Large language models are increasingly viewed as a potential means of mitigating global health inequities, yet their outputs often reflect dominant high-resource medical traditions and provide limited coverage of traditional medical knowledge systems. Tibetan medicine, one of the world's four major traditional medical systems, has an independent and highly structured theoretical framework. When models lack grounded understanding of Tibetan medicine, they may fall back on dominant epistemic systems and distort the native knowledge structure during reasoning. However, quantitative tools for evaluating cultural bias in Tibetan medicine remain largely absent. To address this gap, we introduce TreeProbe, the first cultural-bias benchmark organized around the native Tree of Medicine framework in Tibetan medicine. It contains 4,719 expert-adjudicated items covering 467 diseases and 10 subtasks along the three roots. Experiments on representative LLMs show that current models remain limited in native Tibetan medical contexts and exhibit systematic external ontology drift. Further analysis reveals that models diverge in whether they drift toward biomedical or TCM reasoning, shaped by pretraining data composition and surface resemblance between TCM and Tibetan medicine. TreeProbe provides a diagnostic benchmark for developing medical AI systems that are both linguistically inclusive and epistemically fair. Code and data are available in an anonymous repository at https://anonymous.4open.science/r/TreeProbe/.
Medical large language models hold promise for reducing healthcare disparities, yet Hindi remains severely underrepresented. While medical LLMs excel in high-resource languages, their performance degrades sharply in Hindi, particularly on Indian systems of medicine. We argue that robust cross-lingual medical transfer requires Hindi reasoning. To this end, we introduce HiMed, a Hindi reasoning medical corpus and benchmark suite covering both Western and Indian medicine. We further propose HiMed-8B, a Hindi-form medical reasoning LLM, through the design of decaying scaffolding reward. Extensive experiments demonstrate improvement in Hindi medical reasoning performance and reduction in the English--Hindi accuracy gap. Ablation studies validate the contribution of each training stage and reward component. All data and code are available on GitHub: https://github.com/FreedomIntelligence/HiMed.
Dingfeng Jiang, Han Yan, Chenze Ma +12
1The Chinese University of Hong Kong, Shenzhen · 2Indian Institute of Technology (Banaras Hindu University) Varanasi · 3Tongji University +4
Large language models (LLMs) in medicine are mainly evaluated using multiple-choice question answering (MCQA), which can overestimate real clinical ability due to guessing strategies and answer biases. To address these limitations, we introduce an expanded and more challenging benchmark based on Polish medical exams, adding over 15,000 questions, two new domains, and four structural modifications that reduce MCQA-specific artifacts and better test reasoning. We evaluate 21 LLMs and show that evaluation design strongly affects results. Under our harder setup, the best model (Qwen3.5-122B) drops by 28.4 and 31 pp on English and Polish exams, respectively. Despite low evidence of data contamination, standard MCQA scores do not reliably reflect true medical competence. To facilitate further research, we make our benchmark publicly available.
Antoni Lasik, Jakub Pokrywka, Łukasz Grzybowski +7
NASK National Research Institute · Adam Mickiewicz University · ARAAI Poland +4
Evaluating large language models (LLMs) for medical applications remains challenging due to benchmark saturation, limited data accessibility, and insufficient coverage of relevant tasks. Existing suites have either saturated, heavily depend on restricted datasets, or lack comprehensive model coverage. We introduce Medmarks, a fully open-source evaluation suite with 30 benchmarks spanning question answering, information extraction, medical calculations, and open-ended clinical reasoning. We perform a systematic evaluation of 61 models across 71 configurations using verifiable metrics and LLM-as-a-Judge. Our results show that frontier reasoning models (Gemini 3 Pro Preview, GPT-5.1, & GPT-5.2) achieve the highest performance across both benchmarks, most frontier proprietary models are significantly more token efficient than open-weight alternatives, medically fine-tuned models outperform their generalist counterparts, and that models are susceptible to answer-order bias (particularly smaller models and Grok 4). A subset of our evals (Medmarks-T) can be directly used as reinforcement learning environments to post-train LLMs for medical reasoning. Code is available at https://github.com/MedARC-AI/Medmarks
Benjamin Warner, Ratna Sagari Grandhi, Max Kieffer +32