Exploring Post-Training Alignment of Small Language Models for Biomedical Data-to-Text Generation: A Case Study of Medication Leaflet

Large Language Models such as GPT-4o and GPT-5 achieve strong zero-shot performance on biomedical claim verification, but cost and opacity limit scalable use. We fine-tune three small LLMs: Phi-3-mini (3.8B), Qwen2.5-3B, and Mistral-7B, via QLoRA on SciFact and HealthVer, providing the first study of QLoRA models against GPT-4o and fine-tuned BioLinkBERT encoders. Mistral-7B QLoRA surpasses both GPT-4o and GPT-5 (up to 12% F1 gain) at a fractional cost using just 1,008 training examples. We conduct extensive in-domain and cross-domain evaluation: models trained on SciFact tested on HealthVer and vice versa, at matched sizes to isolate dataset structure from data quantity. We identify a previously unreported structural artifact in SciFact that inflates in-domain scores, and show through bidirectional out-of-domain evaluation that training on structurally sound data enables robust cross-domain transfer. We plan to release all code and adapter checkpoints.

This paper narrows the performance gap between small, specialized models and significantly larger general-purpose models through domain adaptation via continual pre-training and merging. We address the scarcity of specialized non-English data by constructing a high-quality German medical corpus (FineMed-de) from FineWeb2. This corpus is used to continually pre-train and merge three well-known LLMs (ranging from $7B$ to $24B$ parameters), creating the DeFineMed model family. A comprehensive evaluation confirms that specialization dramatically enhances $7B$ model performance on German medical benchmarks. Furthermore, the pairwise win-rate analysis of the Qwen2.5-based models demonstrates an approximately $3.5$-fold increase in the win-rate against the much larger Mistral-Small-24B-Instruct through domain adaptation. This evidence positions specialized $7B$ models as a competitive, resource-efficient solution for complex medical instruction-following tasks. While model merging successfully restores instruction-following abilities, a subsequent failure mode analysis reveals inherent trade-offs, including the introduction of language mixing and increased verbosity, highlighting the need for more targeted fine-tuning in future work. This research provides a robust, compliant methodology for developing specialized LLMs, serving as the foundation for practical use in German-speaking healthcare contexts.

Despite the success of large language models (LLMs) on general-purpose tasks, their performance in highly specialized domains such as biomedicine remains unsatisfactory. A key limitation is the inability of LLMs to effectively leverage biomedical tools, which clinical experts and biomedical researchers rely on extensively in daily workflows. While recent general-domain tool-calling datasets have substantially improved the capabilities of LLM agents, existing efforts in the biomedical domain largely rely on in-context learning and restrict models to a small set of tools. To address this gap, we introduce BioTool, a comprehensive biomedical tool-calling dataset designed for fine-tuning LLMs. BioTool comprises 34 frequently used tools collected from the NCBI, Ensembl, and UniProt databases, along with 7,040 high-quality, human-verified query-API call pairs spanning variation, genomics, proteomics, evolution, and general biology. Fine-tuning a 4-billion-parameter LLM on BioTool yields substantial improvements in biomedical tool-calling performance, outperforming cutting-edge commercial LLMs such as GPT-5.1. Furthermore, human expert evaluations demonstrate that integrating a BioTool-fine-tuned tool caller significantly improves downstream answer quality compared to the same LLM without tool usage, highlighting the effectiveness of BioTool in enhancing the biomedical capabilities of LLMs. The full dataset and evaluation code are available at https://github.com/gxx27/BioTool