From Conflict to Consensus: Boosting Medical Reasoning via Multi-Round Agentic RAG

Abstract

Large Language Models (LLMs) exhibit high reasoning capacity in medical question-answering, but their tendency to produce hallucinations and outdated knowledge poses critical risks in healthcare fields. While Retrieval-Augmented Generation (RAG) mitigates these issues, existing methods rely on noisy token-level signals and lack the multi-round refinement required for complex reasoning. In the paper, we propose **MA-RAG** (**M**ulti-Round **A**gentic RAG), a framework that facilitates test-time scaling for complex medical reasoning by iteratively evolving both external evidence and internal reasoning history within an agentic refinement loop. At each round, the agent transforms semantic **conflict** among candidate responses into actionable queries to retrieve external evidence, while optimizing history reasoning traces to mitigate long-context degradation. MA-RAG extends the *self-consistency* principle by leveraging the lack of consistency as a proactive signal for multi-round agentic reasoning and retrieval, and mirrors a *boosting* mechanism that iteratively minimizes the residual error toward a stable, high-fidelity medical **consensus**. Extensive evaluations across 7 medical Q\&A benchmarks show that MA-RAG consistently surpasses competitive inference-time scaling and RAG baselines, delivering **substantial +6.8 points** on average accuracy over the backbone model.