Visual Question Answering (VQA) becomes one of the most active research problems in the medical imaging domain. A well-known VQA challenge is the intrinsic diversity between the image and text modalities, and in the medical VQA task, there is another critical problem relying on the limited size of labelled image-question-answer data. In this study we propose an encoder-decoder framework that leverages the image-text joint representation learned from large-scaled medical image-caption data and adapted to the small-sized medical VQA task. The encoder embeds across the image-text dual modalities with self-attention mechanism and is independently pre-trained on the large-scaled medical image-caption dataset by multiple self-supervised learning tasks. Then the decoder is connected to the top of the encoder and fine-tuned using the small-sized medical VQA dataset. The experiment results present that our proposed method achieves better performance comparing with the baseline and SOTA methods.