MedMCP-Calc: Benchmarking LLMs for Realistic Medical Calculator Scenarios via MCP Integration

Yakun Zhu, Yutong Huang, Shengqian Qin, Zhongzhen Huang, Shaoting Zhang, Xiaofan Zhang


Abstract
Medical calculators are fundamental to quantitative, evidence-based clinical practice. However, their real-world use is an adaptive, multi-stage process, requiring proactive EHR data acquisition, scenario-dependent calculator selection, and multi-step computation, whereas current benchmarks focus only on static single-step calculations with explicit instructions. To address these limitations, we introduce MedMCP-Calc, the first benchmark for evaluating LLMs in realistic medical calculator scenarios through Model Context Protocol (MCP) integration. MedMCP-Calc comprises 118 scenario tasks across 4 clinical domains, featuring fuzzy task descriptions mimicking natural queries, structured EHR database interaction, external reference retrieval, and process-level evaluation. Our evaluation of 23 leading models reveals critical limitations: even top performers like GPT-5 exhibit substantial gaps, including difficulty selecting appropriate calculators for end-to-end workflows given fuzzy queries, poor performance in iterative SQL-based database interactions, and marked reluctance to leverage external tools for numerical computation. Performance also varies considerably across clinical domains. Building on these findings, we develop CalcMate, a fine-tuned model incorporating scenario planning and tool augmentation, achieving state-of-the-art performance among open-source models.
Anthology ID:
2026.acl-long.221
Volume:
Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers)
Month:
July
Year:
2026
Address:
San Diego, California, United States
Editors:
Maria Liakata, Viviane P. Moreira, Jiajun Zhang, David Jurgens
Venue:
ACL
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Publisher:
Association for Computational Linguistics
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Pages:
4845–4873
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URL:
https://preview.aclanthology.org/ingest-acl/2026.acl-long.221/
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Cite (ACL):
Yakun Zhu, Yutong Huang, Shengqian Qin, Zhongzhen Huang, Shaoting Zhang, and Xiaofan Zhang. 2026. MedMCP-Calc: Benchmarking LLMs for Realistic Medical Calculator Scenarios via MCP Integration. In Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers), pages 4845–4873, San Diego, California, United States. Association for Computational Linguistics.
Cite (Informal):
MedMCP-Calc: Benchmarking LLMs for Realistic Medical Calculator Scenarios via MCP Integration (Zhu et al., ACL 2026)
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https://preview.aclanthology.org/ingest-acl/2026.acl-long.221.pdf
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