A Road Less Traveled — My Journey From Clinical Practice To Health Technology
If you were to accuse me of enthusiasm, especially for learning, then I would plead guilty. Ever since elementary school one of my greatest pleasures has been expanding my knowledge base. Once I became an adult, this knowledge was used as a means to being more productive. The journey that I have undertaken and will describe here is not for everyone but my sharing of the experience will hopefully give some guidance to others who might consider it whether their starting point is the medical field or any other career. Many acquaintances of mine who are physicians made it clear that I would be wasting my time. After reading this posting you will hopefully have a clearer picture as to whether a similar path is appropriate for you.
After over 40 years in clinical practice as a podiatrist who has been an integral part of an informal network of primary physicians and specialists, I was looking to expand my horizons and be able to be of service in the health care field on a greater scale. Health technology is defined by the World Health Organization as the “ the application of organized knowledge and skills in the form of medicines, medical devices, vaccines, procedures and systems developed to solve a health problem and improve quality of life”. This was exactly what I was looking to transition into, but it was obvious that I would have to expand my knowledge base to include programming especially for the systems which are listed as part of the health technology definition.
The following are three questions to ask yourself before pursuing the route that I followed along with my personal experience to give you some perspective.
1. Do You Enjoy Programming?
Mark Twain wrote “Find a job you enjoy doing, and you will never have to work a day in your life.” If you are switching careers, it should be for something that you enjoy so that the effort involved and your resulting new career will not be considered burdensome. Someone once explained to me that in programming there are two piles, one consisting of what a person knows and the other consisting of what that person does not know. As a person learns new skills in programming the pile of what is known increases in size while at the same time the pile of what the person does not know also increases in size due to new innovations. This last part was the most appealing to me because it meant that the opportunity to learn new skills would never end. I spent approximately two years learning the Python language utilizing online courses from DataCamp. Any competent course provider is fine. DataCamp was appealing to me because their format is to give video lessons followed by exercises to practice with. At the completion of the two years, I was able to coordinate the building of a supervised learning model that can predict which diabetic patients are more likely to develop ulcers. Having enjoyed that experience, I was now convinced that it would be appropriate for me to advance to software engineering.
2. Are you totally committed?
The next step was to find where I could receive training as a software engineer. There are many organizations offering software engineering, data science, and cybersecurity training. Someone that I networked with recommended The Flatiron School which offered an online part time software engineering (they also offer the other two) training that would allow me to continue clinical practice while being trained as a software engineer. This is where the commitment is necessary. Part time means approximately 25 hours per week. The course entails learning from modules with technical coaches being available for chats or Zoom sessions throughout the day if there is something that needs clarification as well as two 1–2 hour lectures per week. They do have a self-paced option but that option included occasional lectures and not the regular lectures that I felt I needed. In addition, the full time and part time courses consist of cohorts giving the opportunity to interact with peers. If a person is living with a spouse or significant other, then that person must be on board as well for this to succeed. There were times that my wife just wanted to watch television with me in the evening and I was not able to because a project was due. My laptop was open in the office at almost all times and if there was any gap between patients, I would spend those few minutes working on the modules. The COVID-19 pandemic caused an approximately 20% drop in the number of patient visits and had it not been for the pandemic I would have had to cut back on the number of patient encounters in order to complete the course. It was interesting to do rounds in the hospital as the practitioner Dr. Nussbaum writing orders for patients and then not much later being the student David Nussbaum interacting at a lecture with my instructor and fellow students, all in their 20’s.
The course at The Flatiron School is rigorous. The order has since been rearranged, but we had five sections: Ruby, Sinatra, Rails, JavaScript, and React. At Flatiron the instruction is not just in the language being taught but also the development of the skills necessary to learn whatever language we would be using in our work environment. The first section included during the first two weeks what they call “The First Mile” which is basically a long list of tasks that must be accomplished. The deadline was Sunday at midnight and I finished the last part at 10:00 PM. There are no tests during the sections but at the completion of each section the student must create a project based on what was learned in that section and the project must contain certain specified elements. There is an assessment in which the student must demonstrate how the project functions, describe the code created while answering general questions about that section’s programming language, and finally live code whereby the assessor describes what changes are to be made and the student must modify the code appropriately in front of the assessor. The student must pass the assessment in order to move on to the next section. There are deadlines for passing, usually two weeks after the project due date.
During the entire course period I felt as if I was back in college. During the lectures which were all on Zoom I probably asked more questions than anyone else, basically every time something wasn’t totally clear. At first, I thought that this was irritating for everyone else, but then a fellow student who was listening to recordings of the lectures contacted me on Slack to thank me, writing that because of the answer given to my question he now understood the information. All of my fellow students could see that I am older than they are (this in no way affected my interactions with them), but very few knew of my medical background.
3. Are you ready to guide your career after completing the course?
There is tremendous pressure to keep moving forward during the course but after its completion you must be prepared to continue the motivation yourself and know where you’d like to head. A software engineer is always learning new skills and creating apps independent of employment. At this point I am learning more about algorithms and separately Node.js. My projects during the course were patient oriented (allowing a patient to store their medical history in one place, providing a site to list medication complications, among others) and corporate oriented (allowing pharmacies to track the amount of each medication in stock). I am now working on an app for physicians so they can record what occurred during an out of office phone call from the patient and then the physician can have the staff copy it into the patient’s record when it is convenient. You also must have a clear view of where your passion is. I am flexible but would love to work with a health care related company and interact with both the clients (who could be patients, physicians, pharmacies or any other users of the device or program) while at the same time be an active part of the programming team. At this point I am still treating patients until I have a company or group to work with, at which time the transition from clinical practice to health technology will be completed.
You now hopefully have insight whether or not to pursue a journey similar to mine.
Please feel free to share with me any comments that you may have at davidnnussbaum@gmail.com or at https://www.linkedin.com/in/davidnnussbaum
Thanks for reading!
