MedPMC: A Systematic Framework for Scaling High-Fidelity Medical Multimodal Data for Foundation Models
Authors: Hyunjae Kim, Dain Kim, Pan Xiao, Serina S. Applebaum, Younjoon Chung, Xuguang Ai, Yu Yin, Roy Jiang, +20 more
Organizations: Yale University, New Haven, CT, USA · Korea University, Seoul, South Korea · Washington University in St. Louis, St. Louis, MO, USA · The University of Queensland, Brisbane, QLD, Australia · The University of Texas Health Science Center at Houston, Houston, TX, USA · University of Washington, Seattle, WA, USA · Microsoft Research, Redmond, WA, USA
Medicine is inherently multimodal, requiring clinicians to synthesize information across diverse data streams. Yet the development of multimodal foundation models is constrained by limited access to large-scale, high-quality clinical data. Although PubMed Central (PMC) offers a complementary source of expert-authored image-text data, existing PMC-derived resources remain limited in fidelity, reproducibility, and clinical validation. We introduce MedPMC, an automated, continuously updatable framework that transforms permissively licensed literature into high-fidelity infrastructure for medical multimodal models. Applied to 6.1 million PMC articles, MedPMC curated 11 million medical image-text pairs. Component evaluations showed strong performance for initial screening (F1 = 93.2), multi-panel figure detection (F1 = 96.5), figure separation (mAP = 89.8), caption separation and alignment (F1 = 81.4; ROUGE-L = 85.3), and medical figure classification (F1 = 96.5). Manual review by five annotators, three with medical training, found 95.3% of MedPMC images medically relevant, versus 19.7% in a prior PMC-derived dataset. Across 26 benchmarks spanning 11 specialties, a MedPMC-trained CLIP-style model improved average zero-shot AUC by 7.1 percentage points over the strongest architecture-matched biomedical CLIP baseline despite using fewer than half as many image-text pairs. As the vision encoder in a multimodal large language model, it improved medical visual question-answering by 1.9 and 16.9 percentage points across two benchmarks. In 10,524 Yale New Haven Health System dermatology photographs, it improved morphology-to-image retrieval Recall@5 by 11.7 percentage points. These findings show that high-fidelity literature curation strengthens medical multimodal foundation models across benchmark and clinical settings. We publicly release the framework, corpus, benchmarks, and pretrained models.
Large-scale biomedical image-text datasets extracted from scientific literature provide valuable resources for medical multimodal model training. These datasets are commonly organized as image-caption pairs; however, figure captions are often short, context-dependent, and only partially informative without the surrounding article text. At the same time, large-scale automatic extraction introduces structural noise such as missing captions, residual markup, duplicated context, and incoherent multi-paragraph figure descriptions. We revisit data construction for medical multimodal continued pretraining (CPT) and present PMC-InterCPT, a context-grounded biomedical interleaved corpus that incorporates figure-referencing body text in addition to captions. Our pipeline recovers missing captions, cleans caption and context text, reconstructs coherent interleaved image-text samples, and applies LLM-supervised medical relevance and quality classifiers to filter noisy records. We further reveal strong modality imbalance in the resulting corpus and introduce a four-bucket evidence taxonomy for modality-aware resampling. Through CPT followed by supervised fine-tuning (SFT) on Qwen3.5-4B-Base, PMC-InterCPT effectively improves medical and general multimodal performance while using fewer CPT tokens than the raw source pool. The experimental results also illustrate the complementarity between the data quality and modality for medical multimodal CPT.
Multimodal Large Language Models (MLLMs) have demonstrated impressive capabilities in understanding common visual elements, largely due to their large-scale datasets and advanced training strategies. However, their effectiveness in medical applications remains limited due to the inherent discrepancies between data and tasks in medical scenarios and those in the general domain. Concretely, existing medical MLLMs face the following critical limitations: (1) limited coverage of medical knowledge beyond imaging, (2) heightened susceptibility to hallucinations due to suboptimal data curation processes, (3) lack of reasoning capabilities tailored for complex medical scenarios. To address these challenges, we first propose a comprehensive data curation procedure that (1) efficiently acquires rich medical knowledge data not only from medical imaging but also from extensive medical texts and general-domain data; and (2) synthesizes accurate medical captions, visual question answering (VQA), and reasoning samples. As a result, we build a multimodal dataset enriched with extensive medical knowledge. Building on the curated data, we introduce our medical-specialized MLLM: Lingshu. Lingshu undergoes multi-stage training to embed medical expertise and enhance its task-solving capabilities progressively. Besides, we preliminarily explore the potential of applying reinforcement learning with verifiable rewards paradigm to enhance Lingshu's medical reasoning ability. Additionally, we develop MedEvalKit, a unified evaluation framework that consolidates leading multimodal and textual medical benchmarks for standardized, fair, and efficient model assessment. We evaluate the performance of Lingshu on three fundamental medical tasks, multimodal QA, text-based QA, and medical report generation. The results show that Lingshu consistently outperforms the existing open-source multimodal models on most tasks ...
Large language models (LLMs) have demonstrated strong capabilities across diverse domains, showing considerable potential in medicine. However, their application in medical settings remains limited by the scarcity of visual question answering (VQA) datasets that capture clinical reasoning and explicit image-text alignment. Here, we leverage de-identified medical images and expert commentaries shared on clinician-oriented social media. By combining an advanced LLM with clinician-in-the-loop verification, we established a rigorous pipeline to construct ThoughtMed-1M, a long-form medical VQA dataset containing over one million VQA pairs and designed to capture structured clinical logic and medical image-text alignment. To demonstrate its utility, we developed a FOundational LLM Trained on ThoughtMed-1M (FOLTMed). FOLTMed achieved state-of-the-art performance across 42 medical VQA benchmark datasets, with a macro accuracy of 85.4%, and generated more clinically coherent responses on the ThoughtMed-1M test set. It outperformed state-of-the-art models by 3--5% across factuality and similarity metrics, highlighting a scalable paradigm for advancing research on clinically grounded multimodal LLMs.