Zhicheng He, Xiaohan Xing, Hongqiu Wang, Kun Yuan, Guankun Wang, Yanheng Li, Haoxuan Che, Nassir Navab 等 10 位作者
Multimodal large language models (MLLMs) have shown strong potential in robotic surgery for question answering, scene understanding, and grounded assistance, but their high computational cost limits real clinical deployment. Knowledge distillation provides a practical way to build compact surgical MLLMs, yet direct distillation is not well suited to surgical data because surgical samples vary greatly in difficulty, visual ambiguity, and required clinical context, making uniform teacher-student transfer unstable. In addition, the role of supervision changes during training: early stages require stronger teacher guidance for multimodal alignment, while later stages rely more on task supervision for effective optimization. To address these challenges, we propose SurgPace, a complexity-aware continuous curriculum framework for progressive distillation of surgical vision-language models. SurgPace estimates sample complexity using predictive confidence and Lorentz geometric consistency, and uses the fused score to guide a continuous easy-to-hard training process. We further introduce hierarchical representation alignment, which aligns the student with the teacher at the feature, logit, and probability levels, while gradually shifting the training focus from teacher imitation to task supervision. This design separates sample-level curriculum from objective-level scheduling, leading to more stable and effective distillation. We evaluate SurgPace on Surg-396K, a benchmark built from four public surgical datasets and covering five dialogue paradigms. SurgPace consistently outperforms strong MLLM distillation baselines, demonstrating its effectiveness for building compact, memory-efficient surgical MLLMs with faster decoding under controlled benchmarks. Code is available at https://github.com/hezhicheng2002/SurgPace.
Zhefan Rao, Meng Chu, Xuan Billy Zhang, Jingfan Chen, Guohao Cai, Runyi Li, Shiyi Du, Xu Huang 等 92 位作者
World Models (WMs) can support Multimodal Agents (MAs) through simulated experience, while Agent trajectories can inform World Model refinement. Evaluating this interaction requires separate evidence about action selection and state evolution. We introduce Dual Exam, which tests Agents under fixed environment response mechanisms and World Models under fixed action interventions across physical, digital, social, and scientific domains. The Agent track compares 10 configurations on 1,088 items in 15 reporting categories. The World Model track contains 400 cases across eight scenarios; 15 configurations have full coverage and one covers six scenarios. GPT 6 Astra leads the case-weighted Agent Index at 31.3, and GPT-Image-2 leads the full-coverage WM Overall at 21.7. These scores use different tasks and metrics and are not directly comparable. A 150-case pilot of one coupled pairing records zero task successes and motivates component-level diagnosis. Results reveal uneven task performance and failures to preserve task-relevant state. Their value for predicting coupled success or sustained reciprocal learning remains to be established.
Xiangyu Li, Jincheng Li, Tianle Du, Yanheng Li, Haoxuan Che, Yuxin Sun, Long Bai, Liangliang Liu 等 9 位作者
A question about a whole-slide image rarely names every morphological finding needed to answer it. Question-guided patch selection can therefore overlook supporting morphology, while slide-level compression can dilute focal evidence. Inspired by how pathologists combine broad slide review, question-directed examination, and integration of their findings, we introduce BEYONDPATH, a Preserve-Focus-Fuse framework for whole-slide image question answering. Preserve learns a question-agnostic Morphology Bank through answer supervision across multiple questions about each training slide. Focus retrieves questionspecific evidence from all foreground patches, including regions outside the Bank. Fuse integrates the preserved morphology at the retrieved evidence positions through Morphology-on-Visual-Evidence Fusion, producing a fixed 96-token visual prefix. On WSI-Bench, BEYONDPATH achieves an Avg-9 of 0.769 and leads all eight reported report-generation metrics using the same checkpoint. It also achieves 0.639 zero-shot overall accuracy on SlideBench-BCNB. Controlled ablations show complementary benefits from morphology preservation and question-directed retrieval, and support cross-question supervision and fusion at the evidence positions. These results support looking beyond the question's explicit cues: preserving broader slide morphology while retaining the ability to seek evidence for each question.