A perspective for adapting generalist AI to specialized medical AI applications and their challenges.

Wang, Zifeng; Wang, Hanyin; Danek, Benjamin; Li, Ying; Mack, Christina; Arbuckle, Luk; Biswal, Devyani; Poon, Hoifung et al. · NPJ Digit Med · 2025

review · Level V

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Abstract

We introduce a framework to adapt large language models for medicine: (1) Modeling: breaking down medical workflows into manageable steps; (2) Optimization: optimizing model performance via advanced adaptations; and (3) System engineering: developing agent or chain systems. Furthermore, we describe varied use cases, such as clinical trial design, clinical decision support, and medical imaging analysis. Finally, we discuss challenges and considerations for building medical AI with LLMs.