Dr. Akshay Shetty (centre right) is an Internal Medicine Resident at the University of Calgary Dr. Won Hyung A. Ryu (centre left) is a Neurosurgery Resident at the University of Calgary
Dr Aleem Bharwani is Director for the Medical Teaching Unit, Internist, and assistant prof at the University of Calgary
For budding young physicians, it’s almost a rite of passage: you finish your residency, accrue research along the way and then enter the clinical workforce. But a small wrinkle has crept into this tried and tested formula. More than ever, physicians in training are disrupting their medical education to foster innovation and improve the field of health care through non-conventional means, but often at the expense of their own traditional careers. Classically in the field of medicine, innovation was thought of as contributing to the dialogue of research in peer reviewed journals. In contrast, entrepreneurship in health care has erroneously been characterized as ‘profits before patients’, but young physicians are beginning to show that innovation through entrepreneurship can also benefit the public. Without a natural home within the current academic health structure, it appears we are losing these maverick innovators in Canada’s very own medicine brain drain.
One such individual breaking from the usual path is Dr. Breanne Everette, a plastic surgery resident at the University of Calgary, who founded Orpyx Medical Technologies. Inspired by her encounters with patients suffering from diabetic neuropathy, she sought to develop a technology to tackle this clinical problem. With no avenue in place to pursue her idea alongside her clinical training, she was forced to pause her residency in order to enroll in an executive MBA program. This unconventional approach has landed her many achievements including last year’s ASTech Outstanding Science and Technology Start-Up award
Dr. Everette’s experience begs the question, is all innovation judged equally in the eyes of the Faculties of Medicine, or is the sole responsibility of the clinician scientist to focus on contributing to peer reviewed journals? Pausing and taking a leave from her residency removed a young, creative, and productive individual from the academy. Promising young investigators do not leave the academy when they pause residency in clinical investigator programs; must clinician entrepreneurs?
The current medical education system has failed to keep pace with the benchmark that leaders in other fields have set. The problem appears to be that we are staying stagnant by seeing physicians as only clinicians, researchers, or a mix of both. This leaves young physicians with an innovative idea at a difficult cross roads; contribute to their novel ideas that merge industry and healthcare or further their own traditional medical career. The solution to this problem may be as simple as flipping perspectives and seeing how other industries have fostered innovation. For example, UBC’s Engineers in Scrubs (EIS) program and McGill University’s Medical Physics Research Training Network (MPRTN), transplant young learners into the medical field and provide them with resources from medical technology companies to transform their ideas into reality. These programs foster close collaborations with private sectors aimed to translate innovations in the fields of engineering and medical research into clinical practice.
Then there are groups like H@ckingHealth that are stepping up to create a platform for innovation that currently doesn’t exist in our medical system. They help bring small ideas to fruition by connecting the concept with the technical know-how. With recent workshops out of Toronto, Montreal, and Calgary, these three day “Hackathons” as they are described, pair front-line clinicians with programmers, developers, and engineers to help take novel ideas into real world practice. Past examples include a triage ER app, a smart scheduling software for a physician's office, and a pharmacy program that re-sorts and fills medications. H@ackingHealth isn’t the only answer, but it serves as an important example of what an alternative medical education can look like; one that allows choice for innovation in varied fields alongside a traditional curriculum.
In an era of ever expensive health reform, it is important that we rethink our current standard of practice - how we deliver care, create experiences for our patients, run our operations, and transfer knowledge to the next generation of physicians. While it is imperative to devote oneself in the preparation of becoming a physician, this tendency to stick to the traditional path is leaving a source of wasted potential; medicine’s own brain drain. Maybe, for the next generation of young physicians, we begin to question that tried and tested formula of medical school, residency, and then clinical work. What is needed is a medical system that not only highlights various forms of innovation, but allows parallel pursuits in clinical practice at the same time. Only then, can we truly avoid the pitfalls of our current shortcomings and turn Canada’s brain drain, into medicine’s brain gain.