Things they don’t tell you at Medical School.. but I learnt during my start-up internship

In the chill of January, summer seems a distant memory. Whilst most people were soaking up UV rays on the shores of Magaluf or backpacking across the terrains of western Europe, I spent the majority of my summer understanding the dynamics of building a successful healthcare start-up in the UK, and learning how a team of committed, intelligent individuals work everyday to create outcomes-based healthcare like nothing we have seen before.

My internship at Outcomes Based Healthcare (OBH) was a summer I would trade for no other. It completely changed my outlook on healthcare and my career prospects for the future. Most importantly though, I learnt things at OBH that no one ever tells you at medical school. No one! So I thought I would share a few of those lessons here with you:

1. Pay more attention to the workings of the healthcare system 

In training to become a doctor – with much practice, patience and perseverance – we become amazing at paying attention to the people under our care, understanding their abilities and weaknesses. Why do we not take the same diligence towards excellence in our healthcare system? I mean, let’s face it, Lewis Hamilton can’t be an excellent driver, if he’s in the driving seat of a Toyota Prius. It is the same for doctors working in the healthcare system; we, as future doctors, are currently learning to drive in a system that is breaking down right in front our eyes!

Yet, for the most part we ignore it, with the hope it will get better. Well, let me fill you in on a little secret. It is not going to get any better if you don’t do something about it. Full stop! It has gotten so bad that there are failures in the system that are so obvious we have begun to ignore them (e.g. using fax machines to share patient information).  A fax machine!

I learnt more than anything from my time at OBH, that the failures in our system can have as bad an impact on our patients as any one doctor. The data speaks for itself. It is therefore our job, as future doctors, to question structural inefficiencies and do everything that we can to fix them. If not for our own sanity, then at least for the good of our patients.

2) Understanding Data is understanding how to improve healthcare

I am convinced that in the next few years, no decision in medicine will be made without data informing much of a clinician’s everyday decisions.

Now you may not agree, but I’d like to point you to every other industry (literally every other industry other than healthcare) that this is very much currently the case. More than anything, I was astonished from my time at OBH, by the insight that could be gained from referring to the data that currently exists, to inform system based and clinical focused decisions. In identifying patterns, investigating causations and using data to test the value of innovation, I can’t see why healthcare wouldn’t move in the direction I described above. It will happen.

With this theory, I believe, we as medical students, need to build a superficial (if not technical) understanding of querying data, aggregating models and possibly even building systems that can support us alongside our practice.

My plea to you is to pick up some understanding of this world of ‘big data’, ‘machine learning’, ‘artificial intelligence’, ‘information systems’, and anything associated. Learn a bit about what this ‘coding’ business is about. Have a look at what companies like Google and Amazon are doing already. All these terms (and more!) are in no doubt going to be part of our future careers as doctors. Mark my words.

3) Use your naivety to ask questions, continuously – as in don’t stop

Upon entering the ‘club’ of medicine, you become a natural at asking ‘why?’, significantly more than those who have been members of this ‘club’ for decades. This is important to embrace.

Without the confidence to question, you begin to accept the norm. In turn, nothing is challenged. If nothing is challenged, nothing is changed. The NHS needs positive change. So, be curious. The more you do it, the less you feel silly about it, and the more likely you are to find a question to which no-one really knows the answer to. The key then is to find the answer.

5) Equip yourself with a range of skills and understanding beyond your medical degree

Medical schools exist to produce doctors who all have comparable skills, knowledge and ability. This, in many regards, is a blessing and a curse. We create fantastic doctors who enter the NHS at a relatively equal level in clinical ability, and are similar to each other in their skills and abilities beyond medicine. What I mean by this is that, it is not standard for doctors in training to build knowledge in areas such as business, system structures, health policy, supply chains, health economics, data science and so on. Yet, these are each all important subject areas that could complement your medical degree, and support you in creating the NHS we need over the next 10 years and beyond.

I learnt this from understanding how both Rupert and Nasrin at OBH have complemented their medical degrees with an MBA and computer science degree respectively. It is in my mind, without doubt, that these complementary skills and understandings haVE allowed them to co-found a successful company in healthcare with their commercial colleague, Juliana. Therefore, until things change, we medical students need to own other talents and interests related to, or even unrelated to, medicine because we need (desperately need) doctors of diverse skill and ability to solve the big problems that exist ahead of us within healthcare.

6) Finally, you’re not ‘just’ a medical student

I hear this phrase all the time. For me, it is a phrase that diminishes the potential we hold to create positive change. Medical students, in many regards, are some of the brightest, most personable and analytical people you will meet. Yet we say, “I’m ‘just’ a medical student”. We don’t fulfil our potential, because our mind-set is already limited. We could be building, creating, testing, policymaking, campaigning, researching, lobbying and more. There is a world out there that is saturated with problems and I think it is our duty as future doctors to solve them, healthcare related or not. I want to see more medical students join me in building the future. Experiment with new ideas. Test the (what might appear to be) ‘crazy’ or even mundane assumptions people have, and see what you find or what value you are able to create.

If statistics stand correct, we will all practice as a doctor for at least 30–40 years of our life. That’s the majority of your lifetime (on average). So why not spend the first 5–10 years in your career, doing something a bit different to what is ‘expected’ of you. Seriously think about it, what’s the worst that could happen?

My experience at OBH has motivated me to push the boundaries of what a medical student can do, and the value we can bring to the world, simply by engaging with the problems that exist, developing the complementary skills and acting to bring solutions into the world. As long as we are trying, there is no such thing as failure.

So that’s it, a few snippets of thoughts and insights that I gained from being at OBH. The team at OBH, has helped me to be more precise, inquisitive and entrepreneurial in my medical way of thinking. I hope this post helps in some way to pick up on some of those lessons, and open your horizons ever so slightly. A huge thank you to OBH for a fantastic 3 months. It’s been truly memorable.

*PS any medical student, doctor etc, feel free to reach out regarding this, I am very happy help if I can*