Xiaohong Gu

Chanyong Luo, Jirui Dai, Zhendong Wang et al.

Medicine is an empirical discipline refined through long-term observation and the messy, high-variance reality of clinical practice. Physicians build diagnostic and therapeutic competence through repeated cycles of application, reflection, and improvement, forming individualized methodologies. Yet outcomes vary widely, and master physicians' knowledge systems are slow to develop and hard to transmit at scale, contributing to the scarcity of high-quality clinical expertise. To address this, we propose Med-Shicheng, a general framework that enables large language models to systematically learn and transfer distinguished physicians' diagnostic-and-therapeutic philosophy and case-dependent adaptation rules in a standardized way. Built on Tianyi, Med-Shicheng consists of five stages. We target five National Masters of Chinese Medicine or distinguished TCM physicians, curate multi-source materials, and train a single model to internalize all five knowledge systems across seven tasks, including etiology-pathogenesis analysis, syndrome diagnosis, treatment principle selection, prescription generation, prescription explanation, symptom evolution with regimen adjustment, and clinical advice. Implemented on Qwen2.5-1.5B-Base, Med-Shicheng runs on resource-constrained GPUs while achieving performance comparable to DeepSeek-R1 and GPT-5. We also examine the reliability of LLM-as-a-judge versus physician evaluation: automated judging tracks overall trends but shows bias on fine-grained individualized distinctions, highlighting the need for physician involvement when ground truth is unavailable and for domain-adapted judge models.

Zhi Liu, Tao Yang, Jing Wang et al.

Natural medicines, particularly Traditional Chinese Medicine (TCM), are gaining global recognition for their therapeutic potential in addressing human symptoms and diseases. TCM, with its systematic theories and extensive practical experience, provides abundant resources for healthcare. However, the effective application of TCM requires precise syndrome diagnosis, determination of treatment principles, and prescription formulation, which demand decades of clinical expertise. Despite advancements in TCM-based decision systems, machine learning, and deep learning research, limitations in data and single-objective constraints hinder their practical application. In recent years, large language models (LLMs) have demonstrated potential in complex tasks, but lack specialization in TCM and face significant challenges, such as too big model scale to deploy and issues with hallucination. To address these challenges, we introduce Tianyi with 7.6-billion-parameter LLM, a model scale proper and specifically designed for TCM, pre-trained and fine-tuned on diverse TCM corpora, including classical texts, expert treatises, clinical records, and knowledge graphs. Tianyi is designed to assimilate interconnected and systematic TCM knowledge through a progressive learning manner. Additionally, we establish TCMEval, a comprehensive evaluation benchmark, to assess LLMs in TCM examinations, clinical tasks, domain-specific question-answering, and real-world trials. The extensive evaluations demonstrate the significant potential of Tianyi as an AI assistant in TCM clinical practice and research, bridging the gap between TCM knowledge and practical application.