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“Innovation is the ability to see change as an opportunity – not a threat” – Steve Jobs [1]


The world is changing rapidly. Healthcare has seen a fast reform, especially as a consequence of COVID-19. Urology is a rapidly evolving specialty at the forefront of surgical innovation. So, what is next? And how do we lead the future in our field as urologists? By the time a trainee has completed their specialty training, there may already be a change in practice, as a result of new research or new technology (hardware or software). There are many arising opportunities in the world of healthcare innovation, so where do we find these opportunities?

Unless you are very lucky and it just lands on your desk, then a little bit of work is required. There are no strict rules on finding opportunities and it can often be a case of creating them. Here are a few tips I wish somebody had told me:

  1. Set your mindset to actively look. As obvious as it seems, take a step back and observe! We pick up on a lot more from our surroundings if we do so. Have you ever just observed in theatre or clinic, and realised the inefficiencies in practice?
  2. Seize the opportunity fast! There is never the ‘perfect time’ to take up a new opportunity, however Out of Programme Experiences (OOPE) are often more suited to earlier years of specialty training.
  3. Research your interest. Read and study the latest updates in urology and healthcare innovations in any journal and explore the various industry stands at conferences.
  4. Network. Connect, share knowledge and experiences with others. You will find it’s a great way to get yourself out there and understand the industry, where opportunities arise.

Every trainee’s journey is different, and I have learnt lots from hearing other colleagues’ journeys, so I’ll share mine. As a foundation year doctor working in a GP practice, I saw the long waiting times for patients seeking specialist referrals. This was a combination of referral criteria not being met and existing long waiting lists. As a result, patients sometimes opted for a shorter and more expensive route privately. I could see the frustration in all parties, which made me wonder if there was an alternative way in managing this. After identifying these issues, I researched the healthcare market and brainstormed with colleagues over a few months. I read as much as possible about the healthcare industry and software development. This led to the development of MyConsultant, a video-consultation platform allowing patients to directly book video-call appointments with specialists.

Despite my limited experience initially, almost five years later, I have learnt to set up a company, oversee project management for software development and lead a team of individuals. I have gained a wealth of knowledge on marketing, sales, regulation in health technology, accounting and investment. Along the way, I have made hundreds of mistakes, but my passion has allowed me to continue developing my company.


Figure 1: The MyConsultant App.


Figure 2: eConsult urology questionaire.


During my journey, I attended many conferences where I met some inspirational leaders. I became aware of the NHS Clinical Entrepreneur Programme [2], to which I applied and was successfully accepted. This is a programme founded by Professor Tony Young, a urologist. The programme was set up to lead innovation across the NHS, educate healthcare professionals on entrepreneurship and support innovative ventures alongside working in the NHS. I explored various opportunities that arose regarding education, partnerships and mentorship. Interestingly, I came across other urologists and surgeons in training who had developed exciting projects such as digital consent, healthcare on blockchain, surgical simulation and digital pathways.

Eventually, I decided to undertake an OOPE, working alongside Professor Young and Dr Murray Ellender who founded eConsult. Following my ST3 year, I relocated to London to work as a Clinical Outpatient Transformation Fellow for the NHS. Additionally, I undertook the role of Outpatient Clinical Lead for eConsult.

It has been fascinating gaining experience working in a fast-paced start-up company, with an ever-growing team at eConsult. The core focus of my OOPE, was to revolutionise the delivery of outpatient care in the NHS using digital pathways and building a virtual outpatient platform for NHS Mid & South Essex, in partnership with eConsult.

We are all familiar with the challenges the outpatient sector faces in terms of waiting lists, patient safety and efficiency with limited resources. At present I am helping in the building of a platform that enables clinicians to triage patients more effectively. By using pathway-specific questionnaires, there is a potential for:

  1. Reduction in follow-up appointments
  2. Timely advice and guidance
  3. Patients being seen in the right place, first time
  4. Improved referral profiles
  5. Patient Initiated Follow Up (PIFU)

Throughout this year in innovation, I have worked alongside a variety of stakeholders and team members including the Chief Executive Officer, Chief Innovation Officer, Chief Medical Officer, National Director for NHS Innovation, NHS executives, operational teams, surgeons, physicians, GPs, nurses, physiotherapists, NHS digital teams, marketing experts, designers, product development teams, commercial teams, engineers, project managers, quality assurance teams and clinical directors, at all levels, both within the public and private sectors of healthcare.

"Trainees have the potential to lead innovation projects and be the change we wish to see"

I have also been involved in the implementation of various urology specific projects including introducing digital urinalysis [3], digital consent [4], and digital PSA tracking into local departments. This is an entirely futuristic vision of delivering urology services that I am now discovering.

So, what is the value in taking a year OOPE and what have I learned? I have been exposed to a completely different idea of how healthcare can be delivered in the NHS. Throughout our careers as surgeons, we develop a wide skillset and by exposing ourselves to a different environment, we have the potential to enhance some of these skills and develop new ones. During my non-clinical journey, I’ve certainly developed my leadership skills and have widened my teamworking abilities with colleagues from various backgrounds. These are transferrable skills I hope to implement when I return to training. Surgical practice is advancing quickly, and the landscape provides plenty of scope for innovation. We, as surgeons, could lead this locally and globally, and this can most certainly be done throughout training if you are passionate enough!



1. Baker G (Snr). Four concepts to drive innovation in a time of crisis. Forbes [online] 2020

2. NHS Clinical Entrepreneur Programme.
3. Healthcare at the speed of life.
4. CEO DL. Concentric Health | Digital consent.

All links last accessed 7 July 2022.


Acknowledgements: Professor Tony Young, Consultant Urologist and National Director of Innovation, NHS England, Dr Murray Ellender, CEO of eConsult and Sarika Nalagatla, Speciality Registrar.

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Ibrahim Ibrahim

West of Scotland Deanery, UK.

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