Abstract
Vision-language models (VLMs) have shown significant potential for medical tasks; however, their general-purpose nature can limit specialized diagnostic accuracy, and their large size poses substantial inference costs for real-world clinical deployment. To address these challenges, we introduce CLARIFY, a Specialist-Generalist framework for dermatological visual question answering (VQA). CLARIFY combines two components: (i) a lightweight, domain-trained image classifier (the Specialist) that provides fast and highly accurate diagnostic predictions, and (ii) a powerful yet compressed conversational VLM (the Generalist) that generates natural language explanations to user queries. In our framework, the Specialist's predictions directly guide the Generalist's reasoning, focusing it on the correct diagnostic path. This synergy is further enhanced by a knowledge graph-based retrieval module, which grounds the Generalist's responses in factual dermatological knowledge, ensuring both accuracy