NPCBench: A Clinical Apprenticeship Benchmark for Multimodal Care-Pathway Reasoning in Nasopharyngeal Carcinoma

Pengkai Wang, Wei-Wei Zhang, Yan Li, Min Tang, Zhitian Hou +11

Current medical benchmarks typically break down clinical competence into isolated factual questions, single-image tasks, or static case vignettes. These tests score individual answers, but reveal less about whether a model can integrate subspecialty knowledge with multimodal evidence and track a patient's condition throughout a course of care. To close this gap, we introduce NPCBench, a clinical apprenticeship benchmark for nasopharyngeal carcinoma (NPC). NPCBench mirrors specialist training, from guideline and foundational knowledge to case planning, longitudinal review, CarePath integration, and open-ended consultation. It contains 4,777 component and consultation items and a 100-patient CarePath cohort with 417 scored diagnostic and care tasks. The episode-level evaluation tests whether diagnostic and care answers are jointly correct within a care pathway. By linking stepwise tasks to patient-level care trajectories, NPCBench evaluates whether models ground decisions in visual evidence, interpret changes in patient state, and meet clinical requirements in consultation. Across 30 evaluated models, we observe a composition gap: strong performance on individual tasks does not…