QoQ-Med: Building Multimodal Clinical Foundation Models with Domain-Aware GRPO Training

This repository contains the model weights for QoQ-Med-VL-7B (Qwen Omni-Reasoning on Medical Questions), a multimodal clinical foundation model with reasoning capabilities.

📚 Paper | 💻 Code

Abstract

Clinical decision-making routinely demands reasoning over heterogeneous data, yet existing multimodal language models (MLLMs) remain largely vision-centric and fail to generalize across clinical specialties. To bridge this gap, we introduce QoQ-Med-7B/32B, the first open generalist clinical foundation model that jointly reasons across medical images, time-series signals, and text reports. QoQ-Med is trained with Domain-aware Relative Policy Optimization (DRPO), a novel reinforcement-learning objective that hierarchically scales normalized rewards according to domain rarity and modality difficulty, mitigating performance imbalance caused by skewed clinical data distributions. Trained on 2.61 million instruction tuning pairs spanning 9 clinical domains, we show that DRPO training boosts diagnostic performance by 43% in macro-F1 on average across all visual domains as compared to other critic-free training methods like GRPO. Furthermore, with QoQ-Med trained on intensive segmentation data, it is able to highlight salient regions related to the diagnosis, with an IoU 10x higher than open models while reaching the performance of OpenAI o4-mini. To foster reproducibility and downstream research, we release (i) the full model weights, (ii) the modular training pipeline, and (iii) all intermediate reasoning traces at this https URL .

Model Overview

QoQ-Med is the first open generalist clinical foundation model that jointly reasons across:

• Medical images (2D/3D)
• Time-series signals (ECG)
• Text reports

The model is trained with our novel Domain-aware Relative Policy Optimization (DRPO), a reinforcement learning objective that hierarchically scales normalized rewards according to domain rarity and modality difficulty, addressing performance imbalance in heterogeneous clinical data.

Key Features

• Multimodal Integration: Processes and reasons across 1D, 2D, and 3D clinical data
• Domain-Aware Training: DRPO balances learning across 9 clinical domains
• Enhanced Interpretability: Generates reasoning traces and highlights salient regions
• State-of-the-Art Performance: Outperforms existing open-source clinical MLLMs

Clinical Domains

QoQ-Med spans multiple clinical specialties:

• Cardiology (ECG, Chest X-ray)
• Radiology (CT, MRI, Ultrasound)
• Dermatology
• Ophthalmology (Fundus)
• Pathology
• Mammography

Model Weights

Quick Start

Use with Front End Apps

Prefer a point-and-click experience? Community-maintained GGUF builds are already on the Hub. They load instantly in desktop chat front-ends such as LM Studio, Ollama, and other llama.cpp-compatible apps—just search for “QoQ-Med-VL-7B/32B,” click Download, and start chatting. No Python environment, GPU, or command-line setup required.

Installation

First, ensure you have the necessary dependencies:

pip install transformers qwen-vl-utils torch

Loading the Model

You may load the QoQ-Med model and processors via transformers package:

from transformers import AutoModelForVision2Seq, AutoProcessor

model = AutoModelForVision2Seq.from_pretrained(
    "ddvd233/QoQ-Med-VL-7B", 
    torch_dtype="auto", 
    device_map="auto"
)

processor = AutoProcessor.from_pretrained("ddvd233/QoQ-Med-VL-7B")

For better performance with flash attention:

import torch
from transformers import AutoModelForVision2Seq

model = AutoModelForVision2Seq.from_pretrained(
    "ddvd233/QoQ-Med-VL-7B",
    torch_dtype=torch.bfloat16,
    attn_implementation="flash_attention_2",
    device_map="auto",
)

Configuring Visual Token Range

You can adjust the visual token range to balance performance and computational cost:

min_pixels = 256 * 28 * 28
max_pixels = 1280 * 28 * 28

processor = AutoProcessor.from_pretrained(
    "ddvd233/QoQ-Med-VL-7B", 
    min_pixels=min_pixels, 
    max_pixels=max_pixels
)

Preparing Multimodal Input

Create a message with both image and text content:

messages = [
    {
        "role": "user",
        "content": [
            {
                "type": "image",
                "image": "path/to/your/medical/image.jpg",
            },
            {"type": "text", "text": "Describe this medical image."},
        ],
    }
]

Processing the Input

Prepare the input for model inference:

from qwen_vl_utils import process_vision_info

text = processor.apply_chat_template(
    messages, tokenize=False, add_generation_prompt=True
)

image_inputs, video_inputs = process_vision_info(messages)

inputs = processor(
    text=[text],
    images=image_inputs,
    videos=video_inputs,
    padding=True,
    return_tensors="pt",
)

inputs = inputs.to("cuda")

Generating Output

Run inference and decode the output:

generated_ids = model.generate(**inputs, max_new_tokens=128)

generated_ids_trimmed = [
    out_ids[len(in_ids):] 
    for in_ids, out_ids in zip(inputs.input_ids, generated_ids)
]

output_text = processor.batch_decode(
    generated_ids_trimmed, 
    skip_special_tokens=True, 
    clean_up_tokenization_spaces=False
)

print(output_text[0])

Citations

If you find the project useful, please cite the following papers:

@article{dai2025climb,
  title={Climb: Data foundations for large scale multimodal clinical foundation models},
  author={Dai, Wei and Chen, Peilin and Lu, Malinda and Li, Daniel and Wei, Haowen and Cui, Hejie and Liang, Paul Pu},
  journal={International Conference on Machine Learning},
  year={2025}
}
@article{dai2025qoq,
  title={QoQ-Med: Building Multimodal Clinical Foundation Models with Domain-Aware GRPO Training},
  author={Dai, Wei and Chen, Peilin and Ekbote, Chanakya and Liang, Paul Pu},
  journal={arXiv preprint arXiv:2506.00711},
  year={2025}
}

Important Note

This model is intended for research purposes only. Before extensive real-world testing (like human trials), it is not suitable for clinical deployment. This is a research preview, not a product approved by federal agencies.