arXiv:2610.35842v1 Announce Type: new Abstract: Multimodal medical AI requires a common visual interface for encoding heterogeneous imaging evidence for patient condition modeling. However, existing medical visual tokenizers are often tied to a specific dimension and imaging modality, forcing multimodal systems to rely on fragmented and poorly reusable representations. We introduce MedVTok, a general-purpose visual tokenizer that maps 2D images and 3D volumes from diverse imaging modalities into a unified token space. Building such a tokenizer poses two key challenges: preserving anatomical structure across dimensions and capturing clinical semantics across modalities. To this end, MedVTok introduces (i) slice differential regularization, which explicitly models inter-slice anatomical coherence missing in previous per-pixel/per-voxel supervision, and (ii) multi-expert representation alignment, which integrates knowledge from multiple medical expert encoders while retaining modality-specific complementary knowledge. Trained on 28M images and 70K volumes across 9 imaging modalities, MedVTok supports classification, retrieval, segmentation, synthesis, visual question answering, and medical report generation through a single tokenizer. Across 24 benchmarks, MedVTok achieves state-of-the-art performance, demonstrating a scalable token interface that unifies medical image dimension, modality, and task usage.