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Self-supervision drives representational convergence in medical foundation models more than clinical supervision

Research Medical/Healthcare AI

Merged summary

TL;DR - A controlled study of medical foundation models finds that representational convergence is driven more by self-supervised pretraining objectives than by clinical supervision, model scale, or capability. The limited shared geometry still enables useful cross-encoder and cross-hospital classifier transfer.

  • Compared 18 image and 7 text encoders across five imaging modalities, including 650,982 chest radiographs.
  • Matched self-supervised encoders aligned most (40.4%), versus label-supervised (21.1%) and image-text models (3.3%).
  • Convergence did not significantly increase with model size and neither extended to clinical language nor matched radiologists’ similarity judgments.
  • Linear classifiers transferred across encoders and five held-out hospitals, retaining roughly 85% of within-encoder performance.

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Self-supervision drives representational convergence in medical foundation models more than clinical supervision

arXiv cs.CV Soroosh Tayebi Arasteh, Sebastian Ziegelmayer, Mahshad Lotfinia, Lisa Adams, Sven Nebelung, Jakob Nikolas Kather, Daniel Truhn 2026-07-22 arXiv:2607.20274

TL;DR - A controlled study of medical foundation models finds that representational convergence is driven more by self-supervised pretraining objectives than by clinical supervision, model scale, or capability. The limited shared geometry still enables useful cross-encoder and cross-hospital classifier transfer.

  • Compared 18 image and 7 text encoders across five imaging modalities, including 650,982 chest radiographs.
  • Matched self-supervised encoders aligned most (40.4%), versus label-supervised (21.1%) and image-text models (3.3%).
  • Convergence did not significantly increase with model size and neither extended to clinical language nor matched radiologists’ similarity judgments.
  • Linear classifiers transferred across encoders and five held-out hospitals, retaining roughly 85% of within-encoder performance.
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