Search arXivSearch

arXiv · 2509.11517

PeruMedQA: Benchmarking Large Language Models (LLMs) on Peruvian Medical Exams -- Dataset Construction and Evaluation

Abstract

BACKGROUND: Medical large language models (LLMs) have demonstrated remarkable performance in answering medical examinations. However, the extent to which this high performance is transferable to medical questions in Spanish and from a Latin American country remains unexplored. This knowledge is crucial as LLM-based medical applications gain traction in Latin America. AIMS: To build a dataset of questions medical examinations taken by Peruvian physicians pursuing specialty training; to fine-tune a LLM on this dataset; to evaluate and compare the performance in terms of accuracy between vanilla LLMs and the fine-tuned LLM. METHODS: We curated PeruMedQA, a multiple-choice question-answering (MCQA) dataset containing 8,380 questions spanning 12 specialties (2018-2025). We selected ten medical LLMs, including medgemma-4b-it and medgemma-27b-text-it, and developed zero-shot task specific prompts to answer the questions. We employed parameter-efficient fine tuning (PEFT) and low-rand adaptation (LoRA) to fine-tune medgemma-4b-it utilizing all questions except those from 2025 (test set). RESULTS: Medgemma-27b showed the highest accuracy across all specialities, achieving the highest score of 89.29% in Psychiatry; yet, in two specialties, OctoMed-7B exhibited slight superiority: Neurosurgery with 77.27% and 77.38, respectively; and Radiology with 76.13% and 77.39%, respectively. Across specialties, most LLMs with <10 billion parameters exhibited <50% of correct answers. The fine-tuned version of medgemma-4b-it emerged victorious against all LLMs with <10 billion parameters and rivaled a LLM with 70 billion parameters across various examinations. CONCLUSIONS: For medical AI applications and research that require knowledge bases from Spanish-speaking countries and those exhibiting similar epidemiological profile to Peru's, interested parties should utilize medgemma-27b-text-it.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Rodrigo M. Carrillo-Larco, Jesus Lovón Melgarejo, Manuel Castillo-Cara, Gusseppe Bravo-Rocca. 2026-02-25. PeruMedQA: Benchmarking Large Language Models (LLMs) on Peruvian Medical Exams -- Dataset Construction and Evaluation. https://doi.org/10.1007/s40670-026-02692-w

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

Hierarchical attention interpretation: an interpretable speech-level transformer for bi-modal depression detection

Depression is a common mental disorder. Automatic depression detection tools using speech, enabled by machine learning, help early screening of depression. This paper addresses two limitations that may hinder the clinical implementations of such tools: noise resulting from segment-level labelling and a lack of model interpretability. We propose a bi-modal speech-level transformer to avoid segment-level labelling and introduce a hierarchical interpretation approach to provide both speech-level and sentence-level interpretations, based on gradient-weighted attention maps derived from all attention layers to track interactions between input features. We show that the proposed model outperforms a model that learns at a segment level ($p$=0.854, $r$=0.947, $F1$=0.897 compared to $p$=0.732, $r$=0.808, $F1$=0.768). For model interpretation, using one true positive sample, we show which sentences within a given speech are most relevant to depression detection; and which text tokens and Mel-spectrogram regions within these sentences are most relevant to depression detection. These interpretations allow clinicians to verify the validity of predictions made by depression detection tools, promoting their clinical implementations.

cs.CL

Cultural Alignment in Large Language Models Using Soft Prompt Tuning

Large Language Model (LLM) alignment is commonly achieved through supervised fine-tuning or reinforcement learning, both of which require labeled or preference data and update model weights. Without targeted cultural adaptation, however, deployed LLMs often exhibit culturally homogeneous behavior that fails to reflect diverse local values. Aligning models to cultural value frameworks such as Hofstede's Value Survey Module (VSM13) presents a distinct challenge: alignment signals are available only as aggregated survey-level scores computed after generating responses to an entire survey, providing no per-token gradient and requiring no preference data by construction. This makes standard gradient-based alignment methods ill-suited to the task. We propose a deployment-friendly approach that encodes cultural behavior in short, tunable soft prompts optimized with Differential Evolution (DE), while keeping model weights frozen and requiring no preference data. At inference, the system inserts the appropriate cultural-specific prompt to adapt model responses for different cultures. Experiments across four countries and four instruction-tuned models show that DE-optimized prompts generally reduce discrepancy with VSM13 reference profiles, improve rank agreement with the World Values Survey (WVS), an independent framework not seen during optimization, and are preferred in blinded pairwise evaluations using majority voting across three LLM judges.

cs.CL

VQ-Logits: Compressing the Output Bottleneck of Large Language Models via Vector Quantized Logits

Large Language Models (LLMs) have achieved remarkable success but face significant computational and memory challenges, particularly due to their extensive output vocabularies. The final linear projection layer, mapping hidden states to vocabulary-sized logits, often constitutes a substantial portion of the model's parameters and computational cost during inference. Existing methods like adaptive softmax or hierarchical softmax introduce structural complexities. In this paper, we propose VQ-Logits, a novel approach that leverages Vector Quantization (VQ) to drastically reduce the parameter count and computational load of the LLM output layer. VQ-Logits replaces the large V * dmodel output embedding matrix with a small, shared codebook of K embedding vectors (K << V ). Each token in the vocabulary is mapped to one of these K codebook vectors. The LLM predicts logits over this compact codebook, which are then efficiently "scattered" to the full vocabulary space using the learned or preassigned mapping. We demonstrate through extensive experiments on standard language modeling benchmarks (e.g., WikiText-103, C4) that VQ-Logits can achieve up to 99% parameter reduction in the output layer and 6x speedup in logit computation, with only a marginal 4% increase in perplexity compared to full softmax baselines. We further provide detailed ablation studies on codebook size, initialization, and learning strategies, showcasing the robustness and effectiveness of our approach.

cs.CL