Pretraining of Medical Visual Encoders Toward Multi-modal Large Language Models

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Multimodal Large Language Models (MLLMs) commonly reuse visual encoders pretrained with CLIP, although the features of these ViTs are ultimately consumed by autoregressive LLMs. We refer to this mismatch as the semantic-interface gap and introduce MedMLIP, a framework that pretrains the visual encoder through report generation with a frozen LLM, while employing Local Relational Distillation (LRD) to preserve relationships among visual patches to avoid visual collapse. We pretrain MedMLIP on IU-Xray and Open-PMC-300K and evaluate the resulting encoders on VQA-RAD and SLAKE. Only the ViT is transferred, while the guiding LLM and projector are replaced, allowing us to assess cross-LLM transferability. Our cross-LLM transfer experiments demonstrate the value of pretraining visual encoders for their autoregressive LLM interface while trying to preserve more fine-grained visual information. Code and the pretrained model are available at https://github.com/SkyCol/MedMLIP