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Med School Minutes
Med School Minutes is where we discuss all things related to medical education. Provided by Saint James School of Medicine, this podcast tries to educate students on selecting and successfully completing a medical school. Our topics are fun and educational, and our hosts are knowledgeable and fun.
Med School Minutes
Med School Minutes-Ep. 56 | From Film School to Neurosurgery w/ Dr. Colin Son
🎬 From film school dreams to the operating room reality, Dr. Colin Son’s journey is anything but ordinary. In this episode of Med School Minutes, he shares how he went from aspiring screenwriter to board-certified neurosurgeon, and how his creative background now shapes his work at the intersection of medicine, AI, and entrepreneurship.
💡 Tune in to learn:
- How nontraditional paths can strengthen a medical school application
- Why AI is transforming healthcare without replacing doctors
- How storytelling skills translate into better patient care
🎧 Watch now and see how following curiosity, not convention, can lead to extraordinary careers in medicine.
#SaintJamesSchoolOfMedicine #SJSM #MedSchoolMinutes #AIinMedicine #Neurosurgery #FutureofMedicine #MedicalInnovation #HealthcareAI #MedicalEducation #DoctorsandAI #NontraditionalPath #MedicinePodcast
Hello, and welcome to another episode of the Med School Minutes Podcast, where we discuss what it takes to attend and successfully complete a medical program. This show is brought to you by St. James School of Medicine. Here is your host, Kashik Gua.
SPEAKER_03:Welcome to another episode of Med School Minutes where we talk about everything MD related with a focus on international students, specifically students from the Caribbean. My name is Koshik Guha, and today we're joined by a unique guest, Dr. Colin Sun. He's trained as a neurosurgeon certified by the American Board of Neurological Surgery, specializing in minimally invasive brain and spine care. But Dr. Sun didn't stop at surgery. He's now moving into entrepreneurship, applying artificial intelligence to transform patient access to physicians. In this conversation, we'll dig into his transition from medicine to business, explore what real-world AI means in the neurospace today, the challenges he's facing, and his vision for where things go next. Let's turn to Dr. Sun now. Thank you so much for your time, Dr. Sun. Really appreciate uh you making time to come on our podcast. Uh, why don't we start by you giving us a little bit about your background and uh your journey in the field of medicine?
SPEAKER_01:Yeah, that thank you for having me. Um I really, really appreciate it and uh appreciate what y'all y'all are doing with this podcast in terms of you know, uh, you know, I'm sure it's a marketing tool, but it's also seems super educational for medical students and and especially pre-med. Uh so my name's Colin. I am a neurosurgeon. I'm up in Texas. Uh I uh uh am also an entrepreneur, so I've gone part-time clinical. I've totally jumped on uh kind of the AI hype train and how I think it's gonna, you know, really, really change uh how we train physicians, how we educate medical students, how we access care, how we pay for care, how we regulate care. Um uh and so I have uh a company trying to get off the ground in that space. Um, but still practicing neurosurgery part-time. Uh I came to neurosurgery very circuitously. I went to film school. Okay out in out in California and tried to be a screenwriter, and uh uh it quickly became clear uh maybe uh maybe some of those things like selling myself or or maybe even my talent as a writer were were gonna leave me waiting tables. Um and so I started, I was like, well, I'm pretty good at school.
unknown:Right.
SPEAKER_01:Maybe I'll do something, uh go back to professional school and and looked into um, you know, uh business school and law school, applied to both, applied uh to medical school uh for the same reasons. And while I was doing all that, I shadowed a neurosurgeon and uh had never been in the OR before, uh, didn't really watch a lot of ER as a kid. Um, but uh that was I was like, oh my goodness, this is um this is really impressive. So I came into medical school pretty much knowing I wanted to be a surgeon. It was the whole reason I was there, and uh led led to this.
SPEAKER_03:Wow. So I I do want to focus a little bit on on about this uh uh film writing uh aspect. That is so interesting. Um and and and one of the reasons I do want to focus on that is because this would be truly inspirational. Because um what I hear, especially in the United States for more mainstream medical schools, uh, is that if you have uh if you vacillated on your career, that is typically not the ideal candidate for a lot of US medical schools. Um however, it seems like you have obviously turned that around and you were in LA at some point, waiting tables, trying to get into Hollywood. But then in my opinion, I would think that neurosurgery is probably should have been a much different difficult path than trying to get break into Hollywood. But you obviously chose the harder path. But I do want to focus on a little uh hear a little bit more about that. Can you tell us a little bit more about the how you you went from film writing or script writing to um uh neurosurgery?
SPEAKER_01:Yeah, so um so I I went to film school. Um and uh and it was uh it was a four-year program. I was I was already getting my bachelor's, um, but I was not looking at medical school. I was not pre-med. Right. In my junior year, I was like, oh my goodness, um uh this is uh this is not, you know, I'm not not sure uh trying to do this long term is for me. And so like I said, I started looking into all these schools. When I when I started doing that, um, you know, the second semester of my junior year, I actually took a biology class, which counted as a prereq just in case. I was also like, you know, I took like a pre-law class, like my electives were uh, and then um when I decided that year, I I really wanted to try for medical school. Um I did uh I did summer work at a local community college, um, which allowed me to get a lot of credits and then uh more more kind of prereqs work. Um, you know, I I hear what you're saying that it is so competitive nowadays, uh everywhere, and that uh you know I think I definitely had some knocks against me doing doing some of my prereqs hurriedly, like at community college. Um, but uh I also you know, maybe it was just the way I kind of went into the process, but I also kind of viewed it as um, you know, this kind of atypical path as uh as a real selling point, honestly. I don't remember getting a lot of questions like in interviews, like uh, you know, people want to know, you know, as they always do, why you want to be a physician. But I uh I really, you know, when I went into these interviews or even my personal statement, um I really kind of pitched it as uh as like a unique path, right? Uh this is part of the reason I'm sure about medicine. These are the experiences I had uh before deciding on medical school. This is how I think my creative side um makes me more empathetic uh and uh and ideal for dealing with patients. And so um, you know, I I think I have lots of friends who took very non-traditional paths, you know, time off, uh worked, uh had careers before before medicine. And I I think sometimes when you're applying to medical school, that can be, you know, when you're selling yourself, that can be a real benefit.
SPEAKER_03:Okay, well, I mean, uh that's really interesting. So it almost sounds like spending and and the film school was, I'm assuming, full four years.
SPEAKER_01:It was, yeah.
SPEAKER_03:Yeah. So film school gave you the tools to write a strong story that strengthened your application. It probably did. Yeah. Because I I will say, I mean, uh, I've I've spoken to I speak and interact with a lot of physicians, and obviously the physicians who make it to upper management are very, very strong people persons. Um, uh, I think without that they can't really get to business side. Yeah. Yeah. Um however, also I will caveat this by saying people who are hospitalists aren't necessarily the most uh people oriented, uh generally speaking. I mean, and I don't mean any disrespect, I just think that uh it's just not a skill that uh is absolutely essential to be a good physician. So it's compared to other professions, I would say that that tends to be a little more uh rudimentary for most physicians. But it it sounds like um your experience in film school really bridged that gap and made you a better, more holistic uh candidate. Would you agree or disagree to that?
SPEAKER_01:I think I think I did. Um I am uh uh I'm a pretty introverted, kind of nerdy, uh you know, not I mean I've gotten better over time, but like uh if I had if I had been going into medical school interviews, having been a pre-med, having been only around pre-meds, just with my social skills uh coming out of high school, I bet I would have been a worse applicant than having gone through this uh the field school and um yeah. Okay.
SPEAKER_03:So uh going back to today, where as you mentioned, it's incredibly competitive. Um medical school, generally speaking, is incredibly competitive. Um and I feel like a lot of the medical schools generally really focus on reasons to reject students. And if you don't have a more traditional pathway, from what I've seen, at least nowadays, it seems a harder task. You don't necessarily see people nowadays saying, I went to film school, or as you said, you had friends. Um and and I feel like this might have been a paradigm shift sometime in the mid-2000s. Um and do you think that today the programs are probably doing a disservice by looking at somebody who's done pre-med, then they want to go to medical school, and then they're looking for residents, uh, especially in the uh uh very elite specialties like neurosurgery, orthopedic surgery, ENT, etc. etc. Uh, what are your thoughts on that?
SPEAKER_01:Yeah, I can imagine that really being the case. Um uh you know, for people who are non-traditional, um you know, the path I kind of took and probably would be my advice uh is to really lean into it. Um I d I you don't need to be defensive about it, but I I think these non-traditional paths can certainly uh make people better physicians. And if you're able to articulate that argument like in your interviews, like in your personal statements, like when you ask for letters of recommendation, like discussing that with your you know, uh with your mentors. Um you know, I I I don't think these are things that should be you should have I I agree that sometimes it probably feels like you have to, but uh that you should try to excuse. Um, and I I think they can be a strength, really.
SPEAKER_03:Okay. Wow. So, you know, this is something we tell our students all the time. Everything in this world is determined by storytelling. And how do you formulate your story, your life? And it sounds like you're really saying the same thing that it it all depends on how you present the things. Um I I have to ask one more question about your background. You did say you looked at uh MBA and law, but you chose not to do that. You chose to go to neurosurgery. Uh what made you go to medical school over MBA or law?
SPEAKER_01:Oh, that's shadowing experience. It was a single time in the in the OR. So I had taken the LSAT, uh, I'd taken GMAT. I I had applied along with medical school to a bunch of a bunch of those programs. And um I went out and you know, in terms of strength, you know, knowing what I wanted to do and of course strengthening my application, uh, went looking for actual shadowing opportunities. And the one I came across um here in town through a family friend, happened to be a neurosurgeon. And uh, you know, most of neurosurgery uh is is spine surgery, especially in private practice. But this turned out to be a brain tumor case. And I was like, this is amazing, holy moly. And uh, and so uh yeah, that that singular shadowing experience while I was deciding, yeah, totally totally.
SPEAKER_03:So it almost sounds so it almost sounds like it was the aha moment when you were there. Definitely what I want to do.
SPEAKER_01:Yep. I went into I went into applying just being like, I am good at school. Yeah, uh, I was very good in high school. I don't know what I want to do. It seems safe to stay in school. Like I went into it very scared. Uh, and it was, you know, me applying to all these schools was very much just driven kind of by fear. Like, I I am not gonna make it in Hollywood. Uh, I have to do something else. School seems safe, but after that aha moment, I was like all in on medicine. It it totally changed my perspective, yeah.
SPEAKER_03:Right. I and I can I can definitely assert that uh you don't necessarily become a neurosurgeon by fluke. There has to be some focus there. But um, you know, I mean, uh can we switching gears? Do you said that you actually are an entrepreneur now? Can you tell us a little bit about your business?
SPEAKER_01:Yeah, so this is my first company. It's a startup. So from scratch, uh, it is a tech company, and I'm not in Silicon Valley. So we'll see how this works out. But um, like I said, I I have maybe I've been one-shotted, but um, but I'm all in on the AI hype. Okay. I really think it is uh gonna be transformational for healthcare. It's as big as the internet, it's gonna be as big as mobile phones, it's uh I think really, really gonna alter society over the next few decades. And so um uh my company is uh is a telehealth platform. There are a million of those, but it's AI native. So connect your connect your medical records, right? Patients can connect their medical records, have that as context for AI, just for informational conversations. Hey, what does this mean? What were my last labs? But when you need a physician, get connected seamlessly, basically in chat. Um so I'm very much like focused on kind of urgent care, uh simple primary care. When we get off, we're in beta right now. Um but this is this is my first uh my first entrepreneurial steps. And I know you have a lot of experience, but it's uh it's it's different. Even though I was in private practice as a neurosurgeon, so basically kind of a small business owner for for a while with partners. Uh this is this is definitely some different skills, skill sets.
SPEAKER_03:Yeah, right, right. Um, so you mentioned that you think that AI will be transformative. Obviously, the jury is out on that one. Nobody really knows. Uh, I mean, everybody has the same feeling, but there seems to be a lot more apprehension than there there is adoption and uh people embracing this as a new technology. So, as an example, I'll tell you a lot of my uh our students come in saying that, oh my god, you know, we're gonna be out of a job. Uh AI is gonna take, you know, like everybody seems to pinpoint on radiology specifically, that oh, AI is gonna do so much uh better than radiologists. And, you know, I've spoken to Dr. uh Patel, who's the CMO of uh uh Prime Health. Uh we've spoken to uh the president of the uh University of North Florida, and their view is pretty diametrically opposite. That they're saying that AI is actually going to supplement and make physicians better. What's your view?
SPEAKER_01:I think it's gonna be a mix, but um but I think clearly, right, this kind of fear-mongering about job losses and things, at least in the in the short term, has has been doomerism. There was a there was a recent great article um looking, you know, uh some very famous people uh in the AI field, obviously famously, you know, five plus years ago were like, oh, radiology is right for the pickings. It is true that most uh AI software as a medical device that have been approved by the FDA are AI uh radiology tools. But um this great article, it's like two weeks old, but looking at the average radiologist's you know compensation, uh, which is outstripped the average physician compensation. Right. Like it doesn't it uh AI right now is not taking radiology jobs. Um and I I think uh you know there's a there's a lot that radiologists do just besides just looking at images beyond just the the technical aspects of hey, out of the lab, how do these radiology models perform? And obviously, you know, an LLM can't consult, you know, with another physician, it can't perform procedures, it can't so I um you know I would never I would not be telling people who are considering medical school, hey, don't because AI is is gonna take physician jobs in 10 years. I I just don't think that's the case.
SPEAKER_03:Right. Um and and I think uh, you know, we've spoken to some uh leaders of some large hospital systems, and uh, they've always obviously echoed the same thing that radiologists tend to make a lot more money. Uh however, their feeling was that they're not gonna hire less radiologists.
SPEAKER_01:Yeah, I agree.
SPEAKER_03:Their expectation is that they're expecting the radiologists to do more. Um, a case in point, uh uh this is a little uh deviated from uh what uh medicine, but uh I have a friend who works at uh one of the largest uh truck manufacturers in the world. And they are in the cutting edge of technology as well, where they're developing AI trucks, et cetera, et cetera. So I asked him, does this mean that truck drivers are going to become obsolete? And he said that, well, we'll need less truck drivers, but what this also means is that if you are a truck driver, you just cannot really drive a truck. You have to have a more broad-based skill where you have to do a little bit of coding because if we are doing uh truck caravans that are AI powered with the first, second, third trucks all AI driven following the first truck. If something goes wrong, and it does always, the person driving the per uh in the first cab has to be able to service this. So just having a CDL is just not going to be good enough in down the road. Um and and I think you know, when I spoke to these uh hospital system leaders, a lot of them have suggested the same thing that radiologists will be there's not going to be any cut in compensation, they're not expecting to hire less, but they are expecting in due course of time radiologists to be able to do more. Um would you what are your thoughts on that? I and and we've seen that in Google and some of these IT software companies too, where they're expecting the production to triple quadruple per software engineer.
SPEAKER_01:Yeah. Well, we'll see, even as even as AI writes what you know, whatever these these tech companies claim 90% of of code, right? But um yeah, I I will tell you that that is that is probably my more realistic fear. Um that uh you know what you know, as you have these clinical decision support tools or these computer assisted assisted diagnosing tools that like radiologists can use, what it what's that gonna do for insurance reimbursement and um the expectation on like the radiologist work workflow and work workload, right? Like, oh the the computer's doing some of this for you, read three times as many films, right? Um so uh we'll s yeah, that that might be how this plays out. Um I do think that uh as these tools proliferate, just having a basic understanding of them, AI in general, um is is gonna be important for physicians. Okay.
SPEAKER_03:Uh so uh in your specific field, uh surgery and neurosurgery more specifically, do you think AI has impacted your field directly yet?
SPEAKER_01:I do. I'll give you I'll give you a core example. So I I even have a little, I'm even more subspecialized in neurosurgery. I I do mostly neurovascular stuff, so blood vessel diseases. Um and so big strokes, like thrombectomies, brain aneurysms, things like that. And this is very, very niche, but I'll give an example where AI has mattered a lot to my patients. So I take a a lot of stroke call. Um in stroke call over the past 10 years, uh for large vessel occlusions, so when a big blood vessel gets blocked to the brain and is causing a stroke, there's been this paradigm shift where we know that much like when people have a heart attack and the cardiologists go in and reopen the vessel, that reopening these large vessels emergently can uh prevent people from having a stroke or keep their stroke small. And so that uh that is a very emergent thing. So people will come into the ER with a stroke, they will get these this imaging, a head CT, a CT angiogram that looks at the blood vessels of the brain, and they get that um pretty much a standard of care urgently. And if you see a blocked blood vessel, right, you have to activate the team, activate me, get them over to the angiosuite to get the blood vessel open. And there have been a proliferation of tools, even though radiologists uh are obviously very good at detecting these blocked blood vessels. These um these apps can do that in 15 seconds, right? What used to maybe take 10 to 15 minutes of kind of radiology workflow. Oh, the images get pushed over to a radiologist, the radiologist looks at it, the radiologist calls the ER doc, the ER doc calls me. Now uh you get the scan and the AI like pings immediately. There's a blocked blood vessel, and it just shows up on your phone. And and even those 15 or 20 minutes, right? We know from the literature uh can affect outcomes in terms of the chance of people doing well. So that's one place that I use weekly that AI has really made a difference. There's no doubt.
SPEAKER_03:Oh wow. And um has AI reduced the workflow though for you? Do you think so?
SPEAKER_01:I think I think it's in that very, very niche example, yes, it has made us more efficient. There's no doubt. I use a lot of other AI tools, so other popular ones, right? Um clinical decision support tools like open evidence, right? Oh, this is, you know, put in, you know, ask questions rather than going just to PubMed and searching. Uh I do use an AI scribe. It's kind of plus or minus, right? These are tools that listen to your conversations in clinic with patients and then spit out a note for you. Um, I think that's a little bit helpful. But I I would say that um that that probably that stroke example has been the most meaningful in terms of for my patients.
SPEAKER_03:Awesome. Um, so one thing I do want to touch upon and switching gears to like more um uh less, you know, like internal medicine and family medicine. One thing I get a lot of questions from from students is that um, you know, a lot of patients are using uh ChatGPT to really diagnose initial problems that aren't major medical emergencies. That, oh, I have a skin spot, this is the situation, they take pictures, chat GPT gives a bunch of diagnoses, uh, et cetera, et cetera, which has made a lot of um students who want to do family medicine or internal medicine really nervous about uh their professions. What are your thoughts on that?
SPEAKER_01:Yeah, I th I think that's uh an increasing use case. It's even kind of it's even kind of the principle that that I'm building a company around, right? Um, but I don't think we are near uh automating away physician knowledge work. Um uh and so I I do if I was gonna go into a mostly knowledge-based field, uh even you know, primary care or a medical subspecialty. I I think uh the future is bright. Um even with AI. Uh I don't think uh these tools are, even though they're changing rapidly, who knows what it looks like in five years, but I don't think they're they're there in terms of uh safety. Um I think there are gonna be huge non-technical things to replacing physicians: societal trust, reimbursement, liability. I do think these tools, you know, 10 years from now might how we practice medicine look a little bit different. Um AI is triage or things like that. Uh yeah, of course. But uh I think there is a long future for primary care, uh, even with AI.
SPEAKER_03:Okay. And um so so obviously we've talked a lot about what AI can do. Um but I I think that there are some downsides, and I'd like to talk about that. What you feel like the downsides of AI is. One thing that I have seen is that the proliferate and as this is not just AI, I think it's just generally information. The proliferation of information um is good and bad. We we can see some of the uh bad consequences of democratization of information in society. But one thing I have noticed is that there seems to be a lot more pushback from the patient side in the sense that a patient will go in and they have some sort of a diagnosis in their mind that Chat GPT told them. And the the the physician will come and tell them that no, I don't think this is what is it, what it is. Uh this is probably more likely, and the patient comes like, oh yeah, the physician doesn't know anything. Uh I trust ChatGPT. And I think that that is an incredibly dangerous aspect, and I and I dub it as uh the age of expertise is over to a certain extent, because now people think that I could type in a prompt in ChatGPT and get all the information I need, or I can watch a uh five-minute YouTube video that ChatGPT pulls out for me, and I'm just as good as um uh any physician or any other specialty profession. Uh, what are your what so I think I feel like that's a pretty big downside. Um, I don't know if you've experienced that and what your views on um that is.
SPEAKER_01:Yeah, I to be honest, even when I heard you talking, I was about to about to say we've even before you use the term, we've we've entered the age of of anti expertise, right? Yeah. Um I I don't I don't think that's uh You know, I I think uh that a little bit uh predates uh AI. Um I mean, not to get into politics right, but you're you see, you know, RFK yesterday basically saying, hey, we don't we uh we shouldn't trust experts, that's not science. Um and so I do think there's uh there's I do think that's uh there's a lot of that and that AI might might make that worse. I do think it's kind of a broader societal trend though, uh not just AI. Um you know, even when it's frustrating, even when it uh seems personal, that I have just come to be like have grace for patients. There is nothing wrong with patients, even if it's it seems misdirected to you, like guided by AI, of them going and getting a second opinion. You know, I think we have to trust our our colleagues to to handle it the same the same way. Um but it can be a frustrating aspect of practice, there's no doubt about it.
SPEAKER_03:Well, I mean I will I will go out on a limb and say this is not just for medicine, it's for every profession. Um people, you know, um I'm a CPA by training. I I have a lot of colleagues who are accountants, and they come and say that they ran it through AI. And in some cases, this is true, this does work, but they're like, oh, my tax refund could be so much larger because AI told me so. Um and there are certain nuances that they don't understand, there are certain physicalities that they don't understand. So, for example, in certain cases, um, you know, an accountant might know better the family that just had a kid, and AI missed that because they either they didn't put it in the prompt, or you know, I mean it's the AI is as good as the prompt. And I think that that human touch is pretty necessary for almost every profession, and I think more so for physicians than than any other profession. But uh one thing that I've noticed is that AI is absolutely terrible at managing chaos. Um, it cannot handle chaos, and that's and uh let's face it, human beings are chaotic, our thoughts are chaotic, our thoughts are not organized, logical, and streamlined. Um, as you mentioned, RFK Jr., I would say that his thoughts are pretty chaotic too. Um, and and that's what uh trick trickles down. Do you see any major disadvantages of our adoption of AI beyond obviously the societal impact?
unknown:Yeah.
SPEAKER_03:From a technical perspective.
SPEAKER_01:Yeah, I mean, uh, technical challenges with AI, where we stand right now. I mean, with the caveat that things are still continue to change very rapidly, whatever you think about the newest models. I mean, uh, I completely agree. Um, AI is pretty poor, even when you try to design tools around these models, at going out and seeking information, okay. Which physicians are great at, right? You know, uh patient comes into the exam room, medical student is interviewing them, they mention something, oh, this triggers something there, I'm gonna follow up, right? Maybe this wasn't the chief complaint. Or you know, AI is amazing at synthesizing data, um, but not seeking it out itself. Uh it's also not very novel. Um, you know, that maybe that's getting better as as as it tries to get into science, but it you know, things it has uh not seen before and not been trained on, it's not it's still not great with. Um and so these are these are things that I think physicians are still much, much, much better at. Yeah. If you give AI all the context, right, yeah, it's it's great at synthesizing it as long as you've given it everything it needs. But um, yeah.
SPEAKER_03:Okay. And um do at some point, I would assume AI, AI's been transitioning in leaps and bounds. Just two weeks ago, there have been updates across all the AI platforms um that have essentially, you know, replaced a lot of uh or will be replacing a lot of consultants because uh as long as you can communicate with AI appropriately, it can do uh Excel sheets, it can do pro charts and and and all of that. Um but do you feel that that'll change at any time in the near future, in the distant future, where we don't need to go to a physical person, but we're just sitting and I don't know, talking to a chat GPT persona?
SPEAKER_01:Um we may get there, uh especially in terms of like initial care. You know, you I can I can envision a you know, a kind of medium-term future, maybe where physicians do a lot of triaging, a lot of like edge cases. Hey, the AI is unsure, hey, review the AI's work, um click in when when it needs more. It that might happen. Um I will say, you know, we just in a broader sense, uh there's there's a lot of talk about AI taking jobs. Um I uh not just for physicians, but I just think historically, right? Um with uh as technology has become you know, everything of of the twentieth and twenty-first century, right? The driving force. Even as technology has advanced it has it has really shifted the type of work that humans do. Um but it's it's not like you know the internet killed male mail carriers or something like that. And so um I think AI may really change how physicians practice and maybe how uh patients access care. Probably not in the in the in the very, very short term, but longer term. But I don't think um physicians are gonna become like dinosaurs at all. Right.
SPEAKER_03:Right. I I w I would definitely agree with you. Uh one thing I do want to say when you talk about jobs, from everything that I've spoken to, uh everybody I've spoken to, it really seems like uh these large hospital chains are not necessarily interested in cutting or looking to cut any physician positions. What they are looking to change is they are looking to change the headcount and looking to uh use AI and leverage AI as much as possible, but they're looking to eliminate a lot of lower-level administrative positions. And um, but but because of that, do you anticipate the nature of physicians changing where they're doubling up and doing a lot of the functions that uh not all of it, but a lot of the functions that potentially uh a nurse is doing now? Hypothetically, I'm you know, because uh because uh they might have more free time now because AI is doing some of the analysis work or some of that uh busy work, as you said, for radiologists. They're going through many, many reports, and something that used to take 10 minutes is taking 30 seconds now. Uh and and if there is not an increased patient volume, they're looking at uh doing more just like a truck driver is being considered to essentially be a software engineer as well, or a software engineer is going to be driving trucks also nowadays. Um, do you anticipate that kind of a world where a physician is also doubling up as uh doing a lot of the basic work just because they have more time?
SPEAKER_01:Um that's a really good question. I uh I had never considered like physicians doing more. I mean, not that this is what nurses do, but more more like scut work. I I I guess I'm probably a little bit skeptical of that. Okay um I'm interested in, you know, I don't I want to be careful, but um you know, health healthcare has you know, we're all in this to help people, but healthcare as a business does a pretty remarkable job of uh creating its own demand, right? So, you know, I think a lot of people um look look at medicine as some sort of fixed thing. When you're sick, you go to the doctor, but I uh you know, I'm not sure that's a hundred percent how and you know, and people only get sick so much, but I'm not sure that's a hundred percent how it works in the real world. And so um I think there will always, you know, in the in the medium term, uh even if AI makes us more efficient, that there's there's gonna be enough patience. Um and so I think it's probably more realistic that like we talked about, uh, you know, I think it's gonna be important for physicians to know how to use these tools, troubleshoot these tools, absolutely. Um and I think like we talked about with the radiologist, that maybe there's demand to be for more throughput, more be more productive. I can I can envision that.
SPEAKER_03:Okay. Um and and I think this kind of goes back to the uh the the pyramid structure of our healthcare system, where at least in the United States, um they focus a lot more on primary care in the beginning, so that specialists have less let's not call it a workload, but uh less acute patients at the latter end. Because if you're dealing with hypertension at a relatively early age at the PCP level, uh you're probably less uh likely to develop complications that you would be seeing uh at your level. And that's generally the pyramid, but uh I think what you're suggesting that makes a lot of sense where um maybe the level of care is increased to have a healthier population. Um I definitely think that that's possible. That and and I and that makes a lot of sense to me. Um so I want to switch gears a little bit, and since we are an educational organization, what do you think? And and I have to caveat this by telling you that education moves at a glacial pace. Um, I can tell you right now, so many conversations I've had with faculty members, program directors, um people who are in various leadership roles in various uh residency programs who absolutely abhor AI. They have clearly said that if you are using AI, you're probably an idiot. You don't know what you're doing. I want people to do all of these things hands-on. So there's still a lot of pushback, and I think that that'll stay for at least another half decade or so, if not longer. Um and even from our accreditors and the accreditation standpoint, um, there have been no mandates on any particular course that's tech-driven, AI-driven. Um they are, in fact, when we say that we want to introduce some of uh some courses like this, the general reaction is that you know, we have a curriculum, we want to stick to it, we don't want to take away from what we have. So from the educational standpoint, at least uh general leadership, we don't necessarily see a whole lot of movement on what schools should be doing to train our physicians um appropriately. What are your views on what schools should be doing to train our the physicians of tomorrow?
SPEAKER_01:I think training people on tool use is uh absolutely important even right now, right? And and you know, you're training young people who are generally more technologically inclined, right? They're probably learning these tools already um by themselves. I uh, you know, uh it'll be really interesting how AI comes into education, even medical school education. I am I am pretty sympathetic, and I've heard similar arguments that that you have. I'm pretty sympathetic to the idea of using, you know, of what is what are the costs of using generative AI. Uh like you know, I think there's a lot of value in terms of critical thinking and organizing your thoughts to uh a simple task like writing. And when you offload that, what are what are kind of the long-term costs? And so I'm sympathetic to people who really don't like that. But um, you know, I I'm I'm really curious to see how, you know, holy moly, right? Uh does every does every lecture need to be live, right? My goodness, right? We we asked AI about this topic and it generated this whole hour-long audio lecture and slides itself and um or uh you know using it to to do research, things like that. So uh yeah. I think it'll be really interesting. I mean, you're you're obviously a lot closer to it than I am um in the education field. Uh I do think you have to be careful when you're trying to offload your critical thinking to it. I think it is an amazing research tool. It can be amazing for like helping you learn, um, for synthesizing stuff. But if you're like, well, I'm just gonna have this AI write this essay for me, um I I don't know.
SPEAKER_03:Right, right. Well, I mean, uh absolutely so so that's just being lazy. Like if you're disparating AI to completely substitute something, but um so one of the challenges that we've had is that right now AI is pretty disparate. You have ChatGPT, you have Claude, you have Perplexity, you have uh Google Gemini, you have Grok. They all are different and they all have somewhat different answers. And and we've tested all of these. All the ones, the five that I mentioned, we've uh I have personally used all of them. Um and the results are not reliable in the sense that uh obviously uh I I'm asking it relatively subjective questions. I just basically choose the answer that I like best, that I think fits my narrative the best, which is obviously a little bit of critical thinking. Um but when you're saying if you were to hire somebody or or if you were to get a neurosurgeon resident, a first-year resident, uh, for your uh in your university, would you care that they know what these five systems are and how to use them and how to uh create a username. Does that matter to you as as of today?
SPEAKER_01:Uh no, to be honest. Uh I uh, you know, there would certainly be expectations. Hey, these are the tools we use. Uh this is the ambient scribe we use in our clinic. This is the, you know, this is the stroke alert tool we use in our clinic or hospital. Um, you know, learn the basics of these. But would I care if they do the nuance of, hey, I've discovered Claude is better at you know at writing and ChatGPT codex is better at coding. Uh no, I wouldn't. Okay.
SPEAKER_03:So uh when you're when we're talking about AI education in general, do you think uh what what would matter to you? Like how how to write a prompt? They have a general idea of how to write a prompt, um, having some guidelines or guardrails that they personally know that we shouldn't do these things with AI. What what's the flow that you would care about as an AI entrepreneur, as a neurosurgeon, when you're hiring somebody, what would what would matter to you?
SPEAKER_01:Uh I want them, yeah. I want them to have be relatively technologically savvy, right? All these, even the tools we're building on top of models, they all work generally the same, right? Hey, you're coming in and you know, uh I'll give you an example, right? I mean, this is not a new challenge. Uh AI is not new, but my goodness, looking at my we, you know, we we recently, well, about a year and a half ago, sold ourselves to a big healthcare system. We were private practice and we became employed. And that uh entailed, because this was entirely new employees, entirely new hospital, uh, a new EMR. And like watching my you know, 60-year-old partners try to get a handle on that, uh, you know, it's a it's a slow, painful process. So, you know, these a lot of these tools work very, very similarly. Being familiar, being able to pick up new tools, I think being able to prompt um and to critically assess AI's responses, right? Oh, that that's like not right. Um, and to be able to ask it uh questions and give it context where that's a lot less common and it gives you uh answers that you're looking for, yes, is absolutely key uh as well.
unknown:Okay.
SPEAKER_03:So so generally the concept of prompting, which I think is really the basis and backbone. I don't know uh I've been using AI for about two years now, and I think the sophistication that I needed to create a prompt to give me meaningful answers two years ago has dramatically reduced today. Uh back in the day I felt like it almost needed to follow a certain formula. Yeah, perfectly. Yes, and whereas today I feel like I can just have a just talking to a person and I can keep elaborating until I get to that answer. So I do think AI is getting more sophisticated, but at the same time, having that knowledge of what the structure originally should be like helps me get better answers. So I think uh having a course that kind of talks to students, not necessarily about uh what uh AI is, but generally having a general understanding. And you know, especially one thing I've noticed is even today we have this these token limits on AI, which means that if you keep the same chat window open and you keep asking questions at some point only as so much context, yeah. Yeah, uh and and it's at some point it starts spewing gibberish because it's run out of tokens. Um, this is something that I've been a little surprised to know that most people don't know. So the answers that you get in the beginning of the conversation versus the answers that you will get towards the end, they're a lot looser. Um AI hallucination is still a factor, which is again, I'm surprised that a lot of people don't know. But I think having a course that really talks about these concepts, and again, these are changing so much uh over time and may not maybe completely obsolete at some point for hallucinations. Um, and and if they have that kind of a structure and a knowledge, would that be beneficial to a person like yourself?
SPEAKER_01:Honestly, that'd be super beneficial. Yes. Okay.
SPEAKER_03:Uh awesome. My final question about AI is really do you see AI ever leveling the playing field? Because let's face it, today in medicine, uh, if you're a neurosurgeon, if you're an ENT, if you're an orthosurgeon, uh, for one reason or the other, there is dramatically uh a lot more prestige, let's say. And and and not to say that I think just generally being the doctor, uh, you know, I have my view that there are only four real professions in the world. Um, and I think uh being a doctor is definitely one of them, no matter what kind of a physician you are. Um but I think uh do you think AI will ever level the playing field between the discrepancy between all these specialties and doctors? Number one, number two, obviously, uh in some of the more elite fields like radiology, anesthesiology, surgery, the different kinds of surgery, uh there's still a little bit of stigma for IMGs. Um I know that stigma has gone away quite a bit for medicine in general. Um, as I said, our school is since 1999. We saw a lot of that in the early years. Uh, I've personally had conversations with the program directors who've said that if you're from a Caribbean school, this is not the program to apply for. Um, which is, in my opinion, completely baseless because in the United States we have a standardized system. You have everybody takes the same tests. If you score well on these tests, I don't see the problem with with uh applying. But um but do you see AI ever really leveling the playing field and uh decreasing the discrepancy between the various medical professions and then within the medical profession, say the DOs, the M uh the Caribbean MDs and the American MDs? Do you see that happening? And if so, how do you anticipate that to play out?
SPEAKER_01:Yeah, I uh that's a really good question. Um and I haven't given it a ton of thought, but I you can envision a scenario where that might be the case. I really think that if that does happen, it's probably probably more medium to long term. But um, you know, I as AI may really kind of I can envision a scenario where AI kind of levels um the compensation structure, levels the prestige factor for physicians, um and a lot of that is you know kind of what drives competitiveness. Uh and so if if that happens, right, if AI leads to say uh lower compensation for procedures or something like that, which I could totally see happening. Um yeah, I mean, I think uh that could dramatically kind of change the face of what what constitutes a competitive specialty or not and change um you know the whole residency application process is awesome without doubt.
SPEAKER_03:Okay, well that's very interesting. So um do you think that AI will and we've touched upon this briefly earlier in our conversation, but um do you think the demand for physicians, and I know you mentioned that the healthcare system has a uh a way of creating its own demand in the sense that having healthier, healthier people, and and and this is very apparent in our life expectancy. We've seen this. Like I life expectancy, even in my lifetime, I remember when I first moved to the United States, the US life expectancy at the time was uh in the late 70s, today it's in the early 80s, uh, or very close to 80, if I'm not mistaken. Um, and I and that this is exclusively uh because uh the government and physicians have worked towards making doctors more accessible, and and and yes, that there's a whole healthcare and and uh insurance argument. I'm not getting into that, but generally being able to see physicians earlier just allows people to get healthier. But do you think AI at any point will reduce the demand um for some specialties across the the the realm of physicians? Maybe family physicians, you don't need to see them that many um that much. Uh maybe dermatologists, that that could be one. If I have a skin tag, I put it up on Chat GPT and chat GPT. Maybe your software is doing that.
SPEAKER_01:I uh I really think that it's going to change how physicians practice. But uh I I don't think I mean I'll just stress again like if I was going to medical school right now, I would not have a major fear that oh my goodness, we're gonna have a glut of primary care physicians in 10 years because AI's doing too much of this work. Um I don't think so.
SPEAKER_03:Awesome. Well, thank you so much, Dr. Son. I know we're out of time, but uh this was such an invigorating conversation, an eye-opening conversation. I think I have some homework because I'm gonna go and create uh uh a course for our students that we uh we we actually have some, yeah, we actually do have a very yeah, a basic course that just pre-residency, we actually tell students to get uh a little more acquainted with AI. But I think uh I'm definitely gonna push our academic team to create a program that's in a uh embedded in our curriculum. But uh it's been very eye-opening. Uh, before we leave, I do want to uh ask you a little bit about your business. We already spoke about that, but the name um and uh how do you think uh as a school, do you think we can help in any way? Do you think uh some of the things that you're doing can actually uh help students be equipped with uh in facing the real world of AI?
SPEAKER_01:Yeah, I'm I'm always uh happy to talk to anyone uh just in general about medicine and career in medicine, but but especially AI, if anyone wants to ever reach out. Um uh but yeah, I am working on this company called South A Health. It is in beta. Um, but like I said, it's it's kind of a patient-facing AI telehealth platform, and and you know, hopefully if in the future, if any of your students are are looking for for work to even telehealth remote work, uh love them to reach out as well. So after they finish residency.
SPEAKER_03:Thanks again, Dr. Collinson, for joining us today and sharing uh your journey from neurosurgeon to entrepreneur and how AI is reshaping the future of medicine. If you enjoyed this episode, make sure to follow or subscribe to the podcast on your favorite platform, leave a review, and share it with a friend or colleague who's passionate about healthcare and innovation. You can also download past episodes and find updates on our uh upcoming guests. And remember, there is no shortcut to getting an MD.
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