Abstract
Smaller language models (SLMs) make it feasible to deploy clinical natural language processing where large proprietary models are too costly, and parameter-efficient fine-tuning allows them to be specialised on commodity hardware. One obstacle persists after training: on medical tasks these models answer at far greater length than the clinical question requires. In clinical decision support and point-of-care use, where time is short, such verbosity is hard to act on even when the underlying reasoning is sound. Existing length-control methods depend on preference optimisation, reward models, or proprietary teachers that undercut the accessibility making SLMs attractive. We introduce Parameter-Efficient Conciseness Adaptation (PECA), which adds a single differentiable conciseness term to the QLoRA supervised fine-tuning objective. Because the token count is discrete and non-differentiable, PECA instead raises the end-of-sequence probability once generation exceeds a token budget, a smooth signal optimised during ordinary training, with no preference data, no auxiliary model, and a single commodity GPU. On a 1.7-billion-parameter model fine-tuned on the medical-o1-reasoning-SFT corpus, PECA reduces mean response length by 72.8% while improving multiple-choice diagnostic accuracy from 40.8% to 44.0%. A sweep over the conciseness strength traces an interpretable accuracy-to-length frontier for balancing brevity and diagnostic completeness.
Abstract (translated)
URL
https://arxiv.org/abs/2611.17128
