Aligning Large Language Models (LLMs) with high-stakes medical standards remains a significant challenge, primarily due to the dissonance between coarse-grained preference signals and the complex, multi-dimensional nature of clinical protocols. To bridge this gap, we introduce ProMedical, a unified alignment framework grounded in fine-grained clinical criteria. We first construct ProMedical-Preference-50k, a dataset generated via a human-in-the-loop pipeline that augments medical instructions with rigorous, physician-derived rubrics. Leveraging this corpus, we propose the Explicit Criteria Injection paradigm to train a multi-dimensional reward model. Unlike traditional scalar reward models, our approach explicitly disentangles safety constraints from general proficiency, enabling precise guidance during reinforcement learning. To rigorously validate this framework, we establish ProMedical-Bench, a held-out evaluation suite anchored by double-blind expert adjudication. Empirical evaluations demonstrate that optimizing the Qwen3-8B base model via ProMedical-RM-guided GRPO yields substantial gains, improving overall accuracy by 22.3% and safety compliance by 21.7%, effectively rivaling proprietary frontier models. Furthermore, the aligned policy generalizes robustly to external benchmarks, demonstrating performance comparable to state-of-the-art models on UltraMedical. We publicly release our datasets, reward models, and benchmarks to facilitate reproducible research in safety-aware medical alignment.

The growing emotional stress in modern society has increased the demand for Emotional Support Conversations (ESC). While Large Language Models (LLMs) show promise for ESC, they face two key challenges: (1) low strategy selection accuracy, and (2) preference bias, limiting their adaptability to users’ emotional needs. Existing supervised fine-tuning (SFT) struggles to address these issues, as it rigidly trains models on single gold-standard responses without modeling nuanced strategy trade-offs. To overcome these limitations, we propose a novel two-stage framework that optimizes strategy selection preferences at each dialogue turn. We first leverage Monte Carlo Tree Search to construct ESC-Pro, a high-quality preference dataset with turn-level strategy-response pairs. Then training on ESC-Pro with Chain-of-Strategy Optimization (CSO) improves both strategy accuracy and bias mitigation, enabling LLMs to generate more empathetic and contextually appropriate responses. Experiments on LLaMA-3.1-8B, Gemma-2-9B, and Qwen2.5-7B demonstrate that CSO outperforms standard SFT, highlighting the efficacy of fine-grained, turn-level preference modeling in ESC.

Large language models (LLMs) show potential in healthcare but often generate hallucinations, especially when handling unfamiliar information. In medication, a systematic benchmark to evaluate model capabilities is lacking, which is critical given the high-risk nature of medical information. This paper introduces a Chinese benchmark aimed at assessing models in medication tasks, focusing on knowledge and reasoning across six datasets: indication, dosage and administration, contraindicated population, mechanisms of action, drug recommendation, and drug interaction. We evaluate eight closed-source and five open-source models to identify knowledge boundaries, providing the first systematic analysis of limitations and risks in proprietary medical models.