Automatic prompt optimization is a practical alternative to fine-tuning for adapting large language models (LLMs), yet existing approaches often trade off signal quality against computational cost. Methods that rely on generative feedback can be informative but expensive to scale, while sampling-based optimization typically requires many evaluations and exhibits high variance. Even loss-driven prompt optimization remains limited by costly segment attribution that scales with prompt length and by overfitting to a single evaluator, which weakens transfer across model families and domains. We propose Gradient-guided Multi-judge Prompt Optimization (GMPO), a scalable framework that improves both efficiency and robustness. GMPO uses a first-order gradient approximation to score segment importance in a continuous masking direction, requiring only one forward and one backward pass. GMPO further employs a generate multi-judge design in which candidate prompt edits are proposed by a generator and selected using cross-entropy losses aggregated from multiple lightweight judge models, reducing evaluator bias and improving generalization. Experiments across math, reasoning, instruction-following evaluation, and safety robustness benchmarks demonstrate consistent gains with substantially lower optimization overhead.

Medical visual question answering (MVQA) requires in-depth understanding of medical images and questions to provide reliable answers. We summarize multi-level progressive capabilities that models need to focus on in MVQA: recognition, details, diagnosis, knowledge, and reasoning. Existing MVQA models tend to ignore the above capabilities due to unspecific data and plain architecture. To address these issues, this paper proposes Multi-level Visual Language Model (MLeVLM) for MVQA. On the data side, we construct a high-quality multi-level instruction dataset MLe-VQA via GPT-4, which covers multi-level questions and answers as well as reasoning processes from visual clues to semantic cognition. On the architecture side, we propose a multi-level feature alignment module, including attention-based token selector and context merger, which can efficiently align features at different levels from visual to semantic. To better evaluate the model’s capabilities, we manually construct a multi-level MVQA evaluation benchmark named MLe-Bench. Extensive experiments demonstrate the effectiveness of our constructed multi-level instruction dataset and the multi-level feature alignment module. It also proves that MLeVLM outperforms existing medical multimodal large language models.