Real-world clinical practice demands multi-image comparative reasoning, yet current medical benchmarks remain limited to single-frame interpretation. We present MedFrameQA, a video-derived, transcript-grounded benchmark for multi-image reasoning VQA, built from educationally-validated diagnostic sequences. To construct this dataset, we develop a scalable pipeline that leverages narrative transcripts from medical education videos to align visual frames with textual concepts, automatically producing 2,851 high-quality multi-image VQA pairs with explicit, transcript-grounded reasoning chains. Our evaluation of 13 advanced MLLMs (including reasoning models) exposes severe deficiencies in multi-image synthesis, where accuracies mostly fall below 50% and exhibit instability across varying image counts. Error analysis demonstrates that models often treat images as isolated instances, failing to track pathological progression or cross-reference anatomical shifts. MedFrameQA provides a rigorous standard for evaluating the next generation of MLLMs in handling complex, temporally grounded medical narratives.

Autoregressive neural language models (LMs) generate a probability distribution over tokens at each time step given a prompt. In this work, we attempt to systematically understand the probability distributions that LMs can produce, showing that some distributions are significantly harder to elicit than others. Specifically, for any target next-token distribution over the vocabulary, we attempt to find a prompt that induces the LM to output a distribution as close as possible to the target, using either soft or hard gradient-based prompt tuning. We find that (1) in general, distributions with very low or very high entropy are easier to approximate than those with moderate entropy; (2) among distributions with the same entropy, those containing ”outlier tokens” are easier to approximate; (3) target distributions generated by LMs – even LMs with different tokenizers – are easier to approximate than randomly chosen targets. These results offer insights into the expressiveness of LMs and the challenges of using them as probability distribution proposers.