Recent research has shown that CLIP models struggle with visual reasoning tasks that require grounding compositionality, understanding spatial relationships, or capturing fine-grained details. One natural hypothesis is that the CLIP vision encoder does not embed essential information for these tasks. However, we find that this is not always the case: The encoder gathers query-relevant visual information, while CLIP fails to extract it. In particular, we show that another branch of Vision-Language Models (VLMs), Generative Multimodal Large Language Models (MLLMs), achieve significantly higher accuracy than CLIP in many of these tasks using the *same* vision encoder and weights, indicating that these Generative MLLMs *perceive more*—as they extract and utilize visual information more effectively. We conduct a series of controlled experiments and reveal that their success is attributed to multiple key design choices, including patch tokens, position embeddings, and prompt-based weighting. On the other hand, enhancing the training data alone or applying a stronger text encoder does not suffice to solve the task, and additional text tokens offer little benefit. Interestingly, we find that fine-grained visual reasoning is not exclusive to generative models trained by an autoregressive loss: When converted into CLIP-like encoders by contrastive finetuning, these MLLMs still outperform CLIP under the same cosine similarity-based evaluation protocol. Our study highlights the importance of VLM architectural choices and suggests directions for improving the performance of CLIP-like contrastive VLMs.

Large Language Models (LLMs) offer transformative potential across diverse fields, yet their safe and effective deployment is hindered by inherent knowledge conflicts—stemming from temporal evolution, divergent sources, and contradictory guidelines. This challenge is particularly acute in medicine, an interdisciplinary frontier for NLP. Rapid medical concept drift can lead LLMs to provide incorrect or outdated advice, impacting their utility and the broader societal benefits of NLP advances. This study introduces ConflictMedQA, a benchmark designed to systematically evaluate how LLMs manage varied knowledge conflicts in clinical guidelines. Our assessment of seven state-of-the-art models across 4,290 scenarios reveals significant difficulties in rejecting incorrect recommendations and frequent endorsement of conflicting advice, highlighting an important gap for NLP systems intended for real-world impact. We explore two fundamental mitigation approaches: retrieval-augmented generation and preference fine-tuning via direct preference optimization. While each offers improvements, their synergistic combination yields the best results. These findings emphasize the need for LLMs to discern subtle but critical guideline conflicts. This is a crucial step in advancing NLP’s capabilities and ensuring its dependable application in critical societal domains. The proposed dataset is available at https://huggingface.co/datasets/RDBH/DriftMed.