Will the Last Doctor To Leave Please Turn Off the Lights?

How AI is poised to transform patient care

The year is 2065. You stroll into your local NHS tertiary care centre to be greeted by a machine with a soothing voice and flashing lights. It doesn’t ask for your name; it already knows through its front facing camera. Instead, it inquires gently, “What brings you in today?” Within moments, your response is integrated with your electronic health record, epigenetic profile and recent smartwatch telemetry. Before a human technician has lifted a stethoscope, a diagnostic and treatment pathway has been optimised.

Welcome to the era of intelligent medicine.

Within medicine, we see countless examples of algorithmic flowcharts and decision making. Take any NICE guideline—flowcharts with binary decisions, thresholds, and predefined outcomes. Cardiology, in particular, is a field of data-driven decisions and practically functions as a living algorithm. This sort of algorithmic decision making is a prime target for AI and unlike the human, the algorithm doesn’t tire at 3am or make inaccuracies to the same degree as we do.

The AI algorithm above works on a premise: Similarity. If two patient profiles are “similar” enough, what worked for one should work for the other, right? Yet defining similarity is where things get truly philosophical—and even dangerous. Similar in age? Genes? Diet? Social factors? Every added parameter increases strength—but also noise.

Timeless questions about data quality resurface here. What happens when electronic health records (EHRs) are patchy, incomplete, or just plain wrong? A reality all too familiar within the NHS. Imagine the typical scenario: someone’s inadvertently typed a BMI of 42 for the woman in bed 14, when it should clearly be 24—something any alert clinician would spot in seconds after seeing the patient. But will the algorithm? These systems are only as good as the data they’re fed, and unlike humans, they don't "sense-check" for obvious discrepancies. Many quite rightly suggest that the project of creating a unified, standardised health platform for all patients across the UK has been unsuccessful in recent times which is a symptom of how far we are away on a technological level from widespread use of AI in the NHS.

One of the more comfortable myths among clinicians is that our job is safe because of the so-called “human touch.” Patient’s won’t pour their hearts out to spreadsheets. David Dranove of Kellogg points out that doctors rely heavily on emotional intelligence: patients often reveal crucial information only when trust is earned, when empathy is perceived.

But this argument deserves interrogation. Trust is not inherently human—it is relational. And over decades, relationships can be formed with systems that appear responsive, attentive, and predictable. Let’s not also forget that we often withhold information when we fear being judged or scrutinised - feelings that (for now) remain all too human. A machine doesn’t seem to carry these traits, it just searches for a diagnosis. Could it be that we are more likely to open up to a machine in light of this?

There’s a joke in hospital corridors that doctors spend 70% of their time doing things no one went to medical school for: writing notes, filling forms, chasing results. AI’s first great triumph may be not in replacing diagnosis but in liberating clinicians from this burdensome admin load.

Imagine a ward round where voice recognition software not only transcribes but synthesises the encounter, updating records, booking tests, even drafting the discharge letter—all in real time. Multidisciplinary team meetings could be recorded and logged.

Predicting the exact trajectory of AI is challenging, but one thing is certain: in just five years, AI will be vastly different from what we know today. We can't fight or ignore technology—it’s coming whether we’re ready or not. The best approach is to embrace it, understand it, and shape our profession and own practice in a way that leverages its capability.

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The GMC Has Left the Chat…

The GMC has waved goodbye to its X account. As fee-paying members, we’re of course entitled to transparency from our regulator. What did we get? A quasi-explanation with some vague rationale: ‘…we are focusing on platforms where we can engage more effectively with our audience.’ And now, for updates, we’re directed to (checks notes…) Instagram?

If we examine similar departures, we might find clues. In November 2024, The Guardian announced it would no longer post on X, telling its 10.7 million followers: ‘the benefits of being on X are now outweighed by the negatives and that resources could be better used promoting our journalism elsewhere’. They cited the rise in racism and conspiracy theories—a stance unsurprising given their political friction with X’s owner. Whatever your view on their decision, at least the reasoning was explicit and coherent.

The GMC, in contrast, offers no such reasoning. Perhaps their timeline was flooded with reactive, impulsive content from within the profession or trolls from wider society. Perhaps X has lost its utility for meaningful engagement or this is just a symptom of the wider online landscape. But if that’s the case, where is the alternative? What online platform finds itself devoid of trolls and people typing before thinking? In abandoning the platform without clarity, the GMC hasn’t avoided noise—it’s only deepened the silence.

The Anatomy Of A Medical Student

How has the recipe for making a doctor changed?

As we get ready for another day in the NHS, Americano in hand, it's worth pausing to consider: how are we educating the next generation of doctors? Medical education has undergone significant transformations since the days when hefty textbooks and memorisation dominated learning. But what form has this change taken, and what are its implications?​

Traditionally, medical training was all about mastering the basics—anatomy, physiology, pathology—before entering clinical practice. But recent reforms have shifted toward integrating these subjects with hands-on experience earlier on. The General Medical Council’s “Tomorrow’s Doctors” initiative pushed for less focus on raw facts and more on skills, community learning, and patient-centred care. Put simply, in around 1993, emphasis went from gaining knowledge (through memorising and reproducing factual data) to ‘a critical study of principles and the development of independent thought’ - As Professor Roger Kneebone from Imperial College puts it, being able to handle complex situations with critical thinking now trumps having a head full of facts.

The definition sounds great, apart from when one is pressed on what it means to develop ‘independent thought’ and ‘critical reasoning’ and how we best go about achieving that.

We want our consultants to be experts in critical reasoning, and some may argue that, in 2025, with information so easily accessible, memorising facts is a waste of time. But here's the issue: how can one expertly sift through the vast sea of online content when you're not well-versed in the basics? To effectively evaluate information, you need a foundational understanding of the sciences and the ability to critically appraise sources. Both of which seem to be getting diluted in the medical curriculum. If we don't need this basic understanding to make wise medical decisions, then why even have doctors in an age of the internet?

Professor Blythe, a professor of medical education, isn’t the first to highlight that “medical education is in crisis globally, with chronic underinvestment and a reduction in the number of clinical educators.” Most of the research in medical education is observational and cross-sectional, and there are significant research gaps in areas such as how we select students for medical school. We now need to ask: How evidence-based is our decision-making in medical education?

A Life-Long Sentence - Eternal Reflection

Then there’s the sacred cow of UK medical training: reflection. It’s based on Constructivist Learning Theory—a genuinely useful idea that we build knowledge through experience and, crucially, thinking about that experience. For example, after performing a procedure, you may mess it up, but you spend the evening thinking critically about what went wrong, how it relates to the basic sciences and anatomy you learned, and what changes you can make next time.

In principle, this is golden. Who wouldn’t want doctors to be thoughtful, self-aware, ever-improving human beings? But in practice? Welcome to the great British tradition of turning something meaningful into a joyless bureaucratic ritual. Write 250 words about that one time you learned how to write up fluids. Log it in your e-portfolio. Tick the box. Never think about it again. This mandatory nature of reflection creates an environment where shallow reflections reign supreme. Perhaps, we teach our students and doctors about the theory behind these choices instead of just throwing reams of reflection at them. Explain how to do it and the evidence behind why it may help. Only then, may changes and meaningful reflection begin to surface.

“Didn’t even get a Roaring 20s before this great depression. I got an F2 job in Geriatrics”

“Talk in the news of a plastics consultant trying to kill another colleague? They really don’t do that narcissistic stereotype any favours do they…”

“The BMA resident doctor committee has told the DDRB that it will re-enter dispute on the 9th of April if the already delayed DDRB report is not released, putting forward their pay recommendation for this year”

What’s on your mind? Email us!

Some things to review when you’re off the ward…

DDRB have delayed the release date of their report until the summer where they recommend our pay uplift for the following year. Check out the BMA’s response from last week

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Whistleblown Away? The GMC and Referrals

In a recent move by the GMC, one of the first questions they ask when a doctor is referred to the GMC is simple but significant: To your knowledge, has this doctor ever raised patient safety concerns in the past…

It is a question that aims to prevent doctors from being unfairly targeted for raising legitimate concerns in the past.

Take the advice recently shared by Rahman Lowe Solicitors, who have been helping several doctors—many of whom are Consultants—whose careers were harmed after they raised concerns about patient safety. Since March 2020, these doctors have faced professional fallout, not from their actions, but from the possible retaliation they faced for blowing the whistle.

The worry is that some NHS trusts may be using the GMC referral process as a way to “get back” at doctors who previously flagged issues like health and safety concerns. The GMC’s question is designed to screen out these “tit-for-tat” referrals

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