Large language models (LLMs) show significant potential in healthcare, prompting numerous benchmarks to evaluate their capabilities. However, concerns persist regarding the reliability of these benchmarks, which often lack clinical fidelity, robust data management, and safety-oriented evaluation metrics. To address these shortcomings, we introduce MedCheck, the first lifecycle-oriented assessment framework specifically designed for medical benchmarks. Our framework deconstructs benchmark development into five stages from design to governance, and provides a comprehensive checklist of 46 medically-tailored criteria. Using MedCheck, we conducted an in-depth empirical evaluation of 56 medical LLM benchmarks. Our analysis uncovers widespread, systemic issues, including a profound disconnect from clinical practice, a crisis of data integrity due to unmitigated contamination risks, and a systematic neglect of safety-critical evaluation dimensions like model robustness and uncertainty awareness. Based on these findings, MedCheck is both a diagnostic tool for existing benchmarks and an actionable guideline for a more standardized, reliable, and transparent approach to evaluating AI in healthcare.

Recent advancements in Large Vision Language Models (LVLMs) show promise for pathological diagnosis, yet their application in clinical settings faces critical challenges of multimodal hallucination and biased responses. While preference alignment methods have proven effective in general domains, acquiring high-quality preference data for pathology remains challenging due to limited expert resources and domain complexity. In this paper, we propose EAGLE (Expert-guided self-enhancement for preference Alignment in patholoGy Large vision-languagE model), a novel framework that systematically integrates medical expertise into preference alignment. EAGLE consists of three key stages: initialization through supervised fine-tuning, self-preference creation leveraging expert prompting and medical entity recognition, and iterative preference following-tuning. The self-preference creation stage uniquely combines expert-verified chosen sampling with expert-guided rejected sampling to generate high-quality preference data, while the iterative tuning process continuously refines both data quality and model performance. Extensive experiments demonstrate that EAGLE significantly outperforms existing pathological LVLMs, effectively reducing hallucination and bias while maintaining pathological accuracy. The source code is available at https://github.com/meidandz/EAGLE.