AMNESIA: A Large Scale Medical Unlearning Benchmark Suite with Disease-Informed Analysis

Language models trained for clinical disease inference are trained on patient data, which may include sensitive and private information, and data owners may request the removal of their data from a trained model due to privacy or copyright concerns. However, exactly unlearning patient-specific data is intractable, and retraining with minor data removal is resource-intensive. While there exists several machine unlearning methods that can be used, their utility is generally restricted to non-medical domains. Moreover, the existing benchmarks for evaluating such unlearning methods primarily utilize synthetically curated datasets, which are not truly representative of real-world systems. Hence, the effectiveness of these unlearning methods in the medical domain is largely unclear. To this end, we introduce REMEDI, an extensive benchmark for machine unlearning tailored to multi-label and multiclass clinical disease inference, where label correlations, longitudinal structure, and safety constraints make unlearning particularly challenging. Unlike the existing benchmarks, REMEDI considers: (1) a relevant application domain (medical), (2) comprehensive unlearning setups involving diverse sets of forget instances, (3) challenging unlearning scenarios including multi-label and multi-class classification tasks, and (4) evaluation metrics involving performance both in terms of utility and extent of unlearning achieved. REMEDI is developed using the MIMIC-III clinical database that contains comprehensive clinical data of patients. Experiments with existing unlearning methods indicate that there exists a trade-off between utility and unlearning performance. They are also largely unsuited to multi-label classification tasks. To facilitate reproducibility, we make our benchmark publicly available.

Federated learning enables medical-imaging models to be trained across hospitals, and privacy law, most explicitly the GDPR ``right to be forgotten'', turns removing a hospital's, a class's, or a patient's influence from such a model into a federated unlearning problem. This need is most acute in medicine, where patients withdraw consent and hospitals leave collaborations. Yet nearly all unlearning evidence comes from natural images, whose heterogeneity and task structure differ sharply from clinical data, so it is unclear whether existing methods transfer, and no shared protocol covers clinical data. We present Lethe, a benchmark for federated unlearning in medical imaging. It evaluates twelve methods across eight task families, from classification and segmentation to denoising, cross-modality synthesis, and vision-language question answering, at three forgetting granularities and against a retrained gold standard on utility, privacy, and cost. The central result is that what separates methods is the difficulty of the forgetting request, not the method itself. The easy removals that dominate the literature leave the methods that preserve utility indistinguishable, while only hard ones separate them. More striking, on the many medical tasks that generalize across sites, forgetting a client barely changes task performance, leaving residual membership as the signal that must be erased.

Machine unlearning in LLMs is the targeted removal of specific knowledge while preserving all other capabilities, critical for privacy and safety. Yet existing benchmarks measure it unreliably. They miss knowledge that resurfaces under paraphrased or indirect queries, a failure we call under-forgetting, and lack the semantic, syntactic, and lexical probes needed to verify that unrelated knowledge is preserved, a failure we call over-forgetting. Both failures reflect an asymmetric generalization problem. Forget evaluation must cover diverse query formulations of the same target facts, testing whether forgetting holds beyond exact training prompts. Retain evaluation must probe a far larger and implicitly defined set, namely every fact disjoint from the forget target. The retain set thus defines the effective forget set, yet current datasets provide no fine-grained annotation of this forget-retain boundary. We address this with SUITE, an evaluation protocol and training corpus that captures forget-retain structure for real-world factual domains. Methods trained on SUITE improve substantially, showing that training data is as important as algorithmic design. Building on the obtained insights, we introduce JensUn++, an unlearning algorithm that achieves the best forget-retain utility trade-off across three LLMs, in both sequential and joint unlearning settings. Code and datasets are available at https://amitpeleg.github.io/forget-narrowly-retain-broadly