The Forgotten Shield: Safety Grafting in Parameter-Space for Medical MLLMs
Bibliographic record
Abstract
Abstract Medical Multimodal Large Language Models (Medical MLLMs) have achieved remarkable progress in specialized medical tasks; however, research into their safety has lagged, posing potential risks for real-world deployment. In this paper, we first establish a multidimensional evaluation framework to systematically benchmark the safety of current SOTA Medical MLLMs. Our empirical analysis reveals pervasive vulnerabilities across both general and medical-specific safety dimensions in existing models, particularly highlighting their fragility against cross-modality jailbreak attacks. Furthermore, we find that the medical fine-tuning process frequently induces catastrophic forgetting of the model’s original safety alignment. To address this challenge, we propose a novel “Parameter-Space Intervention” approach for efficient safety re-alignment. This method extracts intrinsic safety knowledge representations from original base models and concurrently injects them into the target model during the construction of medical capabilities. Additionally, we design a fine-grained parameter search algorithm to achieve an optimal trade-off between safety and medical performance. Experimental results demonstrate that our approach significantly bolsters the safety guardrails of Medical MLLMs without relying on additional domain-specific safety data, while minimizing degradation to core medical performance.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.022 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.003 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".