Understanding Multilingual Medical ASR Adaptation Through Layer-Wise Analysis

Although Whisper models benefit from large-scale multilingual pre-training, their performance on Burmese medical speech remains limited. This work presents a Burmese medical speech recognition framework built on a high-quality 28-hour corpus recorded and validated by native speakers. We fine-tune Whisper models using full fine-tuning (FFT) and parameter-efficient fine-tuning (PEFT) with LoRA. To evaluate robustness, we apply waveform- and spectrogram-level data augmentation under controlled noise and simulated room acoustics. While augmentation reduces performance on clean speech, it significantly improves robustness in noisy and reverberant environments across FFT and PEFT settings. Our best-performing system, fully fine-tuned myMediWhisper-Medium without augmentation, achieves a state-of-the-art Word Error Rate (WER) of 23.44%, outperforming much larger general-domain fine-tuned models. Dataset and other resources can be found at the Huggingface repository: https://huggingface.co/datasets/LULab/mediTalk-mm-rdy.

This article concerns comparative studies on the Automatic Speech Recognition (ASR) model incorporated with the Large Language Model (LLM) used for medical interviews. The proposed solution is tested on polish language benchmarks and dataset with medical interviews. The latest ASR technologies are based on convolutional neural networks (CNNs), recurrent neural networks (RNNs) and Transformers. Most of them work as end-to-end solutions. The presented approach in the case of the Whisper model shows a two-stage solution with End-To-End ASR and LLM working together in a pipeline. The ASR output is an input for LLM. The LLM is a component by which the output from ASR is corrected and improved. Comparative studies for automatic recognition of the Polish language between modern End-To-End deep learning architectures and the ASR hybrid model were performed. The medical interview tests were performed with two state-of-the-art ASR models: OpenAI Whisper incorporated with LLM and Scribe ElevenLabs. Additionally, the results were compared with five more end-to-end models (QuartzNet, FastConformer, Wav2Vec 2.0 XLSR and ESPnet Model Zoo) on Mozilla Common Voice and VoxPopuli databases. Tests were conducted for clean audio signal, signal with bandwidth limitation, and degraded. The tested models were evaluated on the basis of Word Error Rate (WER) and Character Error Rate (CER). The results show that the Whisper model performs by far the best among the open-source models. ElevenLabs Scribe model, on the other hand, performs best for Polish on both general benchmark and medical data.

Large Language Models (LLMs) perform strongly in English medical tasks but degrade substantially in Arabic, a gap widely attributed to limited training data. We systematically investigate this assumption via tuned lens probing and causal activation patching, and find that Arabic medical knowledge is present in intermediate model representations but fails to surface at the output. This mechanistic insight motivates a targeted adaptation strategy: rather than fine-tuning the full network, we propose Targeted Low-Rank Adaptation (TLoRA), restricted to the layer window where cross-lingual representations diverge, upstream of the output layers where the failure manifests. We evaluate TLoRA on multiple-choice medical QA, where our approach outperforms full-network LoRA, zero-shot, and few-shot baselines. We further evaluate it on short-answer generation and multi-turn clinical dialogue, where it performs competitively without the need for task-specific finetuning. We additionally introduce AraClinicDialog, a clinician-constructed Arabic medical dialogue benchmark in MSA with validated variants across four Arabic dialects. Together, these contributions demonstrate that mechanistic diagnosis can serve as a practical guide for targeted adaptation in underrepresented-language medical LLMs.