Calibrated and Robust Foundation Models for Vision-Language and Medical Image Tasks Under Distribution Shift

Foundation models like CLIP and SAM have advanced computer vision and medical imaging via low-shot transfer learning, aiding CADD with limited data. However, their deployment faces two key challenges. \textit{distribution shift} where pre-training and post-training data distributions differ (e.g., due to inter-center image acquisition) and \textit{confidence misalignment}, which leads to overconfident errors. These issues surface differently, vision-language models (e.g., CLIP) suffer from 2D embedding shift (image-text misalignment), while medical models (e.g., SAM) encounter 3D domain shifts (e.g., scanner variation) and voxel-wise calibration need. Existing solutions are domain-specific. We propose \textbf{StaRFM}, a fusion of Fisher information penalty (FIP) and confidence misalignment penalty (CMP) tackling both challenges. It applies FIP, extended to 3D via patch-wise regularization, to reduce embedding shift, and CMP, reformulated for voxel-level predictions, to calibrate segmentation uncertainty. We derive PAC-Bayes bounds. FIP controls generalization via the Fisher-Rao norm, and CMP reduces calibration error via Brier score minimization. StaRFM surpasses baselines by \texttt{+}3.5\% accuracy and 28\% lower ECE on 19 vision datasets (e.g., ImageNet, Office-Home), achieves +4.2\% DSC over SAM-FT and 4.8mm HD95 on medical benchmarks (e.g., BraTS, ATLAS), and reduces cross-domain gaps by up to 20\%. The framework is plug-and-play, requiring minimal architectural changes. Code and models are available at: \href{https://anonymous.4open.science/r/StaRFM-C0CD/}{\textcolor{blue}{\underline{StaRFM}}}