A case for the full-stack clinicians

How we educate our next generations of clinicians is still largely based on rote learning. This must change.

Right now, the landscape of medical innovations is fragmented: the scientists produce discoveries that take a long time to benefit bedside care; the technician may not fully understand the needs of the patient management; the business professionals could face challenges in gaining trust for their social enterprises; the clinicians find it difficult to articulate practical product design. This must change.

Many clinicians constantly get reminded about the two main career paths in medicine. The first path is to stay in the clinical route and pursue clinical excellence and the second path is to leave medicine and work as a biomedical scientist or consultant. The effort to integrate these two paths often face administrative difficulties, lengthy training years and worse “work-life balance”. This is a pity. This must change.

The idea of “full-stack clinician”1 came to my mind: someone who is skilled/knowledgeable in the very back-end of biomedical science, the media of soft and hardware technology and the very front-end of patient management - all strung by lean business development.

Perhaps, it feels like another synonym for clinician-scientist/entrepreneur/engineer, but I cannot resist the excitement of integrating multiple domains to developing a minimum viable product that ultimately push medicine forward. Unlike any of the clinician- terms above, the role of full-stack clinicians stands from the overall development cycles of medical innovations. Our future full-stack clinicians should be proficient in science and technology but not blinded by feature creep, understand the impact of capitals but look beyond profits, familiar with patient management but not accustomed to its problems.

It takes the whole medical tribe to raise full-stack clinicians. It requires a paradigm-shifting change in our medical education, pre- and post-graduation; it requires our healthcare systems to act more like technical firms that embrace innovation and most importantly, it requires a group of clinicians to step forward, take on the challenge, and build a community that brings about the change.

Yes, change will come in the long run, but how long can we wait. We can’t wait and let our fragmented healthcare system be hit by global pandemics again and again; we can’t wait and allow our healthcare data to be monopolized by unethical firms; we can’t wait and permit our patients and colleagues to endure the lack of effective innovation in our field. As Keynes put it, in the long run, we are all dead.

The change must happen within us.

Let’s bring about the change.

  1. Full-stack is originally a computer science term. “Stack” refers to the set of technical components to complete a task. Being full-stack indicates the capability of doing both back-end server-side and front-end client-side programming. I do full-stack development, too, because understanding the technology is necessary to link biomedicine and bedside care. ↩︎


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