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MedXIAOHE: A Comprehensive Recipe for Building Medical MLLMs

Baorong Shi
Bo Cui
Boyuan Jiang
Deli Yu
Fang Qian
Haihua Yang
Huichao Wang
Jiale Chen
Jianfei Pan
Jieqiong Cao
Jinghao Lin
Kai Wu
Lin Yang
Shengsheng Yao
Tao Chen
Xiaojun Xiao
Xiaozhong Ji
Xu Wang
Yijun He
Zhixiong Yang
Main:24 Pages
10 Figures
Bibliography:5 Pages
7 Tables
Appendix:11 Pages
Abstract

We present MedXIAOHE, a medical vision-language foundation model designed to advance general-purpose medical understanding and reasoning in real-world clinical applications. MedXIAOHE achieves state-of-the-art performance across diverse medical benchmarks and surpasses leading closed-source multimodal systems on multiple capabilities. To achieve this, we propose an entity-aware continual pretraining framework that organizes heterogeneous medical corpora to broaden knowledge coverage and reduce long-tail gaps (e.g., rare diseases). For medical expert-level reasoning and interaction, MedXIAOHE incorporates diverse medical reasoning patterns via reinforcement learning and tool-augmented agentic training, enabling multi-step diagnostic reasoning with verifiable decision traces. To improve reliability in real-world use, MedXIAOHE integrates user-preference rubrics, evidence-grounded reasoning, and low-hallucination long-form report generation, with improved adherence to medical instructions. We release this report to document our practical design choices, scaling insights, and evaluation framework, hoping to inspire further research.

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