Large Language Models (LLMs) have demonstrated impressive capabilities across various specialist domains and have been integrated into high-stakes areas such as medicine. However, as existing medical-related benchmarks rarely stress-test the long-context memory, interference robustness, and safety defense required in practice. To bridge this gap, we introduce MedMT-Bench, a challenging medical multi-turn instruction following benchmark that simulates the entire diagnosis and treatment process. We construct the benchmark via scene-by-scene data synthesis refined by manual expert editing, yielding 400 test cases that are highly consistent with real-world application scenarios. Each test case has an average of 22 rounds (maximum of 52 rounds), covering 5 types of difficult instruction following issues. For evaluation, we propose an LLM-as-judge protocol with instance-level rubrics and atomic test points, validated against expert annotations with a human-LLM agreement of 91.94%. We test 17 frontier models, all of which underperform on MedMT-Bench, with the best model reaching 66.75%. MedMT-Bench can be an essential tool for driving future research towards safer and more reliable medical AI. The benchmark is available in https://github.com/hiyyc/MedMT-Bench.

As applications of large language models (LLMs) become increasingly complex, the demand for robust complex instruction following capabilities is growing accordingly. We argue that a thorough understanding of the instruction itself, especially the latent reasoning structure embedded between the lines, is crucial for improving instruction following. Therefore we target complex instructions that involve implicit reasoning, intricate logical relations, and multi-constraint dependencies. We propose ImpRIF, a method to enhance LLMs’ understanding of implicit reasoning instructions, thereby improving its ability to follow complex instructions. We formalize such instructions as verifiable reasoning graphs, enabling programmatic verification and graph-driven chain-of-thought reasoning. Based on this formulation, we synthesize large-scale single- and multi-turn data, propose fine-tuning with graph reasoning, and apply reinforcement learning to explicitly train models to reason along the graph. On five complex instruction following benchmarks, our models substantially outperform their base models. These results demonstrate that enhancing implicit reasoning capabilities can significantly improve complex instruction following. This project will be open-sourced in the near future.