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Didactic knowledge or Clinical Cases? How Data Types Shape Medical Large Language Models

Summary

A study accepted for oral presentation at NLPCC 2026 uses token-matched experiments to examine how didactic data (textbooks) and clinical data (patient records) differently shape medical large language models. It finds asymmetric transfer: clinical data improves clinic-oriented tasks while staying competitive on knowledge-intensive ones, whereas didactic data mainly helps knowledge-intensive tasks. Error analysis points to a knowing-doing gap, where better knowledge recall does not reliably translate into clinical reasoning.

SourcearXiv AIAuthor: Yuzheng Fan, Haochun Wang, Sendong Zhao, Xiao Han, Ming Ma, Bing Qin
Didactic knowledge or Clinical Cases? How Data Types Shape Medical Large Language Models
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[Submitted on 26 Aug 2026]

Title:Didactic knowledge or Clinical Cases? How Data Types Shape Medical Large Language Models

View a PDF of the paper titled Didactic knowledge or Clinical Cases? How Data Types Shape Medical Large Language Models, by Yuzheng Fan and 5 other authors

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Abstract:Medical large language models are commonly trained on mixtures of didactic data (e.g., textbooks) and clinical data (e.g., patient records), yet how these data types differentially shape model capabilities remains unclear. We address this issue with token-matched experiments that vary the didactic-to-clinical ratio and analyze how data composition affects performance, capability profiles, and error patterns across knowledge-intensive and clinic-oriented tasks. We uncover an asymmetric transfer across task types: clinical data improves clinic-oriented tasks while remaining competitive on knowledge-intensive ones, whereas didactic data mainly improves knowledge-intensive tasks. Error analysis suggests a knowing-doing gap, where improvements in knowledge recall do not reliably generalize to clinical reasoning. We further observe that modest amounts of clinical data yield most of the gains on EHR-grounded tasks, while the optimal mixture ratio varies with the knowledge and clinical reasoning demands of downstream tasks. These findings suggest that medical LLM data curation should be application-driven, with higher proportions of clinical data preferred for reasoning-intensive use cases.

Comments: This paper is accepted by NLPCC 2026 oral

Subjects:

Artificial Intelligence (cs.AI); Computation and Language (cs.CL); Machine Learning (cs.LG)

Cite as: arXiv:2609.22161 [cs.AI]

(or arXiv:2609.22161v1 [cs.AI] for this version)

https://doi.org/10.48550/arXiv.2609.22161

arXiv-issued DOI via DataCite

Submission history

From: Yuzheng Fan [view email] [v1] Wed, 26 Aug 2026 13:33:12 UTC (642 KB)

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Key points and analysis

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Key points

  • Token-matched experiments vary the didactic-to-clinical ratio and measure performance, capability profiles, and error patterns on knowledge-intensive and clinic-oriented tasks.
  • Asymmetric transfer: clinical data helps clinic-oriented tasks without hurting knowledge-intensive ones, while didactic data mainly boosts knowledge-intensive tasks.
  • Modest amounts of clinical data capture most of the gains on EHR-grounded tasks, and the optimal mixture varies with downstream demands.
  • A knowing-doing gap emerges: gains in knowledge recall do not reliably generalize to clinical reasoning, suggesting application-driven data curation.

Highlights and analysis are generated automatically and may contain errors. Check the original source.