly, they rarely distinguish which memories are truly useful for future reasoning. This limits their ability to accumulate compact and reliable experience for long-horizon clinical reasoning. To close this gap, we propose SkeMex, a post-deployment self-evolution framework that improves medical agents through a skill-based memory without updating model weights. SkeMex distills informative interaction trajectories into structured skills that encode reusable procedural knowledge, and organizes them into a multi-branch repository spanning general, task-specific, and action-level experience. To determine which memories should be reused and retained, SkeMex estimates context-dependent utility from environment feedback and uses it to guide value-aware retrieval and repository governance. A closed-loop ``Read--Write--Assess--Govern" lifecycle further supports continual evolution by writing new skills, updating utilities, promoting useful memories, and removing harmful entries. Experiments across diverse clinical tasks show that SkeMex consistently outperforms representative memory-based agents in both offline and online settings. It also generalizes across model backbones and supports transferable skill memory. All data and code will be released publicly.