Abstract
The number of domain fine-tuned models, particularly in the biomedical domain, is rapidly expanding. Fine-tuning promises high-performing models at a fraction of the cost of training a base model, but it can also produce unintended behavioral changes. Multiple studies have shown that safety guardrails can erode with fine-tuning, yet large-scale studies across model architectures, data mixtures, and fine-tuning methodologies remain limited. Where prior work in this space has studied value-centric refusal, this work focuses on knowledge-centric abstention. We audit 25 biomedical domain fine-tuned large language models against 11 paired base checkpoints on MedAbstain and ClinDet-Bench to evaluate the impact of fine-tuning on knowledge-centric abstention. We find that defined appropriate abstention measured by these benchmarks, already low in base models (median 8.3% on MedAbstain), falls further after fine-tuning (median 4.2%, decreasing in 21 of 25 pairs on MedAbstain), and that the magnitude and direction of change are heterogeneous across pairs. These results motivate fine-tuning methods that improve domain-specific capability while preserving appropriate caution.
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URL
https://arxiv.org/abs/2611.08780
