The eminent 19th Century physician Sir William Osler, the founder of the John Hopkins School of Medicine in Baltimore was famously quoted as having said “Medicine will become a science when doctors learn to count”. Sadly, his prophetic words have had little impact. Mathematics, and its younger partner, computer science make barely any contribution to the current medical school curriculum in most universities, just as they did not 150 years ago. And yet medicine is now in the midst of a revolution which may be as profound as the impact of molecular biology in the second half of the last Century. A revolution driven primarily by the extraordinary developments in computers and processing power. Scarcely a field of medicine remains untouched. Primary care provision is coming to terms with vast new data sets comprising comprehensive electronic patient records which will link an individual’s genetic makeup to behavioural and social data and medical history. Miniaturisation and price reduction are boosting point-of-care diagnostics and real-time physiological monitoring. A score of new imaging modalities which leverage the latest advances in artificial intelligence and machine learning are driving the emergence of computational anatomy, providing real time dynamic images of every part of the human body. Robotics are transforming surgery. Genomics, proteomics and metabolomics are creating precision medicine. The list is endless.
Computers and mathematical models lie at the heart of all these advances. Computers are needed to drive the new instrumentation, and then to capture, store and organise the vast data sets they generate. But generating, storing and classifying data are not enough. The real benefits can only arise from the ability to extract the underlying biology and pathology which are embedded in this data. This ability, in turn, requires mathematical modelling : the ability to recognise and formulate the rules and relationships which allow the data to make sense, which enable us to predict the future based on the past, and which ultimately will guide and inform the clinician and establish best medical practice.
The mathematics may be of many different types. It may be classical mathematics, fields such as classical , statistical or quantum mechanics, linear and non-linear differential equations, probability theory, the mathematics of light etc. Or it may be newer branches of mathematics, fields which some mathematicians may not even recognise as legitimate branches of mathematics at all: artificial intelligence, machine learning, high dimensional statistics, computational algorithms etc. Indeed so fluid and dynamic is the interface between mathematics, computer science and biology and medicine that it would be a brave individual who would predict with any confidence the pace or direction of progress which we may observe in the coming decades.
So how can we prepare the next generation of doctors for this brave new world, where they will properly be able to exploit the data and computational revolutions which are already transforming medical care in the 21st Century ? Clearly mathematics and computation will gradually need to be embedded in the medical school curriculum, in the same way that molecular biology and biochemistry have now taken their rightful place alongside the classical study of anatomy and pathology. UCL, one of the top medical schools in the UK, with a long-established commitment to train doctors who are at the cutting edge of medical advances, has recently taken an important step in this direction. UCL’s Programme and Module Approval Panel has recently approved my proposal for a new Intercalated BSc degree in Mathematics, Computers and Medicine, which will be launched in the academic year 2018/2019. The one year degree will be offered as an option in the third year of the medical school curriculum, when all students at UCL have to chose a BSC in a subject of their choice. The course will be interdisciplinary, and will be run jointly by the Faculties of Medical Sciences and the Faculty of Engineering. It will provide teaching in advanced mathematics (capitalising on the fact that a substantial portion of the entry into medical school have an A in Mathematics at A level) , computer programing , mathematical modelling and analysis of big data. Perhaps of greatest importance, the new degree will capitalise on the wealth of interdisciplinary research which already occurs at UCL to offer student research projects at the frontier between biomedicine, computers science and mathematics.
The new degree is a small step in the necessary reform of the medical school curriculum to keep pace with the computer revolution. The graduates will not necessarily become adept mathematicians or computer scientists, just as most of the graduates of the other IBScs do not spend their careers as laboratory scientists. But it will provide a core group of new talented doctors, who have confidence in their ability to understand and interact with mathematicians and computer scientists, and who will provide the leaders in the computational revolution of medical practice.