# MedEvo: Medical Reasoning Evolution through Knowledge Navigation

arXiv: https://arxiv.org/abs/2610.17690 · HTML: https://mlsanity.com/paper/2610.17690/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 64 of its 70 references that are in the map.
- First posted on arXiv 13 Oct 2026.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)

## Builds on (most cited first, 30 of 64)

- [Reflexion: Language Agents with Verbal Reinforcement Learning](https://mlsanity.com/paper/2303.11366/) (2023)
- [Let's Verify Step by Step](https://mlsanity.com/paper/2305.20050/) (2023)
- [Self-Refine: Iterative Refinement with Self-Feedback](https://mlsanity.com/paper/2303.17651/) (2023)
- [MMMU: A Massive Multi-discipline Multimodal Understanding and Reasoning Benchmark for Expert AGI](https://mlsanity.com/paper/2311.16502/) (2023)
- [InternVL3: Exploring Advanced Training and Test-Time Recipes for Open-Source Multimodal Models](https://mlsanity.com/paper/2504.10479/) (2025)
- [Expanding Performance Boundaries of Open-Source Multimodal Models with Model, Data, and Test-Time Scaling](https://mlsanity.com/paper/2412.05271/) (2024)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [PathVQA: 30000+ Questions for Medical Visual Question Answering](https://mlsanity.com/paper/2003.10286/) (2020)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [MedGemma Technical Report](https://mlsanity.com/paper/2507.05201/) (2025)
- [Training Language Models to Self-Correct via Reinforcement Learning](https://mlsanity.com/paper/2409.12917/) (2024)
- [Med-Flamingo: a Multimodal Medical Few-shot Learner](https://mlsanity.com/paper/2307.15189/) (2023)
- [Beyond Human Data: Scaling Self-Training for Problem-Solving with Language Models](https://mlsanity.com/paper/2312.06585/) (2023)
- [PMC-VQA: Visual Instruction Tuning for Medical Visual Question Answering](https://mlsanity.com/paper/2305.10415/) (2023)
- [Rethinking On-Policy Distillation of Large Language Models: Phenomenology, Mechanism, and Recipe](https://mlsanity.com/paper/2604.13016/) (2026)
- [HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs](https://mlsanity.com/paper/2412.18925/) (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)
- [HuatuoGPT-Vision, Towards Injecting Medical Visual Knowledge into Multimodal LLMs at Scale](https://mlsanity.com/paper/2406.19280/) (2024)
- [OmniMedVQA: A New Large-Scale Comprehensive Evaluation Benchmark for Medical LVLM](https://mlsanity.com/paper/2402.09181/) (2024)
- [HealthGPT: A Medical Large Vision-Language Model for Unifying Comprehension and Generation via Heterogeneous Knowledge Adaptation](https://mlsanity.com/paper/2502.09838/) (2025)
- [Learning From Mistakes Makes LLM Better Reasoner](https://mlsanity.com/paper/2310.20689/) (2023)
- [Knowledge Graphs Meet Multi-Modal Learning: A Comprehensive Survey](https://mlsanity.com/paper/2402.05391/) (2024)
- [MMedAgent-RL: Optimizing Multi-Agent Collaboration for Multimodal Medical Reasoning](https://mlsanity.com/paper/2506.00555/) (2025)
- [Purified OPSD: On-Policy Self-Distillation Without Losing How to Think](https://mlsanity.com/paper/2607.02234/) (2026)
- [MMFineReason: Closing the Multimodal Reasoning Gap via Open Data-Centric Methods](https://mlsanity.com/paper/2601.21821/) (2026)
- [Rethinking On-Policy Distillation of Large Language Models II: One Training Example](https://mlsanity.com/paper/2609.04172/) (2026)
- [Disentangling Reasoning and Knowledge in Medical Large Language Models](https://mlsanity.com/paper/2505.11462/) (2025)
- [RSIBench-Data: Benchmarking Data-Centric Research for Recursive Self-Improvement](https://mlsanity.com/paper/2607.25886/) (2026)
- [Dream-RSI: Recursive Self-Improvement through Evolving Worlds](https://mlsanity.com/paper/2609.14858/) (2026)

## Abstract (arXiv)

Medical multimodal reasoning models are typically trained on teacher-generated rationales, discarding the valid reasoning in students' own failed trajectories, while general-domain correction methods offer little guidance for errors in image reading, anatomical context, or differential diagnosis. We propose MedEvo, which uses medical knowledge, namely a tag taxonomy and error-type diagnosis, to navigate both trajectory repair and data selection. For each failed rollout, a gold-blind auditor locates the first consequential error and provides a minimal, answer-free hint; the same student retains the valid prefix and regenerates the erroneous suffix. After each round, MedEvo identifies capability gaps across medical tags on a held-out feedback set and prioritizes related questions for new rollouts and repairs. With supervised fine-tuning (SFT) alone, MedEvo raises Qwen3.5-9B mean accuracy across seven benchmarks from 65.57% to 69.12% (47.40% to 54.50% on the multimodal track of MedXpertQA (MedXpertQA-MM)), surpassing teacher-distillation SFT (66.93%). It also raises Qwen3.5-35B and Qwen3.5-397B mean accuracy from 67.91% to 73.04% and from 71.83% to 74.95%, respectively. Our analyses show that failed trajectories contain reasoning worth preserving, that repair success does not imply learning value, and that independent feedback is key to sustained improvement.