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Sep 23

MedAlign: A Clinician-Generated Dataset for Instruction Following with Electronic Medical Records

The ability of large language models (LLMs) to follow natural language instructions with human-level fluency suggests many opportunities in healthcare to reduce administrative burden and improve quality of care. However, evaluating LLMs on realistic text generation tasks for healthcare remains challenging. Existing question answering datasets for electronic health record (EHR) data fail to capture the complexity of information needs and documentation burdens experienced by clinicians. To address these challenges, we introduce MedAlign, a benchmark dataset of 983 natural language instructions for EHR data. MedAlign is curated by 15 clinicians (7 specialities), includes clinician-written reference responses for 303 instructions, and provides 276 longitudinal EHRs for grounding instruction-response pairs. We used MedAlign to evaluate 6 general domain LLMs, having clinicians rank the accuracy and quality of each LLM response. We found high error rates, ranging from 35% (GPT-4) to 68% (MPT-7B-Instruct), and an 8.3% drop in accuracy moving from 32k to 2k context lengths for GPT-4. Finally, we report correlations between clinician rankings and automated natural language generation metrics as a way to rank LLMs without human review. We make MedAlign available under a research data use agreement to enable LLM evaluations on tasks aligned with clinician needs and preferences.

The Gold Medals in an Empty Room: Diagnosing Metalinguistic Reasoning in LLMs with Camlang

Large Language Models (LLMs) achieve gold-medal performance across many benchmarks, yet it remains unclear whether such success reflects genuine reasoning or pattern matching. From a cognitive science perspective, an informative test is whether models can master an unfamiliar language through explicit metalinguistic deductive learning, a paradigm where human learners can reliably internalise grammatical systems through metalinguistic reasoning. We address this question with Camlang, a novel constructed language that exhibits naturalistic yet unattested feature combinations. Camlang consists of two explicit resources, a grammar book and a bilingual dictionary, which mirror adult second-language learning via explicit grammar rules and lexical lookup, and enable us to disentangle errors in morpho-syntax, lexical semantics, and sentence-level reasoning. Human experiments show that these resources are sufficient for participants to acquire Camlang and successfully solve Camlang tasks. To operationalise evaluation, we adapt CommonsenseQA into Camlang, creating Camlang-CSQA-v0, the first task in a broader suite where solving questions requires applying grammar rules and lexical mappings. Experimental results show that GPT-5 achieves 98\% EM accuracy in English but only 47\% in Camlang, far below human performance at 87\%, while other state-of-the-art reasoning LLMs perform even worse. Human verification further reveals that most model successes stem from shallow lexical alignment while GPT-5 shows emerging metalinguistic awareness to a limited extent but not systematic grammatical mastery as humans. Camlang establishes a cognitively grounded evaluation paradigm that exposes fundamental gaps between current models and human metalinguistic competence.

Wu's Method can Boost Symbolic AI to Rival Silver Medalists and AlphaGeometry to Outperform Gold Medalists at IMO Geometry

Proving geometric theorems constitutes a hallmark of visual reasoning combining both intuitive and logical skills. Therefore, automated theorem proving of Olympiad-level geometry problems is considered a notable milestone in human-level automated reasoning. The introduction of AlphaGeometry, a neuro-symbolic model trained with 100 million synthetic samples, marked a major breakthrough. It solved 25 of 30 International Mathematical Olympiad (IMO) problems whereas the reported baseline based on Wu's method solved only ten. In this note, we revisit the IMO-AG-30 Challenge introduced with AlphaGeometry, and find that Wu's method is surprisingly strong. Wu's method alone can solve 15 problems, and some of them are not solved by any of the other methods. This leads to two key findings: (i) Combining Wu's method with the classic synthetic methods of deductive databases and angle, ratio, and distance chasing solves 21 out of 30 methods by just using a CPU-only laptop with a time limit of 5 minutes per problem. Essentially, this classic method solves just 4 problems less than AlphaGeometry and establishes the first fully symbolic baseline strong enough to rival the performance of an IMO silver medalist. (ii) Wu's method even solves 2 of the 5 problems that AlphaGeometry failed to solve. Thus, by combining AlphaGeometry with Wu's method we set a new state-of-the-art for automated theorem proving on IMO-AG-30, solving 27 out of 30 problems, the first AI method which outperforms an IMO gold medalist.