# TCLA: Training-Free Class-wise Logit Adaptation for Medical Vision-Language Models

arXiv: https://arxiv.org/abs/2607.09562 · HTML: https://mlsanity.com/paper/2607.09562/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 25 of its 34 references that are in the map.
- First posted on arXiv 10 Jul 2026.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 25 of 25)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervision](https://mlsanity.com/paper/2102.05918/) (2021)
- [Learning to Prompt for Vision-Language Models](https://mlsanity.com/paper/2109.01134/) (2021)
- [Conditional Prompt Learning for Vision-Language Models](https://mlsanity.com/paper/2203.05557/) (2022)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [How transferable are features in deep neural networks?](https://mlsanity.com/paper/1411.1792/) (2014)
- [CLIP-Adapter: Better Vision-Language Models with Feature Adapters](https://mlsanity.com/paper/2110.04544/) (2021)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [Tip-Adapter: Training-free Adaption of CLIP for Few-shot Classification](https://mlsanity.com/paper/2207.09519/) (2022)
- [Visual-Language Prompt Tuning with Knowledge-guided Context Optimization](https://mlsanity.com/paper/2303.13283/) (2023)
- [COVID-Net: A Tailored Deep Convolutional Neural Network Design for Detection of COVID-19 Cases from Chest X-Ray Images](https://mlsanity.com/paper/2003.09871/) (2020)
- [Mitigating Neural Network Overconfidence with Logit Normalization](https://mlsanity.com/paper/2205.09310/) (2022)
- [Generalist Foundation Models from a Multimodal Dataset for 3D Computed Tomography](https://mlsanity.com/paper/2403.17834/) (2024)
- [A Review of Generalized Zero-Shot Learning Methods](https://mlsanity.com/paper/2011.08641/) (2020)
- [MedKLIP: Medical Knowledge Enhanced Language-Image Pre-Training in Radiology](https://mlsanity.com/paper/2301.02228/) (2023)
- [Not All Features Matter: Enhancing Few-shot CLIP with Adaptive Prior Refinement](https://mlsanity.com/paper/2304.01195/) (2023)
- [BIOMEDICA: An Open Biomedical Image-Caption Archive, Dataset, and Vision-Language Models Derived from Scientific Literature](https://mlsanity.com/paper/2501.07171/) (2025)
- [BiomedCoOp: Learning to Prompt for Biomedical Vision-Language Models](https://mlsanity.com/paper/2411.15232/) (2024)
- [Few-shot Adaptation of Medical Vision-Language Models](https://mlsanity.com/paper/2409.03868/) (2024)
- [Gaussian Prototypical Networks for Few-Shot Learning on Omniglot](https://mlsanity.com/paper/1708.02735/) (2017)
- [ProKeR: A Kernel Perspective on Few-Shot Adaptation of Large Vision-Language Models](https://mlsanity.com/paper/2501.11175/) (2025)
- [Logits DeConfusion with CLIP for Few-Shot Learning](https://mlsanity.com/paper/2504.12104/) (2025)
- [DeViDe: Faceted medical knowledge for improved medical vision-language pre-training](https://mlsanity.com/paper/2404.03618/) (2024)
- [Rethinking Few Shot CLIP Benchmarks: A Critical Analysis in the Inductive Setting](https://mlsanity.com/paper/2507.20834/) (2025)

## Abstract (arXiv)

Medical Vision-Language Models (VLMs) exhibit strong zero-shot performance, yet their effectiveness still declines on out-of-distribution (OOD) data due to domain shifts and class bias inherited from large-scale pretraining. Existing few-shot adaptation methods typically introduce additional trainable components, which can be unstable in extremely low-data regimes (e.g., 1-shot), and lack robustness on different medical data. We present TCLA, a purely training-free few-shot adaptation method for Medical VLMs, which is fast and model-agnostic. TCLA corrects inference logits based on a small set of support samples, boosting pretrained VLMs performance by improving inter-class deconfusion and reducing domain shift. Extensive experiments on nine datasets across multiple medical imaging modalities including X-ray, Ultrasound, MRI, CT, Histopathology, demonstrate that TCLA consistently improves OOD performance of Medical VLMs and, in most of cases, outperforms existing training-based adaptation methods.