Large language models (LLMs), such as GPT series models, have received substantial attention due to their impressive capabilities for generating and understanding human-level language. More recently, LLMs have emerged as an innovative and powerful adjunct in the medical field, transforming traditional practices and heralding a new era of enhanced healthcare services. This survey provides a comprehensive overview of Medical Large Language Models (Med-LLMs), outlining their evolution from general to the medical-specific domain (i.e, Technology and Application), as well as their transformative impact on healthcare (e.g., Trustworthiness and Safety). Concretely, starting from the fundamental history and technology of LLMs, we first delve into the progressive adaptation and refinements of general LLM models in the medical domain, especially emphasizing the advanced algorithms that boost the LLMs' performance in handling complicated medical environments, including clinical reasoning, knowledge graph, retrieval-augmented generation, human alignment, and multi-modal learning. Secondly, we explore the extensive applications of Med-LLMs across domains such as clinical decision support, report generation, and medical education, illustrating their potential to streamline healthcare services and augment patient outcomes. Finally, recognizing the imperative and responsible innovation, we discuss the challenges of ensuring fairness, accountability, privacy, and robustness in Med-LLMs applications. Finally, we conduct a concise discussion for anticipating possible future trajectories of Med-LLMs, identifying avenues for the prudent expansion of Med-LLMs. By consolidating above-mentioned insights, this review seeks to provide a comprehensive investigation of the potential strengths and limitations of Med-LLMs for professionals and researchers, ensuring a responsible landscape in the healthcare setting.

综述医疗大型自然语言模型（Med-LLM）的进化历史、技术、应用以及对医疗保健的影响，涵盖临床决策支持、报告生成、医学教育等方面，探索其潜力和限制，并讨论公平性、责任感、隐私保护和鲁棒性等挑战，展望未来的发展方向。

医学领域的大型语言模型综述：技术、应用、可信度与未来发展方向