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Generating Multiple-choice Questions for Medical Question Answering with Distractors and Cue-masking

Medical multiple-choice question answering (MCQA) is a challenging evaluation for medical natural language processing and a helpful task in itself. Medical questions may describe patient symptoms and ask for the correct diagnosis, which requires domain knowledge and complex reasoning. Standard language modeling pretraining alone is not sufficient to achieve the best results with BERT-base size (Devlin et al., 2019) encoders. Jin et al. (2020) showed that focusing masked language modeling on disease name prediction when using medical encyclopedic paragraphs as input leads to considerable MCQA accuracy improvement. In this work, we show that (1) fine-tuning on generated MCQA dataset outperforms the masked language modeling based objective and (2) correctly masking the cues to the answers is critical for good performance. We release new pretraining datasets and achieve state-of-the-art results on 4 MCQA datasets, notably +5.7% with base-size model on MedQA-USMLE.