Abstract
The rapid advancements in Vision Language Models (VLMs) have prompted the development of multi-modal medical assistant systems. Despite this progress, current models still have inherent probabilistic uncertainties, often producing erroneous or unverified responses-an issue with serious implications in medical applications. Existing methods aim to enhance the performance of Medical Vision Language Model (MedVLM) by adjusting model structure, fine-tuning with high-quality data, or through preference fine-tuning. However, these training-dependent strategies are costly and still lack sufficient alignment with clinical expertise. To address these issues, we propose an expert-in-the-loop framework named Expert-Controlled Classifier-Free Guidance (Expert-CFG) to align MedVLM with clinical expertise without additional training. This framework introduces an uncertainty estimation strategy to identify unreliable outputs. It then retrieves relevant references to assist experts in highlighting key