Latent reasoning enables reasoning over continuous hidden states rather than explicit tokens, avoiding the language bottleneck and inference overhead of chain-of-thought for medical VQA. However, existing methods suffer from modality collapse, insufficient visual supervision, and train-inference mismatch. Moreover, their opaque latent states offer no interpretability, which is critical in clinical applications. We propose VITAL, a latent-space reasoning framework for medical MLLMs with visual-semantic dual supervision: an auxiliary text decoder reconstructs reasoning chains from latent states, while a visual projector regresses ROI features from a frozen, independent medical vision encoder. Both modules are discarded at inference with zero overhead, yet can be re-attached post-hoc for dual interpretability, providing textual and visual explanations of the reasoning process without sacrificing efficiency. We construct a 61K dataset spanning 9 imaging modalities, exceeding prior medical visual latent reasoning datasets by an order of magnitude. Experiments on 7 benchmarks show that VITAL consistently and substantially outperforms the backbone, all latent reasoning baselines, and medical MLLMs trained on far larger data, achieving state-of-the-art results competitive with trillion-parameter proprietary models.

Large language model (LLM)-based judges are increasingly used to scale the evaluation and optimization of open-ended medical dialogue systems, making their reliability critical in this high-stakes setting. However, existing medical benchmarks mainly assess their medical knowledge, while general judge benchmarks lack clinically grounded consultation criteria. To address this gap, we introduce Med-GRADE, a benchmark for evaluating LLMs as medical dialogue judges. It contains 2,076 real-world patient–LLM dialogues annotated by 56 physicians with a 23-item rubric adapted from Mini-CEX, covering Medical Interviewing (MI), Humanistic Care (HC), and Diagnosis and Treatment Management (DTM). Experiments on 17 LLMs show that current LLM judges achieve only moderate agreement, with the best model reaching 64.89% Macro-F1 and 68.28% Hamming Accuracy. Besides, more complex prompts may even harm performance: CoT disrupts parsing, while few-shot and self-refine introduce item-level instability. Data and code are available at https://github.com/jyd777/Med-GRADE for reproducibility.

While large language models (LLMs) show promise in code generation, existing benchmarks neglect the flowchart-based code generation. To promote further research on flowchart-based code generation, this work presents Flow2Code, a novel benchmark for flowchart-based code generation evaluation. The evaluation dataset spans 15 programming languages and includes 5,622 code segments paired with 16,866 flowcharts of three types: code, UML, and pseudocode. Extensive experiments with 13 multimodal LLMs reveal that current LLMs can not generate code based on flowcharts perfectly. Besides, experiment results show that the supervised fine-tuning technique contributes greatly to the models’ performance. The dataset will be publicly available.