Kan Hatakeyama-Sato

Yue Xun, Junyu Liu, Qian Niu et al.

We introduce JMed48k, a multi-profession Japanese healthcare licensing benchmark for evaluating vision-language models. Built from official PDF materials released by the Japanese Ministry of Health, Labour and Welfare, JMed48k contains 48,862 exam questions and 20,142 images from 11 national licensing examinations between 2005 and 2025, with visual content annotated under an 8-type taxonomy. From this corpus, we derive JMed48k-Eval, a recent five-year evaluation subset with 12,484 scored questions, including 9,905 text-only questions and 2,579 questions with images. We evaluate 21 proprietary, open-source, and medical-specific models, reporting text-only and with-image performance separately. Because these subsets contain different questions, we further introduce a paired image-removal audit that evaluates questions with images before and after removing visual content to explore four answer-transition states. The audit shows that proprietary and open source models gain substantially from images, whereas medical-specific systems show limited observable use of visual evidence, with many correct answers persisting after image removal. Even among proprietary models, the net image-removal effect varies sevenfold across professions, from +5.7 points on Physician questions to +39.8 points on Public Health Nurse questions. We release JMed48k to support reproducible, profession-stratified evaluation of vision-language models in medical licensing settings.

Junyu Liu, Zirui Li, Qian Niu et al.

As Large Language Models (LLMs) are increasingly deployed in healthcare field, it becomes essential to carefully evaluate their medical safety before clinical use. However, existing safety benchmarks remain predominantly English-centric, and test with only single-turn prompts despite multi-turn clinical consultations. To address these gaps, we introduce JMedEthicBench, the first multi-turn conversational benchmark for evaluating medical safety of LLMs for Japanese healthcare. Our benchmark is based on 67 guidelines from the Japan Medical Association and contains over 50,000 adversarial conversations generated using seven automatically discovered jailbreak strategies. Using a dual-LLM scoring protocol, we evaluate 27 models and find that commercial models maintain robust safety while medical-specialized models exhibit increased vulnerability. Furthermore, safety scores decline significantly across conversation turns (median: 9.5 to 5.0, $p < 0.001$). Cross-lingual evaluation on both Japanese and English versions of our benchmark reveals that medical model vulnerabilities persist across languages, indicating inherent alignment limitations rather than language-specific factors. These findings suggest that domain-specific fine-tuning may accidentally weaken safety mechanisms and that multi-turn interactions represent a distinct threat surface requiring dedicated alignment strategies.