让医学AI诊断像医生一样说清楚理由，还能通过临床验证。

The clinical adoption of artificial intelligence (AI) in medical diagnostics is critically hampered by its black-box nature, which prevents clinicians from verifying the rationale behind automated decisions. To overcome this fundamental barrier, we introduce DeepMedix-R1, a foundation model (FM) for chest X-ray (CXR) interpretation that generates not only accurate diagnoses but also a transparent, step-by-step reasoning process grounded in specific visual evidence. Our methodology employs a sequential training strategy, beginning with instruction fine-tuning, followed by a cold-start phase to elicit reasoning capabilities. Critically, we then implement reinforcement learning with grounded rewards to meticulously refine the model, aligning both its diagnostic outputs and its reasoning pathways with clinical plausibility. Quantitative assessments show that DeepMedix-R1 substantially outperforms advanced FMs, achieving improvements in report generation and visual question answering tasks. We also introduce Report Arena, a novel LLM-based benchmark that ranks DeepMedix-R1 first among competing models for output quality. Most significantly, a formal review by clinical experts reveals a profound preference for DeepMedix-R1's generated reasoning over the broadly adopted Qwen2.5-VL-7B model, confirming its superior interpretability and clinical utility.