A Comprehensive Survey of Large Language Models and Multimodal Large Language Models in Medicine

Since the release of ChatGPT and GPT-4, LLMs and multimodal LLMs (MLLMs) have garnered significant attention due to their powerful and general capabilities in understanding, reasoning, and generation, thereby offering new paradigms for the integration of artificial intelligence with medicine. This survey comprehensively overviews the development background and principles of LLMs and MLLMs, as well as explores their application scenarios, challenges, and future directions in medicine. Specifically, this survey begins by focusing on the paradigm shift, tracing the evolution from traditional models to LLMs and MLLMs, summarizing the model structures to provide detailed foundational knowledge. Subsequently, the survey details the entire process from constructing and evaluating to using LLMs and MLLMs with a clear logic. Following this, to emphasize the significant value of LLMs and MLLMs in healthcare, we survey and summarize 6 promising applications in healthcare. Finally, the survey discusses the challenges faced by medical LLMs and MLLMs and proposes a feasible approach and direction for the subsequent integration of artificial intelligence with medicine. Thus, this survey aims to provide researchers with a valuable and comprehensive reference guide from the perspectives of the background, principles, and clinical applications of LLMs and MLLMs.