Medical Multimodal Large Language Models (Med-MLLMs) have shown great promise in medical visual question answering (Med-VQA). However, when deployed in low-resource settings where abundant labeled data are unavailable, existing Med-MLLMs commonly fail due to their medical reasoning capability bottlenecks: (i) the intrinsic reasoning bottleneck that ignores the details from the medical image; (ii) the extrinsic reasoning bottleneck that fails to incorporate specialized medical knowledge. To address those limitations, we propose AMANDA, a training-free agentic framework that performs medical knowledge augmentation via LLM agents. Specifically, our intrinsic medical knowledge augmentation focuses on coarse-to-fine question decomposition for comprehensive diagnosis, while extrinsic medical knowledge augmentation grounds the reasoning process via biomedical knowledge graph retrieval. Extensive experiments across eight Med-VQA benchmarks demonstrate substantial improvements in both zero-shot and few-shot Med-VQA settings. The code is available at https://github.com/REAL-Lab-NU/AMANDA.

Multimodal Large Language Models (MLLMs) have shown impressive performance in vision and text tasks. However, hallucination remains a major challenge, especially in fields like healthcare where details are critical. In this work, we show how MLLMs may be enhanced to support Visual RAG (V-RAG), a retrieval-augmented generation framework that incorporates both text and visual data from retrieved images. On the MIMIC-CXR chest X-ray report generation and Multicare medical image caption generation datasets, we show that Visual RAG improves the accuracy of entity probing, which asks whether a medical entities is grounded by an image. We show that the improvements extend both to frequent and rare entities, the latter of which may have less positive training data. Downstream, we apply V-RAG with entity probing to correct hallucinations and generate more clinically accurate X-ray reports, obtaining a higher RadGraph-F1 score.

The significant breakthroughs of Medical Multi-Modal Large Language Models (Med-MLLMs) renovate modern healthcare with robust information synthesis and medical decision support. However, these models are often evaluated on benchmarks that are unsuitable for the Med-MLLMs due to the complexity of real-world diagnostics across diverse specialties. To address this gap, we introduce Asclepius, a novel Med-MLLM benchmark that comprehensively assesses Med-MLLMs in terms of: distinct medical specialties (cardiovascular, gastroenterology, etc.) and different diagnostic capacities (perception, disease analysis, etc.). Grounded in 3 proposed core principles, Asclepius ensures a comprehensive evaluation by encompassing 15 medical specialties, stratifying into 3 main categories and 8 sub-categories of clinical tasks, and exempting overlap with existing VQA dataset. We further provide an in-depth analysis of 6 Med-MLLMs and compare them with 3 human specialists, providing insights into their competencies and limitations in various medical contexts. Our work not only advances the understanding of Med-MLLMs' capabilities but also sets a precedent for future evaluations and the safe deployment of these models in clinical environments.