# TCMQA: A 38K-Question Traditional Chinese Medicine Benchmark with a Licensed-Practitioner Reference

arXiv: https://arxiv.org/abs/2609.33014 · HTML: https://mlsanity.com/paper/2609.33014/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 6 of its 16 references that are in the map.
- First posted on arXiv 26 Sep 2026.

## Builds on (most cited first, 6 of 6)

- [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)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [TCMBench: A Comprehensive Benchmark for Evaluating Large Language Models in Traditional Chinese Medicine](https://mlsanity.com/paper/2406.01126/) (2024)
- [MedArena: Comparing LLMs for Medicine-in-the-Wild Clinician Preferences](https://mlsanity.com/paper/2603.15677/) (2026)
- [Dr. GPT Will See You Now, but Should It? Exploring the Benefits and Harms of Large Language Models in Medical Diagnosis using Crowdsourced Clinical Cases](https://mlsanity.com/paper/2506.13805/) (2025)

## Abstract (arXiv)

Medical benchmarks for language models are built almost entirely on Western biomedicine. Traditional Chinese Medicine (TCM) is a separate system, with its own diagnostic framework and its own literature, and it remains largely unmeasured. The few TCM evaluations that exist are small, narrow, and rarely paired with a human reference. We present TCMQA, an open benchmark of 38,279 questions from Chinese TCM licensing examinations, paired with 15,151 responses from 101 licensed practitioners. We evaluate 29 instruction-tuned models from 9 families, spanning 0.27B to 14.8B parameters. Accuracy ranges over 59 points, and no model approaches saturation. Pretraining data predicts TCM ability far better than scale: a 12B Western-pretrained model reaches 39.6%, while a Chinese-pretrained model an eighth its size reaches 60.8%. Nine models exceed the practitioner majority vote of 64.9%, the best by 21.8 points, and all nine come from that same Chinese-pretrained family. Yet difficulty does not transfer between models and practitioners: accuracy is flat across practitioner-rated difficulty, item-level agreement is near zero for all 29 models, and on 8.4% of items the practitioners are correct where the leading model is wrong. We release the corpus, the practitioner responses, the harness, and per-item model outputs at https://huggingface.co/datasets/TechTCM/TCMQA.