MMBU: A Massive Multi-modal Biomedical Understanding Benchmark to Probe the Perception Capabilities of Vision-Language Models

We conduct a systematic study of 18 widely used vision-language benchmarks and identify three major issues: 1) many items do not rely on visual cues and therefore fail to effectively measure multimodal understanding; 2) many items are already close to performance saturation for current LVLMs, which limits their discriminative power; 3) a small number of anomalous items affect the reliability of evaluation results. To this end, we propose MMGist, a curated benchmark that covers seven capability dimensions and contains 7,262 items. MMGist is constructed through a three-stage pipeline, which sequentially combines text-ablation filtering, cross-model saturation filtering, and anomaly detection filtering. We conduct extensive experiments on 27 leading LVLMs and compare MMGist with the raw pool of 23,250 items. The results show that MMGist preserves model rankings with high fidelity, with Spearman $ρ= 0.98$, while reducing evaluation items by 69% and improving cross-model discrimination by 78%. Further results indicate that Visual Logic remains a systematic weakness of current LVLMs, while knowledge-intensive dimensions such as Expert Knowledge dimensions remain important factors for distinguishing closed-source models from open-source models. These findings suggest that high-quality evaluation should prioritize visual dependency, discriminative power, and reliability, rather than simply pursuing benchmark scale.

Multimodal large language models (MLLMs) are increasingly used to analyze pathology images. However, dominant multimodal benchmarks in pathology mainly score final diagnostic answers, captions, or reports. These evaluations provide limited insight into whether a model understands the multiscale visual content needed for pathology reasoning and decision-making. We introduce PathVU, a vision-anchored benchmark for fine-grained and multiscale visual understanding in computational pathology. Built from 23 public pathology imaging datasets with human-supervised labels and spatial annotations, PathVU evaluates MLLM understanding in two fields of view: Region FOV for high-resolution local regions and Slide FOV for macro whole-slide views. By converting raw annotations into deterministic task targets, PathVU enables programmatic scoring of region localization, visual recognition, quantity estimation, spatial reasoning, and insufficient-context judgment. The benchmark contains 14 VQA-style tasks, 61,673 images, and 308,070 samples across 28 organs and 7,253,526 annotations. Evaluating 18 representative general-purpose, medical-domain, and pathology-oriented MLLMs, we observe substantial limitations even in advanced models on fine-grained visual tasks across multiscale pathology images. PathVU provides a reproducible basis for developing and evaluating pathology MLLMs with explicit multiscale visual understanding.

This paper introduces a new benchmark test, Medical-Checklist, for assessing medical multimodal models. The recent advancements in multimodal models have demonstrated significant potential in the field of medical vision-language tasks. However, it is becoming increasingly clear that evaluating these models' performance, whether they are applied to natural or medical images, is challenging. The critical question is whether the models can accurately understand an input image while associating it with relevant input text. To address this, Medical-Checklist imposes a binary test on the models: they are given an image and two captions, where one is correct and the other incorrect, and the model must select the correct one. The incorrect caption contains a single medical concept (word or phrase) that is inaccurately substituted from the correct caption. Although the task is simple, this simplicity enables the unified assessment of diverse multimodal models designed and learned on different principles. It also enables us to verify whether models correctly understand a wide range of medical concepts across various medical sub-domains. Medical-Checklist is designed to reduce potential biases in data and to enable evaluation of the models' ability to handle out-of-distribution inputs, which were difficult in existing datasets. When evaluating four state-of-the-art medical multimodal models with Medical-Checklist, it was revealed that despite their excellent performance in specific tasks such as Med-VQA, they may not correctly understand images, suggesting a long journey ahead for clinical application. The dataset and code will be made public upon acceptance.