用强化学习打造可自适应的医学智能代理，提升诊断可靠性

The current progress of Clinical Vision Large Language Models (C-VLLMs) has substantially improved digital diagnostics, still these frameworks often endure lesion noises, modality misalignment, hallucination, and missed contextual grounding in complex clinical cases. Moreover, prevailing agent systems usually depend on static and non-adaptable pipelines and lack the versatility necessary for complex medical reasoning. To resolve these difficulties, we present BioMed-Agent-RL, a unified medical agent that incorporates adaptive orchestration, policy, and reward-based reinforcement learning (RL) models for biomedical applications. To ensure reliability, it invokes clinical context-aware preference optimization (CPO), direct preference optimization (DPO), and group relative policy optimization (GRPO) with dynamic entropy regulation. This pipeline utilizes a multimodal meta-learning approach that operates as a field-specific expert and human judgment synthesizer. The agent adaptively utilizes a set of model-level expertise, such as clinical grounding and reasoner, lesion segmenter, and field-specific synthesizer, across various clinical modalities (e.g., X-ray) by utilizing an iterative and adaptive RL approach. The agent learns to seriously synthesize misleading, conflicting vision cues and trust in inherent reasoning, while specialist advice is faulty. An intensive ablation study is conducted across multiple benchmarks, and the agent significantly outperforms existing state of the art models, such as GPT-5, attaining up to ~73% accuracy (gain of ~5%) over contemporary baselines. As a result, the framework suggests a new standard for building factual, reliable, robust, and expert-like intelligent agent systems for independent clinical reasoning.