Clinicians of the future will not only need to practice medicine, but also play a role in improving the practice of medicine. As a graduate-entry medical school, Duke-NUS trains clinicians who come to medical school with a foundation in an undergraduate discipline such as engineering and social sciences. This adds valuable diversity into medical practice in Singapore, and introduces fresh perspectives on overcoming challenges in healthcare.
Third year Duke-NUS medical student, Anthony Li, is one example of a future clinician who is constantly exploring innovation in medicine and medical education. Apart from being the current head of the MedTECH Student Interest Group at Duke-NUS Medical School, he also explores app development in his spare time and has created an online app that allows his peers to post and share their reflections during their clerkships year. We interview him to learn more.
You studied Electrical Engineering in university. What led you to pursue Medicine?
I graduated from NUS Electrical Engineering in 2013. After working at A*STAR and MOE for 2 years in grant administration and software engineering roles, I decided to pursue my ambition of becoming a doctor.
Admittedly, Medicine was not a childhood dream career. I had been fortunate to work as a combat paramedic beside doctors and nurses during my time in National Service, all of whom showed me the satisfaction of caring for the injured and sick. Although I was inspired at the time, I felt it was too late for me to switch courses. I had always excelled in physics and mathematics, and knew I would do well in engineering, so I went ahead with my selected university course in Electrical Engineering.
During my undergraduate studies, I developed a strong passion for technology and the computer sciences. In my free time, I would develop mobile and web applications. At the same time, I also volunteered with Singapore Red Cross Society as a first aider as a means to continue my interest in emergency medicine and national disaster management. On the academic front, I was fortunate to work with scientists and clinicians on a number of medical technologies-related projects, including (1) Prostate Specific Antigen test kit development, (2) Clinical Vignettes web platform, and (3) Automatic segmentation of Prostate cancer tissue from MRI. This sustained exposure to medicine and medical technologies got me thinking about the possibility of pursuing a career as a clinician innovator. Hence, after gaining some work experience in administration and software engineering, I decided the time was ripe for to make the leap and I applied to Duke-NUS Medical School.
Were you always interested in medical technology?
Truth be told, I wasn’t always interested in technology. I had a very narrow focus on physics and mathematics in my early schooling years. I even failed some of my first few programming tests in university. That was one of the fastest ways to kill interest in an impatient youth who was only concerned with easy successes. After one of those days that I failed a programming test, I told my university teaching assistant that I would never write another piece of software again! My friends encouraged me to persevere and I learnt the importance of grit. Motivating myself with the end goals of engineering, particularly with medical technologies, I was able to convince myself to explore more and I have never stopped since.
You currently head the Duke-NUS MedTECH SIG.
What is the MedTECH SIG all about? The MedTECH SIG is about gathering students with an interest in Medical Technologies and enabling their interest. We want to keep the definition of Medical Technologies (MedTech) broad. It ranges from development of prosthetic arms for the disabled to tissue engineering to medical mobile applications.
We also aim to achieve diverse student membership. We do not want to just attract students with an engineering or technological background. We want to attract future clinicians from all sorts of background who are keen to innovate, break the paradigm and leverage on technology to deliver better patient outcomes. Thankfully, at Duke-NUS Medical School, we are endowed with a lot of diversity and energy in our student community, which is pretty much the driving force behind the SIG.
What are some of the more memorable activities that your SIG has organized or been involved in?
The most memorable activity so far was definitely the Singhealth Hackathon. Our student population participated enthusiastically in the event. Over the course of 2 weekend days, healthcare professionals and students gathered to think about solutions for our clinical work and healthcare system. Admittedly, we did not have enough technical expertise to enable all the solutions we brainstormed about. However, the opportunity to meet individuals from diverse backgrounds within the Singhealth cluster, who are stoked about medicine and technology, was a priceless one.
What do you enjoy about the MedTECH field?
The things I enjoy most are the people and the possibilities.
Why people? MedTech, like medicine, is a teamwork sport. We require a multidisciplinary field to develop the solution and translate the solution into clinical application. From problem statement to designing to prototyping to engineering to clinical trial, it is a very involved process. One can imagine that anyone in healthcare can be involved: podiatrists, nurses, radiological technicians, patient care assistants, patients, doctors, etc.
Why possibilities? This is a very exciting age for technology. With the advent of artificial intelligence, additive manufacturing (aka 3D printing), breakthroughs in DNA engineering and many other adjacent technologies, the future of medicine looks extremely promising for our patients.
We hear that you also developed an app for your peers in the Longitudinal Integrated Clerkships programme, would you tell us a bit more about that?
I have been actively developing mobile web applications since year 1 of medical school in keeping with my goals of medical school. I got the idea of developing an app for my peers in the Longitudinal Integrated Clerkship programme because I wanted to provide my peers with an effective and efficient means to do their reflections in the clinical environment.
To be honest, many of us were initially unconvinced that reflections were necessary for clinical practice. The business of our schedules and the amount of administrative work to be done were not helpful in changing our perception. However, several incidents changed our perspectives. That created the spark for me to begin design and development. My peers and our program director, Dr Shiva, were instrumental in the process. The end result was http://reflective.me. It is a mobile friendly web application. I am still developing it and I am hoping to reach out to the larger medical population on the importance of reflective practice.
Another application my colleague, Tan Chin Yee, and I are currently working on focuses on improving approaches to diseases, history taking and physical examination skills and basic clinical management principles amongst medical students. The objective is to create a patient bot that can interact and teach the learner these skills. This is the culmination of trying to solve some of the problems my peers and I faced during the process of learning medicine. More often than not, the aforementioned clinical skills are best learnt with an actual patient with the pathology of interest. However, these encounters are often opportunistic as patients might not give consent and it is not reasonable to expect patients with a certain type of disease to be constantly in the wards for a student to learn from. Hence, standardized patients and clinician educators’ verbal patient simulations are often used for this purpose. With this bot, we hope to ease the process of learning and lower the barrier to learning clinical medicine.
What kind of clinician do you envision yourself as in the future?
When I served in the military as a combat medic, I was taught the concept that “I am a soldier first, medic second”. If I complete medical school, I would argue, “I am a clinician first, engineer/innovator second”. It should always be the duty of the doctor to ensure that his patients get the best possible care. That will mean honing robust clinical skills, establishing excellent doctor-patient relationship through empathy and compassion, and increasing the depth of medical knowledge.
Only when our patients’ best interests are catered for, can we then consider pushing the boundaries of innovation for even better patient outcomes. Traditionally, this is done through medical research and clinical studies. In the not so distant future, I hope my background can enable me to add value through alternative means: device development and software engineering. Key talent and infrastructure will be required for secure, safe and beneficial usage of technology in medicine. New paradigms might need to be established and I hope to part of a team that enables this future one small step at a time. That is the kind of clinician I aspire to be.
Want to know more? Contact Anthony at Anthony_li@u.duke.nus.edu or llja0112@gmail.com