From what my email inbox tells me there is an interest from junior doctors who want to learn how to code. Some see it as a way to get out of medicine, others see it as a mandatory skill for innovation forced by the ever increasing presence of machine learning and tech in healthcare. Some even express interest in starting a company. They all want to know which language they should be learning and how can they get their code into the hospital computer system. However, I never get the question, should I be learning code? An internet search can confirm whatever choice you want. There are many articles telling you that everyone should. And different search terms will give you articles telling you why you should never learn code. Both sides seem to contradict each other and tell different tales. One side says that developers have a great life, they earn lots and there’s plenty of jobs. Other articles tell you that it’s all hype, you have a lonely life and you work around the clock to be replaced by younger coders in the future. Like most things in life, it’s most probably a bit of both. In healthcare yes I encourage you to code but only if it’s right for you, your goals, and personality. Coding is a tool, saying every doctor and nurse should learn code is like saying every doctor and nurse should take advanced ultrasound courses. It could advance some careers but simply waste money a time for others. Here are a few things to consider when thinking if coding is right for you:

Are you genuinely interested?

This piece of generic advice can be applied to most endeavours. However, it’s still worth assessing your level of interest. I and my friend Nathan have a burning desire to understand how things work. Even if the subject is trivial. I remember Nathan telling my one day that he had come across a mathematical proof proving that if you draw lines two matchsticks apart, throw a large number of matchsticks over the lines, then divide the number of matchsticks not crossing a line by the number crossing the line you will get pi. We spent a day conducting the experiment because we wanted to see the proof in action. There was no gain career-wise, we did it in our spare time, it was fun. If you want to see if certain predictions or simulations follow through then coding is definitely for you. Even if it’s just for a hobby. You have to keep in mind that coding is a technical skill. You have to learn a lot of basic logic that will help you simulate these interesting but not very useful concepts, models, predictions etc. It can take up to half a year before you can start coding things that are of use. Being interested in technology isn’t enough, you have to be interested in solving technical problems. I’ve met plenty of clinicians who are interested in the impact of technology on healthcare so they try and force themselves to learn code. They don’t commit.

They usually don’t commit because they are not enjoying the process of solving the technical problems. They just want to get the to point where the technology is making an impact on a clinical level. The reality is that there has to be a fair amount of code written before it gets to that stage. This doesn’t mean that you should turn your back on technology. Your clinical experience is still valuable in tech. Companies want clinicians’ advice on user interface design, clinical implementation of new tech and areas to improve. Giles, a doctor with no coding skills has still influenced tech development in clinical settings.

Does coding actually fit your career development?

Coding evangelists will tell you that software is infiltrating your workspace, therefore learning how to code will give you an edge. Whilst this is definitely true is some areas it’s not a blanket rule. If we were to make the rule blanket we’d have to conclude that singers would advance their career further if they learnt how to set up microphones. Even if software has become an essential part of your practice it doesn’t mean that you have to have an intricate understanding of it. Like singers spending time improving their singing, your time might be better spent improving traditional aspects of your job. If you want to analyse data in fast effective ways then coding is a tool that will help. If you want to develop new ways of logging data and measuring outcomes then coding will also help. I know a Matron called James. Every time I see him he’s always delving into the technical aspects of sorting problems. He developed a piece of software that enabled charge nurses to log issues which could be fed back to the management team. He is now in talks with other hospitals who want to buy it. He wants to improve workflow in his department and measure outcomes. Coding clearly gives extra firepower for this. Another is an A and E consultant who is developing a triage app to streamline the triage process. A big part of A and E consultants’ concern is the flow and efficiency of care in the department.

The effect of you personally coding has to be considered. High-level languages allow rapid development of simple apps. If you have the desire and position to implement them then I definitely encourage you to learn code. However, if you want to excel in another skill such as being a transplant surgeon then using tech to advance your surgical techniques is advised as opposed to developing the tech itself.

Are you willing to take the risk?

Healthcare is a tough area. Twelve-hour shifts combined with competition for promotions, training places, and revalidation means that you will have to put a fair amount of your time into your traditional development. Although I am attending meetings about Imperial College London’s desire to launch a computational medicine degree in 2018 clinicians harnessing code is still a novel idea. This means that there isn’t much competition in this area. Early adopters of certain fields can get high rewards, however, they also take the risk. If you spend time learning code it is unlikely that it will be taken as a substitute to traditional career development skills. People in traditional careers look at the successful pioneers in silicone valley, business, and finance with envy. They have trained for years to fit into the background and not earn as much as these and it’s not fair. The variable here is risk and reward. These tech start-ups have uncertain career paths. Unlike many who only have to market themselves for job interviews where the career desires and pathways are spelt out for them, they have to constantly market themselves and carve out their own career. The risks are high but so are the rewards.

If you’re a clinician who has decided to learn how to code then you’re taking the high-risk path. Coding is not recognised as a traditional career development skill. It’s not a requirement for clinician jobs. As there are many senior clinicians who have never coded and don’t understand the utilisation of high and low-level coding you will have to market yourself in a way that isn’t known in the industry. You will have to come up with demonstrations of what your skill can bring, you will have to actively seek out or create projects. If you fail to do this then you then you will be at a disadvantage compared to the guy who spent his time going on courses and taking exams that are known to look good on the CV. However, the reward can be very high. Selling a killer piece of software could give you more money than you could ever hope to earn the traditional way. True innovation is risky.

Hopefully, this has clarified your thoughts on if you should code or not. If you’re going to learn how to code properly it’s not fad, you will have to consider the trade-offs. You’re also not a dinosaur or a has been in terms of innovation if you choose not to code. Like most choices in life it’s down to your personal circumstances. Remember if you have any questions feel free to contact me on the contacts page. I love hearing from clinicians who have an interest in coding. Every story is unique.