Organizations: MedAI Technology (Wuxi) Co. Ltd. · Wuhan University of Technology · Technical University of Munich · National University of Singapore
Abstract
Large vision-language models (LVLMs) can be adapted to specialized medical imaging tasks via parameter-efficient fine-tuning approaches such as low-rank adaptation (LoRA), leading to a growing ecosystem of expert models tailored to specific imaging modalities and clinical scenarios. However, deploying multiple expert LVLMs in practice incurs substantial computational and operational overhead. Model merging provides a promising solution by consolidating multiple experts into a single model without retraining, yet it remains largely unexplored in the medical domain. In this work, we present the first systematic study of model merging for medical LVLMs. We introduce MergeMedBench, a comprehensive benchmark spanning eight imaging modalities and diverse clinical task types, comprising 16 LoRA fine-tuned models built upon two mainstream architectures. We conduct an extensive evaluation of existing merging methods and further propose winner-take-all, a simple and hyperparameter-free approach that retains only the most dominant parameters across expert models. By preserving the critical parameters that govern model behavior and discarding weaker ones, our method avoids the information dilution inherent in averaging- or alignment-based strategies. Despite its simplicity, winner-take-all consistently outperforms existing approaches, offering both a new perspective on LoRA merging and a strong practical baseline for future research.
Medical Vision-Language Models (Med-VLMs) have achieved expert-level proficiency in interpreting diagnostic imaging. However, current models are predominantly trained on professional literature, limiting their ability to communicate findings in the lay register required for patient-centered care. While text-centric research has actively developed resources for simplifying medical jargon, there is a critical absence of large-scale multimodal benchmarks designed to facilitate lay-accessible medical image understanding. To bridge this resource gap, we introduce MedLayBench-V, the first large-scale multimodal benchmark dedicated to expert-lay semantic alignment. Unlike naive simplification approaches that risk hallucination, our dataset is constructed via a Structured Concept-Grounded Refinement (SCGR) pipeline. This method enforces strict semantic equivalence by integrating Unified Medical Language System (UMLS) Concept Unique Identifiers (CUIs) with micro-level entity constraints. MedLayBench-V provides a verified foundation for training and evaluating next-generation Med-VLMs capable of bridging the communication divide between clinical experts and patients.
Multi-task model merging combines separately trained expert models into a single model that handles all tasks without co-training. Standard practice merges experts at their optimal validation loss. We challenge this convention by systematically studying how training duration of domain experts affects the quality of the merged model. We fine-tune experts on five domains (Math, Code, Instruction Following, Multilingual, and Safety) across three model sizes (Qwen 3.5 0.8B, 2B, and 4B), saving checkpoints from 25% to 500% of the optimal training steps and evaluating five merging methods at each duration. Our findings reveal a striking method-dependent pattern: simple averaging degrades sharply with overfitting, while sparsification-based methods achieve their best performance well past the validation optimum. We formalize this through bias-variance decomposition analysis, drawing a parallel to random forests where averaging benefits from high-variance individual learners. These results suggest that training duration and merging method should be chosen jointly rather than independently.
Merging multiple Low-Rank Adaptation (LoRA) experts into a single backbone is a promising approach for efficient multi-task deployment. While existing methods strive to alleviate interference via weight interpolation or subspace alignment, they rest upon the implicit assumption that all LoRA matrices contribute constructively to the merged model. In this paper, we uncover a critical bottleneck in current merging paradigms: the existence of negative modules -- specific LoRA layers that inherently degrade global performance upon merging. We propose Evolutionary Negative Module Pruning (ENMP), a plug-and-play LoRA pruning method to locate and exclude these detrimental modules prior to merging. By leveraging an evolutionary search strategy, ENMP effectively navigates the discrete, non-differentiable landscape of module selection to identify optimal pruning configurations. Extensive evaluations demonstrate that ENMP consistently boosts the performance of existing merging algorithms, achieving a new state-of-the-art across both language and vision domains. Code is available at https://github.com/CaoAnda/ENMP-LoRAMerging.