MedAdapter: Efficient Test-Time Adaptation of Large Language Models Towards Medical Reasoning

Despite their improved capabilities in generation and reasoning, adapting large language models (LLMs) to the biomedical domain remains challenging due to their immense size and privacy concerns. In this study, we propose MedAdapter 1 , a unified post-hoc adapter for test-time adaptation of LLMs towards biomedical applications. Instead of fine-tuning the entire LLM, MedAdapter effectively adapts the original model by fine-tuning only a small BERT-sized adapter to rank candidate solutions generated by LLMs. Experiments on four biomedical tasks across eight datasets demonstrate that MedAdapter effectively adapts both white-box and black-box LLMs in biomedical reasoning, achieving average performance improvements of 18.24% and 10.96%, respectively, without requiring extensive computational resources or sharing data with third parties. MedAdapter also yields enhanced performance when combined with train-time adaptation, highlighting a flexible and complementary solution to existing adaptation methods. Faced with the challenges of balancing model performance, computational resources, and data privacy, MedAdapter provides an efficient, privacy-preserving, cost-effective, and transparent solution for adapting LLMs to the biomedical domain. * Equal contribution. 1 Our implementation of MedAdapter is available at https: //github.com/wshi83/MedAdapter .