Standardized patients (SPs) are indispensable for clinical skills training but remain expensive and difficult to scale. Although large language model (LLM)-based virtual standardized patients (VSPs) have been proposed as an alternative, their behavior remains unstable and lacks rigorous comparison with human standardized patients. We propose EasyMED, a multi-agent VSP framework that separates case-grounded information disclosure from response generation to support stable, inquiry-conditioned patient behavior. We also introduce SPBench, a human-grounded benchmark with eight expert-defined criteria for interaction-level evaluation. Experiments show that EasyMED more closely matches human SP behavior than existing VSPs, particularly in case consistency and controlled disclosure. A four-week controlled study further demonstrates learning outcomes comparable to human SP training, with stronger early gains for novice learners and improved flexibility, psychological safety, and cost efficiency.

As medical LLMs transition to clinical deployment, assessing their ethical reasoning capability becomes critical. While achieving high accuracy on knowledge benchmarks, LLMs lack validated assessment for navigating ethical trade-offs in clinical decision-making where multiple valid solutions exist. Existing benchmarks lack systematic approaches to incorporate recognized philosophical frameworks and expert validation for ethical reasoning assessment. We introduce PrinciplismQA, a philosophy-grounded approach to assessing LLM clinical medical ethics alignment. Grounded in Principlism, our approach provides a systematic methodology for incorporating clinical ethics philosophy into LLM assessment design. PrinciplismQA comprises 3,648 expert-validated questions spanning knowledge assessment and clinical reasoning. Our expert-calibrated pipeline enables reproducible evaluation and models ethical biases. Evaluating recent models reveals significant ethical reasoning gaps despite high knowledge accuracy, demonstrating that knowledge-oriented training does not ensure clinical ethical alignment. PrinciplismQA provides a validated tool for assessing clinical AI deployment readiness.