Benchmarking Speech-to-Text Models for Long-Form Medical Dialogue

Last updated: 8 April 2026 · 43 models tested · Evaluation code open-source on GitHub

Physicians lose countless hours each week to manual note-taking. At Omi, we’re building an on-device AI-Scribe that transcribes and summarises entire consultations without sending patient data to the cloud. Choosing the right speech-to-text engine is the foundation of that product — so we built the most comprehensive medical STT benchmark we could find, and we keep it current.

What’s new

We now rank models by Medical WER (M-WER) — a metric that only counts errors on clinically relevant words (drugs, conditions, symptoms, anatomy, clinical procedures). Standard WER treats “yeah” and “amoxicillin” as equally important. M-WER doesn’t — and the ranking looks very different as a result. We also report Drug M-WER separately, because misspelling a drug name is a patient safety issue, and drug names turn out to be 2–5× harder than other medical terms for almost every model.

Other highlights from recent updates:

• 43 models benchmarked, across cloud APIs (Google, OpenAI, ElevenLabs, Soniox, AssemblyAI, Deepgram, Mistral, Microsoft Azure Speech, Cohere, Groq) and local/open-source (VibeVoice, Qwen3-ASR, Parakeet, Whisper variants, NVIDIA Canary, Gemma 4, and more).

• Google Gemini 3 Pro leads the leaderboard at 2.65% M-WER.

• Microsoft VibeVoice-ASR 9B is the first open-source model to genuinely compete with Gemini-tier cloud APIs (#3, 3.16% M-WER) — and notably outperforms Microsoft’s own new closed MAI-Transcribe-1 in Azure Speech by a wide margin on drug-name accuracy.

• Qwen3-ASR 1.7B is the best small open-source model — 4.40% M-WER at ~7 seconds per file on an A10 GPU. The strongest accuracy-to-cost ratio for a local deployment.

• Custom text normalizer replacing Whisper’s default, after we discovered two bugs in it that were quietly inflating WER by 2–3% across every model in the industry. Open-source and drop-in.

• Full evaluation code is open-source on GitHub. Reproduce our results, run your own models, or contribute improvements.

Full Top 15 below, and the complete 43-model leaderboard (with per-category breakdowns and per-file metrics) is in the GitHub repo.

Dataset — PriMock57

• 57 simulated GP consultations (5–10 minutes each), recorded by seven Babylon Health doctors with role-play patients. 55 files used after removing two that triggered catastrophic hallucinations on multiple models.

• ~80,500 words of British English medical dialogue.

• Reference transcripts cleaned to plain text for fair WER calculation.

• Public repo: babylonhealth/primock57

Evaluation framework

Every model is run through the same pipeline: transcribe the audio, log processing time, normalise the output with our custom text normalizer, and compute WER, M-WER, Drug M-WER, and per-file statistics. Models that crash on long audio get chunking with overlap (typically 30s chunks with 10s overlap and LCS merging). We run on a mix of Apple Silicon (M4 Max), NVIDIA GPUs (T4, L4, A10, H100), and cloud APIs directly. No quantisation on local models unless explicitly noted — we benchmark full precision for fairness.

Top 15 — ranked by Medical WER

Full 43-model leaderboard, per-category breakdowns, and per-file metrics: GitHub.

Key takeaways for choosing a medical STT engine

If you want the best accuracy and can use a cloud API: Google Gemini 3 Pro or 2.5 Pro. Both sit below 3% M-WER and handle long-form conversation natively.

If you want strong accuracy but don’t want to rely on Google: Soniox, AssemblyAI Universal-3 Pro (with medical-v1 domain), or Deepgram Nova-3 Medical. All three are genuinely competitive with Gemini-tier on M-WER, and Deepgram is the fastest cloud API on the board at 13s/file.

If you want the best open-source model, accuracy-first: Microsoft VibeVoice-ASR 9B. First open-source model to compete with Gemini on medical audio. Requires ~18GB VRAM (L4/A10 is enough; won’t fit on T4) and is slow — 97s/file even on H100 — because it’s a 9B LLM processing audio as tokens rather than a purpose-built speech model.

If you want the best open-source model, cost/speed-balanced: Qwen3-ASR 1.7B. ~14× faster than VibeVoice for only ~1.3 points more M-WER. Requires compute capability ≥ 8.0 (A10 or better; not T4).

If you’re deploying on-device for Apple Silicon: Parakeet TDT models are the fastest option, but be aware their Drug M-WER is weak — 22% for the 0.6B v3 — which may not be acceptable in a clinical context.

What to avoid for medical transcription: Google MedASR (despite being medical-specific, it’s built for single-speaker dictation, not conversations — 49.66% M-WER), Facebook MMS-1B-all (multilingual phonetic vocab, 54% M-WER), and current quantised versions of VibeVoice (aggressive quantisation kills drug-name accuracy).

Limitations & what’s next

• UK English only — the PriMock57 dataset is British English. We’ll extend to multi-language datasets in future updates.

• WER ≠ clinical usefulness — M-WER is a meaningful step toward clinical relevance, but human-graded clinical correctness is the next frontier for this benchmark.

• API cost unmeasured — a future update will include $/hour and latency SLO metrics for the cloud APIs.

• Medical vocabulary is extensible — our 179-term list is a starting point; contributions welcome via the repo.

The full evaluation code, every model’s transcripts, and all per-file metrics are open-source on GitHub — reproduce our results, benchmark your own model, or contribute improvements.