SynerMedGen: Synergizing Medical Multimodal Understanding with Generation via Task Alignment

While unified multimodal models (UMMs) jointly perform visual understanding and generation within a single model, functional unification does not guarantee learning synergy: the two objectives may reinforce each other, compete for capacity, or merely coexist. We investigate their relationship at the representation, task, and system levels in a controlled, structurally native setting without pretrained vision priors. At the representation level, we find that each objective provides useful signal to the other: generation enriches the visual features learned for understanding, while understanding strengthens vision--language alignment for generation. However, when both objectives are forced through the same computation path, one tends to dominate. A task-decoupled architecture that specializes conflicting visual computation while preserving semantic interaction avoids this asymmetric degradation. At the task level, through three case studies, we find positive bidirectional transfer when understanding and generation tasks rely on shared knowledge. At the system level, we show that an end-to-end UMM outperforms a matched planner--executor pipeline on complex tasks that explicitly require both image understanding and generation. Together, these results show that the value of UMMs extends beyond a unified interface: appropriate specialization, shared task knowledge, and end-to-end optimization can turn coexistence into synergy.

Unified multimodal models are envisioned to bridge the gap between understanding and generation. Yet, to achieve competitive performance, state-of-the-art models adopt largely decoupled understanding and generation components. This design, while effective for individual tasks, weakens the connection required for mutual enhancement, leaving the potential synergy empirically uncertain. We propose to explicitly restore this synergy by introducing Understanding-Oriented Post-Training (UNO), a lightweight framework that treats understanding not only as a distinct task, but also a direct supervisory signal to steer generative representations. By incorporating objectives that encode semantic abstraction (captioning) and structural details (visual regression), we enable effective gradient flow from understanding to generation. Extensive experiments on image generation and editing demonstrate that understanding can serve as an effective catalyst for generation.

Most unified large multimodal models (LMMs) that support both visual understanding and image generation still rely on curated post-training supervision, such as human annotations, preference labels, or external reward models. We ask whether a unified LMM can improve both abilities autonomously using only unlabeled images. We propose a self-evolving training framework with three internal roles: a Proposer that generates visual questions, a Solver that answers and evaluates them, and a Generator that synthesizes images. Training uses only self-derived consistency signals, without human annotations, preference labels, or task-trained external reward/judge models. To stabilize learning, we introduce Solver Token Entropy (STE), a continuous difficulty signal based on token-level prediction uncertainty that remains useful even when sample-level consistency becomes unreliable. For image generation, we design a multi-scale internal evaluation scheme that combines question-answer fidelity scoring with cycle-consistent captioning. This creates a solver-mediated coupling, where better visual understanding enables more reliable generation assessment and stronger internal training signals. The framework preserves the same role decomposition, reward logic, and training schedule across diffusion-based BLIP3o, rectified-flow BAGEL, and autoregressive VARGPT-v1.1 architectures, requiring only each backbone's native prompting and generation interface. Across eight understanding metrics, our method consistently improves over the corresponding base models. On BAGEL, it achieves a $+3.5\%$ absolute gain on MMMU and improves GenEval image generation performance from $82\%$ to $85\%$. Code and models are publicly released.