Derek Li

Chi Liu, Derek Li, Yan Shu et al.

While large language models show promise in medical applications, achieving expert-level clinical reasoning remains challenging due to the need for both accurate answers and transparent reasoning processes. To address this challenge, we introduce Fleming-R1, a model designed for verifiable medical reasoning through three complementary innovations. First, our Reasoning-Oriented Data Strategy (RODS) combines curated medical QA datasets with knowledge-graph-guided synthesis to improve coverage of underrepresented diseases, drugs, and multi-hop reasoning chains. Second, we employ Chain-of-Thought (CoT) cold start to distill high-quality reasoning trajectories from teacher models, establishing robust inference priors. Third, we implement a two-stage Reinforcement Learning from Verifiable Rewards (RLVR) framework using Group Relative Policy Optimization, which consolidates core reasoning skills while targeting persistent failure modes through adaptive hard-sample mining. Across diverse medical benchmarks, Fleming-R1 delivers substantial parameter-efficient improvements: the 7B variant surpasses much larger baselines, while the 32B model achieves near-parity with GPT-4o and consistently outperforms strong open-source alternatives. These results demonstrate that structured data design, reasoning-oriented initialization, and verifiable reinforcement learning can advance clinical reasoning beyond simple accuracy optimization. We release Fleming-R1 publicly to promote transparent, reproducible, and auditable progress in medical AI, enabling safer deployment in high-stakes clinical environments.

Xingshuai Huang, Derek Li, Bahareh Nikpour et al.

Chain-of-Thought (CoT) prompting has significantly improved the reasoning capabilities of large language models (LLMs). However, conventional CoT often relies on unstructured, flat reasoning chains that suffer from redundancy and suboptimal performance. In this work, we introduce Hierarchical Chain-of-Thought (Hi-CoT) prompting, a structured reasoning paradigm specifically designed to address the challenges of complex, multi-step reasoning. Hi-CoT decomposes the reasoning process into hierarchical substeps by alternating between instructional planning and step-by-step execution. This decomposition enables LLMs to better manage long reasoning horizons and maintain logical coherence. Extensive evaluations across diverse LLMs and mathematical reasoning benchmarks show that Hi-CoT consistently improves average accuracy by 6.2% (up to 61.4% on certain models and tasks) while reducing reasoning trace length by 13.9% compared to CoT prompting. We further show that accuracy and efficiency are maximized when models strictly adhere to the hierarchical structure. Our code is available at https://github.com/XingshuaiHuang/Hi-CoT.

Yan Shu, Chi Liu, Robin Chen et al.

Multimodal Large Language Models (MLLMs) have demonstrated remarkable effectiveness in various general-domain scenarios, such as visual question answering and image captioning. Recently, researchers have increasingly focused on empowering MLLMs with medical conversational abilities, which hold significant promise for clinical applications. However, medical data presents unique challenges due to its heterogeneous nature -- encompassing diverse modalities including 2D images, 3D volumetric scans, and temporal video sequences. The substantial domain gap and data format inconsistencies across these modalities have hindered the development of unified medical MLLMs. To address these challenges, we propose Fleming-VL, a unified end-to-end framework for comprehensive medical visual understanding across heterogeneous modalities. Fleming-VL tackles this problem from a data-centric perspective through three key strategies: (1) scaling up pretraining by integrating long-context data from both natural and medical-specific domains; (2) complementing fine-tuning with rare medical data, including holistic video analysis and underrepresented 2D modalities such as ultrasound and dermoscopy images; (3) extending existing evaluation frameworks to incorporate 3D volumetric and video understanding benchmarks. Through supervised fine-tuning (SFT) and group relative policy optimization (GRPO), we develop Fleming-VL in multiple model scales. Extensive experiments demonstrate that Fleming-VL achieves state-of-the-art performance across multiple benchmarks, including medical VQA, video QA, and 3D medical image understanding. We publicly release Fleming-VL to promote transparent, reproducible, and auditable progress in medical AI.

Mohammad Ali Alomrani, Yingxue Zhang, Derek Li et al.

Large language models (LLMs) have rapidly progressed into general-purpose agents capable of solving a broad spectrum of tasks. However, current models remain inefficient at reasoning: they apply fixed inference-time compute regardless of task complexity, often overthinking simple problems while underthinking hard ones. This survey presents a comprehensive review of efficient test-time compute (TTC) strategies, which aim to improve the computational efficiency of LLM reasoning. We introduce a two-tiered taxonomy that distinguishes between L1-controllability, methods that operate under fixed compute budgets, and L2-adaptiveness, methods that dynamically scale inference based on input difficulty or model confidence. We benchmark leading proprietary LLMs across diverse datasets, highlighting critical trade-offs between reasoning performance and token usage. Compared to prior surveys on efficient reasoning, our review emphasizes the practical control, adaptability, and scalability of TTC methods. Finally, we discuss emerging trends such as hybrid thinking models and identify key challenges for future work towards making LLMs more computationally efficient, robust, and responsive to user constraints.

Derek Li, Jiaming Zhou, Leo Maxime Brunswic et al.

The pursuit of general-purpose artificial intelligence depends on large language models (LLMs) that can handle both structured reasoning and open-ended generation. We present Omni-Thinker, a unified reinforcement learning (RL) framework that scales LLMs across diverse tasks by combining hybrid rewards with backward-transfer-guided scheduling. Hybrid rewards integrate rule-based verifiable signals with preference-based evaluations from an LLM-as-a-Judge, enabling learning in both deterministic and subjective domains. Our scheduler orders tasks according to accuracy backward transfer (BWT), reducing forgetting and improving multi-task performance. Experiments across four domains show gains of 6.2% over joint training and 12.4% over model merging. Moreover, we demonstrate that simple assumptions on accuracy transfer yield accurate predictions of curriculum outcomes, with entropy dynamics explaining deviations due to generative tasks. These findings underscore the importance of BWT-aware scheduling and hybrid supervision for scaling RL-based post-training toward general-purpose LLMs.