Model reference · open weights

medgemma-1.5

LLMs google Vision + text 2 builds Its own licence terms 248k dl/mo

medgemma-1.5 is an open-weight language model from Google. medgemma-1.5-4b-it (BF16) weighs 8.6 GB; the smallest configuration that runs it is RTX 3060 12 GB.

  • MedGemma 1.5 is a 4.3B parameter multimodal model developed by Google for medical text and image comprehension.
  • It supports a context length of at least 128K tokens and is designed for tasks such as interpreting CT and MRI scans, analyzing whole-slide histopathology, and understanding electronic health records.
  • The model uses a decoder-only transformer architecture with grouped-query attention and is governed by the Health AI Developer Foundations terms of use.

Summary of the google/medgemma-1.5-4b-it model card, 2026-10-01

What it is

Released byGoogle
Released2026-01-07
Parameters4.3B
VRAM8.6 GB for the weights

What it runs on

Memory and cards for medgemma-1.5-4b-it (BF16)

8.6 GBweights, file size
762 MBruntime overhead, at least

How much memory each request adds isn't estimated yet for this architecture. The weights need at least the cards below, plus room for the context.

CardWeights alone
RTX 3060 12 GBfits
RTX 4060 Ti 16 GBfits
RTX 3090 24 GBfits
RTX 4090 24 GBfits
RTX 5090 32 GBfits
L40S 48 GBfits
A100 80 GBfits
H100 80 GBfits
RTX PRO 6000 Blackwell 96 GBfits
DGX Spark (GB10) 128 GB unifiedfits
H200 141 GBfits
B200 180 GBfits

Builds

Sizes, precisions & builds

BuildParamsPrecisionWeightsSmallest setup
medgemma-1.5-4b-it (above) ↗ 4.3BBF16 8.6 GBRTX 3060 12 GB
medgemma-1.5-4b-it-GGUF ↗
packaged by unsloth
26 builds: IQ1_S 1.2 GB … BF16 7.8 GB
—GGUF 2.5 GBRTX 3060 12 GB

From the model card

What Google says about medgemma-1.5

Read the model card

Note: This card describes MedGemma 1.5, which is only available as a 4B multimodal instruction-tuned variant. For information on MedGemma 1 variants, refer to the MedGemma 1 model card.

Model documentation: MedGemma

Resources:

MedGemma's training may make it more sensitive to the specific prompt used than Gemma 3.

When adapting MedGemma developer should consider the following:

Author: Google

Model information

This section describes the specifications and recommended use of the MedGemma model.

Description

MedGemma is a collection of Gemma 3 variants that are trained for performance on medical text and image comprehension. Developers can use MedGemma to accelerate building healthcare-based AI applications.

MedGemma 1.5 4B is an updated version of the MedGemma 1 4B model.

MedGemma 1.5 4B expands support for several new medical imaging and data processing applications, including:

  • High-dimensional medical imaging: Interpretation of three-dimensional volume representations of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI).
  • Whole-slide histopathology imaging (WSI): Simultaneous interpretation of multiple patches from a whole slide histopathology image as input.
  • Longitudinal medical imaging: Interpretation of chest X-rays in the context of prior images (e.g., comparing current versus historical scans).
  • Anatomical localization: Bounding box–based localization of anatomical features and findings in chest X-rays.
  • Medical document understanding: Extraction of structured data, such as values and units, from unstructured medical lab reports.
  • Electronic Health Record (EHR) understanding: Interpretation of text-based EHR data.

In addition to these new features, MedGemma 1.5 4B delivers improved accuracy on medical text reasoning and modest improvement on standard 2D image interpretation compared to MedGemma 1 4B.

MedGemma utilizes a SigLIP image encoder that has been specifically pre-trained on a variety of de-identified medical data, including chest X-rays, dermatology images, ophthalmology images, and histopathology slides. The LLM component is trained on a diverse set of medical data, including medical text, medical question-answer pairs, FHIR-based electronic health record data, 2D and 3D radiology images, histopathology images, ophthalmology images, dermatology images, and lab reports for document understanding.

MedGemma 1.5 4B has been evaluated on a range of clinically relevant benchmarks to illustrate its baseline performance. These evaluations are based on both open benchmark datasets and internally curated datasets. Developers are expected to fine-tune MedGemma for improved performance on their use case. Consult the Intended use section for more details.

MedGemma is optimized for medical applications that involve a text generation component. For medical image-based applications that do not involve text generation, such as data-efficient classification, zero-shot classification, or content-based or semantic image retrieval, the MedSigLIP image encoder is recommended. MedSigLIP is based on the same image encoder that powers MedGemma 1 and MedGemma 1.5.

How to use

The following are some example code snippets to help you quickly get started running the model locally on GPU.

Note: If you need to use the model at scale, we recommend creating a production version using Model Garden. Model Garden provides various deployment options and tutorial notebooks, including specialized server-side image processing options for efficiently handling large medical images: Whole Slide Digital Pathology (WSI) or volumetric scans (CT/MRI) stored in Cloud DICOM Store or Google Cloud Storage (GCS).

First, install the Transformers library. Gemma 3 is supported starting from transformers 4.50.0.

$ pip install -U transformers

Next, use either the pipeline wrapper or the transformer API directly to send a chest X-ray image and a question to the model.

Note that CT, MRI and whole-slide histopathology images require some pre-processing; see the CT and [WSI](https://github.com/

Quoted from the model card on Hugging Face. The full card is behind the Hugging Face link above.

How it works

How language models work

Your prompttext / messagesTransformerattention over tokensNext-token loopgenerate + streamResponsetext · tool callsA language model reads your tokens and predicts the next one, again and again, streaming the reply back.
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