While large language models hold promise for complex medical applications, their development is hindered by the scarcity of high-quality reasoning data. To address this issue, existing approaches typically distill chain-of-thought reasoning traces from large proprietary models via supervised fine-tuning, then conduct reinforcement learning (RL). These methods exhibit limited improvement on underrepresented domains like rare diseases while incurring substantial costs from generating complex reasoning chains. To efficiently enhance medical reasoning, we propose MedSSR, a Medical Knowledge-enhanced data Synthesis and Semi-supervised Reinforcement learning framework. Our framework first employs rare disease knowledge to synthesize distribution-controllable reasoning questions. We then utilize the policy model itself to generate high-quality pseudo-labels. This enables a two-stage, intrinsic-to-extrinsic training paradigm: self-supervised RL on the pseudo-labeled synthetic data, followed by supervised RL on the human-annotated real data. MedSSR scales model training efficiently without relying on costly trace distillation. Extensive experiments on Qwen and Llama demonstrate that our method outperforms existing methods across ten medical benchmarks, achieving up to **+5.93%** gain on rare-disease tasks. Our code is available at https://github.com/tdlhl/MedSSR.

Medical large vision-language Models (Med-LVLMs) have shown promise in clinical applications but suffer from factual inaccuracies and unreliable outputs, posing risks in real-world diagnostics. While RAG has emerged as a potential solution, current medical multimodal RAG systems are unable to perform effective retrieval across heterogeneous sources. The irrelevance of retrieved reports undermines the factuality of analysis, while insufficient knowledge affects the credibility of clinical decision-making. To bridge the research gap, we construct MedAtlas, which includes extensive multimodal report repositories and diverse text corpora. Based on it, we present HeteroRAG, a novel framework that enhances Med-LVLMs through heterogeneous knowledge sources. The framework introduces Modality-specific CLIPs for effective report retrieval and a Multi-corpora Query Generator for tailoring queries to diverse corpora. Incorporating knowledge from such multifaceted sources, Heterogeneous Knowledge Preference Tuning is performed to achieve cross-modality and multi-source knowledge alignment. Extensive experiments across 11 datasets and 3 modalities demonstrate that HeteroRAG achieves state-of-the-art performance in most medical vision language benchmarks, significantly improving factual accuracy and reliability of Med-LVLMs.