MedEvoEval: Evaluating Continual Evolution of Doctor Agents through Simulated Clinical Episodes

Abstract

Doctor agents are moving beyond single-turn answer generation toward evolving clinical decision systems. Within an outpatient episode, they acquire evidence, use examination and consultation resources, and decide when to finalize a diagnosis and management plan. Across episodes, their behavior may change through memory, retrieval, reflection, or other update mechanisms. Current evaluations only partially cover this setting. Fixed-input medical QA benchmarks score final answers from complete inputs, whereas many interactive benchmarks still focus on individual encounters or fixed runs, providing limited support for evaluating how episode-level decisions interact with cross-episode experience. We introduce MedEvoEval, an executable longitudinal evaluation framework based on action-gated simulated outpatient episodes. Each source case is converted into role-specific patient, examination, and manager views; evidence is revealed only through valid actions; and each episode records a structured trace that links observations, actions, final outputs, manager scores, and optional experience write-back. We release a runnable E&D artifact with 700 processed episodes, provenance notes, schemas, an episode runner, scoring scripts, configurations, example logs, analysis code, and trajectory- and step-level derivatives. Experiments show that episode traces expose process costs hidden by final-answer scoring, show how MDT-style consultation reallocates resources, and support longitudinal analyses of memory maturation, held-out transfer, update-stage response, and backward retention. Together, these results show that MedEvoEval provides a concrete basis for evaluating whether doctor agents improve through experience, transfer useful behavior, and retain earlier capabilities over time.