This medical pioneer trains digital doctors with AR and VR

A prominent surgeon uses the latest tech to teach med students and physicians around the world. Every enterprise using VR and AR can learn from his experiences.
Written by Michael Krigsman, Contributor

Dr. Shafi Ahmed is a practicing cancer surgeon who specializes in laparoscopic, or keyhole, colorectal surgery. In his words, "that's kind of my day job."

He's also Associate Dean at the prestigious Barts Medical School in London. It's worth noting that the Medical College of St Bartholomew's Hospital (the oldest remaining hospital in the UK) was founded in 1123 and has provided medical education since that date.

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Dr. Ahmed is also co-founder and Chief Medical Officer of Medical Realities, a company that uses virtual reality and other immersive technologies to "solve big problems in surgical training."

And, crucially, he is a foremost proponent of using virtual reality for medical education.

Given this background, it was a no-brainer for me to invite Dr. Ahmed to episode 281 of the CXOTalk series of conversations with the world's top innovators. The discussion explains how virtual reality is advancing both medical education and telemedicine.

Watch the entire video, which is embedded above, to gain insight into the practical benefits, challenges, and ethics of using this technology to train digital doctors.

You can also read the complete transcript and see edited summary comments below.

How did you become involved with virtual reality for surgery?

Dr. Shafi Ahmed: I initially was one of the Google Glass explorers. We used the Google Glass to live stream an operation around the world. I taught about 14,000 students across the globe in a single operation. They could see what I was watching, and they could text me during the operation, which would come off the Google Glass. I could answer in real time. It was a way of connecting people around the world in a way that hadn't been done before.

That further forwards with the virtual reality, and we created our own kind of live stream using 360 cameras. Then we could bring people into the OR with me in virtual reality using a smartphone and a Google Cardboard. That was a different way of teaching the art of surgery. On that day, I taught 55,000 people in 142 countries in 4,000 cities. It just shows the impact that people have.

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More recently, I've been working with holograms, avatars to connect doctors around the world to discuss patients, to perhaps educate people and to reshape the way that human traction is forming in medicine. I've also used social media, Facebook, Instagram, and Snapchat, which kind of had much interest around the world, reaching millions of people using this media because they're free [and] they're accessible.

Students these days, who are much younger than we are, they're using social media in a way that we haven't seen before. It empowers them, and you can teach 1,000 people in a single day across the globe just by the power of connectivity, Michael.

Why is there so much interest in medical training of this type?

Dr. Shafi Ahmed: Surgery is often shrouded in mystery. It's almost that secret society we're in. We go into the operating theater. We wear masks. No one knows what happens. We want to be more open and transparent so that the public can see what we do. We're only human. They can share our kind of work and look in to see not just the operation, but how the team works in the operating theater.

Also remember, regarding the students, they've been taught surgery for hundreds of years, in the same way, all crammed in together into the operating theater. For example, our medical school. We have six, eight, maybe ten medical students at a time who sit in the OR. Often, they don't get a chance to see what's going on because it's busy and the team is around the patient in the OR.

If you look very carefully, the students in the back of the room are on their smartphones, on Instagram, on the Net going other things, not learning or engaging. They spend six to eight hours a day in that environment learning, so we've got to challenge that and say, "How can we teach it better? How do we use these technologies so that we allow you to get a good value for your training and teaching?" That's been the remit of my work.

Where does VR fit into the history of medical education?

Dr. Shafi Ahmed: People are now using the web internet to learn themselves. I see both augmented reality and virtual reality just as an extension, as a continuum of platforms. We've got to figure out where AR and VR, for example, will allow us to teach people in a way that is validated, makes sense, and that adds something to their educational experience. That's where we are regarding the platforms.

Virtual reality has an advantage, of course, because when you put your headset on, whether it's a smartphone and a headset, or a tethered or a large device, more powerful devices, we're immediately immersed in a 360 environment. Most of the time we've been training on videos and 2D interfaces. You can imagine having a cup of coffee, watching what's going on on YouTube, trying to learn the fundamentals of a video operation.

Video has moved on. Now it's going to be VR where you can see yourself in 360 degrees. You can see the whole team working and see what's going on. We very rarely have been concerned with the soft skills, they call it, how the team is working, how the communications are going in the operating theater. What are you doing?

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Rather than having the points of view, you see a total immersive area of learning. You know what? That's quite important in surgery. People forget surgery is not all about the actual operation and doing it immediately in front of you. It's how you're communicating with the team to give the best outcome for the patient. If things are going wrong, how are you dealing with it? How is that team behaving? I think all of those things add more of intellectual stimulation for learning in that platform. That's where VR is an advantage.

We've been playing around with virtual reality. We've played around with 360-degree video, and that's been quite interesting. Many people now are thinking about storytelling, VR, and 360. Very early on, this was going back, Michael, about three years ago, we made our own 360 cameras, and 3D printed some platform for a few cameras like GoPro and things to stick together. We then produced some images and videos we stitched together ourselves because that wasn't available at the time.

Very quickly, I learned that the 360 videos are one element of learning. It's great. You can add other things like hotspots, like learning material. Make it into a learning package rather than just the operation. That's what I've been working hard on the last two and a half years with my team, Medical Realities, to create a learning platform, content that is powerful and that is validated so that it becomes the way of learning in the future.

What are the primary advantages of virtual reality in medical education?

Dr. Shafi Ahmed: Okay. I think, first, it's very much a visual platform. You may remember most learning now is visual. Video content is what we use now to drive our learning pathway. Video has become such a powerful medium now, whether it's YouTube or something else.

Then we're looking at, what's the real advantage of virtual reality? It is immersive. When you are in the headset, you do feel as though you're there, which is different from watching a 2D interface on television, for example, or on a computer. That element of immersion where you feel that you're physically in the same room adds a different dimension. You're suddenly concentrating on the environment, looking around, and there's more pressure on you. If you're replicating operations or simulation, for example, there's more realism attached to it rather than the traditional method of learning on a video screen maybe using traditional simulation models where it doesn't feel as real. I think the realism certainly is an added value to this.

Virtual reality, sadly now, is hardware driven. A lot of companies out there are bringing headsets out one after the other. That's not the answer. We have to find compelling content in virtual reality to drive the industry and also to drive the headsets to people's houses and homes. The content that has to be compelling. It has to be validated and reliable, which needs to be shown in trials and projects to make the whole virtual reality kind of pathway more helpful to people.

What is the future of medical education?

Dr. Shafi Ahmed: We are still practicing medicine like it was 50 years ago with the same disciplines of anatomy, physiology, biochemistry, and clinical sciences, sometimes integrated, sometimes separate two and three years or three and three years, for example. That's going to change.

Why does it have to change? Because much learning we do is unnecessary. We don't need to learn every muscle of everybody, for example. I think it's irrelevant. We can teach the muscles in different ways. We can teach in AR and VR in the future, so I think that will change.

The curriculum takes a while for things to move on. Remember, you must go through various regulatory bodies to evoke change. Even if it's just an exam question, it takes a two- or three-year cycle. That's the problem.

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At our medical school, we are trying to create doctors of the future. If you look at where technology is heading towards, I call the future doctor the digital doctor or the connected doctor. We are looking at individuals in the next five to ten years who will practice medicine differently to we practice with the onslaught of all these technologies I described like blockchain, like artificial intelligence, like wearable sensors, big data, pharmacogenomics, nanobiotechnology, and VR and AR. All of these are coming together at the same time to impact healthcare, but we haven't taught our medical students what's going to happen or how to deal with these changes.

I think it's the beginning of changing the way we teach our medical students of the future. You know something? They're different from us. Doctors now don't want the careers that we had before, the 120 hours of work every week, for example, for X number of years training hard. They want flexibility. They want to see the world. They want to travel. They want to be entrepreneurs. They want to challenge healthcare in different ways.

I often call them portfolio doctors now. It's a new term again based on the career pathway. You can do more than one thing in medicine. That's where we are at the moment, and that's where I think we need to drive medical school education to produce the doctor of tomorrow, Michael.

CXOTalk offers in-depth conversations with the world's top innovators. Be sure to watch our many episodes! Thumbnail image Creative Commons from Unsplash.

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