MedQARo: A Large-Scale Benchmark for Evaluating Large Language Models on Medical Question Answering in Romanian

Abstract

Question answering (QA) is an actively studied topic, being a core natural language processing (NLP) task that needs to be addressed before achieving Artificial General Intelligence (AGI). However, the lack of QA datasets in specific domains and languages hinders the development of robust AI models able to generalize across various domains and languages. To this end, we introduce MedQARo, the first large-scale medical QA benchmark in Romanian, alongside a comprehensive evaluation of state-of-the-art (SOTA) large language models (LLMs). We construct a high-quality and large-scale dataset comprising 105,880 QA pairs related to cancer patients from two medical centers. The questions regard medical case summaries of 1,242 patients, requiring either keyword extraction or reasoning to be answered correctly. MedQARo is the result of a time-consuming manual annotation process carried out by seven physicians specialized in oncology or radiotherapy, who spent a total of about 3,000 work hours to generate the QA pairs. Our benchmark contains both in-domain and cross-domain (cross-center and cross-cancer) test collections, enabling a precise assessment of generalization capabilities. We experiment with four open-source LLMs from distinct families of models on MedQARo. Each model is employed in two scenarios, namely one based on zero-shot prompting and one based on supervised fine-tuning. We also evaluate two state-of-the-art LLMs exposed only through APIs, namely GPT-5.2 and Gemini 3 Flash. Our results show that fine-tuned models significantly outperform zero-shot models, clearly indicating that pretrained models fail to generalize on MedQARo. Our findings demonstrate the importance of both domain-specific and language-specific fine-tuning for reliable clinical QA in Romanian. We publicly release our dataset and code at https://github.com/ana-rogoz/MedQARo.