# MedRealMM: A Real-World Multimodal Benchmark for Chinese Online Medical Consultation

arXiv: https://arxiv.org/abs/2607.09142 · HTML: https://mlsanity.com/paper/2607.09142/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 38 of its 55 references that are in the map.
- First posted on arXiv 10 Jul 2026.

## Builds on (most cited first, 30 of 38)

- [Judging LLM-as-a-Judge with MT-Bench and Chatbot Arena](https://mlsanity.com/paper/2306.05685/) (2023)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [DeepSeek-V4: Towards Highly Efficient Million-Token Context Intelligence](https://mlsanity.com/paper/2606.19348/) (2026)
- [GLM-5: from Vibe Coding to Agentic Engineering](https://mlsanity.com/paper/2602.15763/) (2026)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [HealthBench: Evaluating Large Language Models Towards Improved Human Health](https://mlsanity.com/paper/2505.08775/) (2025)
- [Towards Expert-Level Medical Question Answering with Large Language Models](https://mlsanity.com/paper/2305.09617/) (2023)
- [PMC-VQA: Visual Instruction Tuning for Medical Visual Question Answering](https://mlsanity.com/paper/2305.10415/) (2023)
- [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)
- [OmniMedVQA: A New Large-Scale Comprehensive Evaluation Benchmark for Medical LVLM](https://mlsanity.com/paper/2402.09181/) (2024)
- [MediQ: Question-Asking LLMs and a Benchmark for Reliable Interactive Clinical Reasoning](https://mlsanity.com/paper/2406.00922/) (2024)
- [DeID-GPT: Zero-shot Medical Text De-Identification by GPT-4](https://mlsanity.com/paper/2303.11032/) (2023)
- [Towards Accurate Differential Diagnosis with Large Language Models](https://mlsanity.com/paper/2312.00164/) (2023)
- [CMB: A Comprehensive Medical Benchmark in Chinese](https://mlsanity.com/paper/2308.08833/) (2023)
- [CBLUE: A Chinese Biomedical Language Understanding Evaluation Benchmark](https://mlsanity.com/paper/2106.08087/) (2021)
- [GMAI-MMBench: A Comprehensive Multimodal Evaluation Benchmark Towards General Medical AI](https://mlsanity.com/paper/2408.03361/) (2024)
- [Benchmarking Large Language Models on CMExam -- A Comprehensive Chinese Medical Exam Dataset](https://mlsanity.com/paper/2306.03030/) (2023)
- [Baichuan-M2: Scaling Medical Capability with Large Verifier System](https://mlsanity.com/paper/2509.02208/) (2025)
- [MedDG: An Entity-Centric Medical Consultation Dataset for Entity-Aware Medical Dialogue Generation](https://mlsanity.com/paper/2010.07497/) (2020)
- [PromptCBLUE: A Chinese Prompt Tuning Benchmark for the Medical Domain](https://mlsanity.com/paper/2310.14151/) (2023)
- [HealthBench Professional: Evaluating Large Language Models on Real Clinician Chats](https://mlsanity.com/paper/2604.27470/) (2026)
- [MediTOD: An English Dialogue Dataset for Medical History Taking with Comprehensive Annotations](https://mlsanity.com/paper/2410.14204/) (2024)
- [MedBench: A Comprehensive, Standardized, and Reliable Benchmarking System for Evaluating Chinese Medical Large Language Models](https://mlsanity.com/paper/2407.10990/) (2024)
- [Pathological Visual Question Answering](https://mlsanity.com/paper/2010.12435/) (2020)
- [3MDBench: Medical Multimodal Multi-agent Dialogue Benchmark](https://mlsanity.com/paper/2504.13861/) (2025)
- [An Automatic Evaluation Framework for Multi-turn Medical Consultations Capabilities of Large Language Models](https://mlsanity.com/paper/2309.02077/) (2023)

## Abstract (arXiv)

Large language models (LLMs) are increasingly deployed in online medical consultation, yet existing benchmarks remain poorly aligned with real clinical practice. Many rely on synthetic conversations or patient simulators, omit patient-uploaded medical images, or evaluate open-ended clinical responses using multiple-choice or lexical-overlap metrics that poorly reflect clinical quality. We introduce MedRealMM, a large-scale benchmark for multimodal online medical consultation built from de-identified patient-doctor interactions collected from a nationwide Chinese internet hospital. MedRealMM uses a Multimodal Clinical Challenge Point (MCCP) extraction framework to identify clinically demanding moments in authentic consultation trajectories and converts each into a standardized next-response generation task while preserving the preceding text-image context. Each instance is paired with a case-specific rubric refined by physicians that rewards clinically desirable behaviors and penalizes unsafe, unsupported, or contradictory responses. The current release contains 5,620 real-world multimodal cases spanning 64 clinical departments. We evaluate 19 general-purpose and medical-specialized LLMs, including text-only and multimodal systems. Our results show that image information is critical for reliable clinical performance and that current frontier models remain below the online physician response. Although some frontier models satisfy as many or more positive clinical criteria than physicians, they trigger more negative criteria, indicating that safety-sensitive error avoidance remains a central bottleneck. MedRealMM offers a realistic and reproducible benchmark for evaluating multimodal medical reasoning in real-world online consultation. The dataset will be publicly available on Hugging Face at https://huggingface.co/datasets/jdh-algo/MedRealMM.