Coding and programming as a growing necessity for the doctors of the future?

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Qwerty122

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So I'm just hoping to get the opinion and advice of sdn'ers on this matter. I think now, more so than ever, learning programming and coding is an important skill for future physicians. Here are some of the reasons...

Pros:
- Medicine and the world is switching to be more electronic-based (EMR, artificial intelligence, wearable tech). Even coding is becoming a required subject in elementary schools. We need doctors that can bridge the gap to utilize technology to improve care through technological innovations.
- Creating new macros to speed up repetitive tasks such as charting.
- Learning programming can teach young doctors the skills of breaking large problems into solvable smaller steps, meticulous attention to detail, and being comfortable with not knowing the problem and successfully navigating through it (as opposed to the more traditional "buzzword" method of learning and testing in medical school exams).
- Marketable skill (to boost residency candidacy maybe?)
- Very helpful for organizing, managing, and interpreting research, especially when dealing with bioinformatics.
- Future citizens (30-40 year olds today) who are more used to technology than today's geriatric population, will be more comfortable implementing wearable tech, allowing for more effective preventative medicine.


Cons:
- Why not hire an expert in computer science (CS) and programming instead of half-assing your education on CS and medicine?
Counter = "The thought of using a hammer on a nail can't be possible if the user doesn't even know that the hammer exists." A doctor that sticks to the status quo without even learning of the potential of utilizing CS and programming will never think about how technology can help. To do this, only an introductory level of coding and programming, not an expert level, is needed. This is where interprofessional teamwork comes into play. Also, to bridge medicine and programming, it's much easier for doctors to learn the intro to coding, rather than programmers to learn the basics of medicine (2 preclinical years (?) lol).

- Steep learning curve.
Counter = Research by Morton et al., who designed a weekend intensive course for medical students at the Imperial College of London, showed that although it's steep, medical students can do it. Students from the study would go on to develop long term projects that combined medicine and programming.

- Less time to focus on education.
Counter = it can be a hobby, people make time for hobbies all the time. With step 1 being p/f, even less incentive to put all your eggs on the basket of "academic excellence", and focus on more "holistic" development. Also, I learned python on my own since the start of the school year, just dedicating 30 minutes of time that I would've used for netflix and youtube to learn, and it's actually quite enjoyable! I've also been keeping up quite well in classes, on top of other extracurricular commitments.


Some examples of doctors who combined medicine and coding:
Philippe Westerlinck MD, rad onc. Created Cancer Risk Calculator app to let patients assess their own risks for cancer based on self-reported genetic factors, environmental variables, and other health metrics.
Michael Abramoff MD PhD, ophthalmology. Created IDX-DR, an accessible machine to be used in PCP clinics that uses machine learning to assess diabetic retinopathy (leading cause of vision-loss globally, that could be easily treated if screened on time) and refer if needed.
Andrew Bastawrous MD, ophthalmology. Created PEEK, which is a smartphone app that uses the phone camera for easy vision screening.


I'm thinking if this is the right direction for future doctors, it might be something worth implementing, at least in my school, as an optional elective. But please, point out where I'm wrong, show me new evidence, I would like to hear your thoughts. Feel free to DM me if you want to talk more, or if you have exciting projects/ideas in this specific field.

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Not a chance in hell. We have too much other stuff to learn for it to ever be a requirement. Personally, I'd love to be able to see my family and actually do things outside of work to learn to code to MAYBE write some app.

I think its more likely that CS people consult docs and they actually do the code writing, ya know cuz thats their job. This is exactly what you spell out but I honestly could not think of a time that I could've learned to code as part of my medical education. There's a reason why CS exists as its own field. Its gonna remain a hobby for some and thats its cap
 
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@Chibucks15 Absolutely, I would 110% prefer spending time for my family as well instead of having to do a required course on coding, so the solution could be making it an optional elective, for those who actually are motivated enough to do it and have the time to do so.

You said that its usually CS people that consult docs, do you mean like CS people have an idea to improve medicine in some way and bring it up to doctors for advice? I've only seen the other way around (doctor asking CS for consult) so I'm curious to hear it go the opposite way.
 
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@Chibucks15 Absolutely, I would 110% prefer spending time for my family as well instead of having to do a required course on coding, so the solution could be making it an optional elective, for those who actually are motivated enough to do it and have the time to do so.

You said that its usually CS people that consult docs, do you mean like CS people have an idea to improve medicine in some way and bring it up to doctors for advice? I've only seen the other way around (doctor asking CS for consult) so I'm curious to hear it go the opposite way.
No definitely the second way. Nobody outside medicine actually understands it, its all just idealized nonsense, which is why you see all the political ads all the time predicting the end of health care if either side wins. People dont have health IQ anymore because insurance companies made it complicated so they believe CNN or FOX news.

Even as an optional elective I doubt it. It just isn't related to medicine in the slightest, and then you gotta bring on a professor for a class maybe 5 people actually want to take. Its much less common for people to want to add on to medical school coursework. Even the decent electives already offered at my school are barely attended cuz of this. People want to do the minimum that they need for boards and get out.

It would be the equivalent of offering a business minor elective, tangetially related to medicine but not the point of medical school.
 
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Just read a reddit thread on automating some EMR stuff using Stepwise. Not real coding, but I'm 100% going to give this a shot when it's time.
 
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So I'm just hoping to get the opinion and advice of sdn'ers on this matter. I think now, more so than ever, learning programming and coding is an important skill for future physicians. Here are some of the reasons...

Pros:
- Medicine and the world is switching to be more electronic-based (EMR, artificial intelligence, wearable tech). Even coding is becoming a required subject in elementary schools. We need doctors that can bridge the gap to utilize technology to improve care through technological innovations.
- Creating new macros to speed up repetitive tasks such as charting.
- Learning programming can teach young doctors the skills of breaking large problems into solvable smaller steps, meticulous attention to detail, and being comfortable with not knowing the problem and successfully navigating through it (as opposed to the more traditional "buzzword" method of learning and testing in medical school exams).
- Marketable skill (to boost residency candidacy maybe?)
- Very helpful for organizing, managing, and interpreting research, especially when dealing with bioinformatics.
- Future citizens (30-40 year olds today) who are more used to technology than today's geriatric population, will be more comfortable implementing wearable tech, allowing for more effective preventative medicine.


Cons:
- Why not hire an expert in computer science (CS) and programming instead of half-assing your education on CS and medicine?
Counter = "The thought of using a hammer on a nail can't be possible if the user doesn't even know that the hammer exists." A doctor that sticks to the status quo without even learning of the potential of utilizing CS and programming will never think about how technology can help. To do this, only an introductory level of coding and programming, not an expert level, is needed. This is where interprofessional teamwork comes into play. Also, to bridge medicine and programming, it's much easier for doctors to learn the intro to coding, rather than programmers to learn the basics of medicine (2 preclinical years (?) lol).

- Steep learning curve.
Counter = Research by Morton et al., who designed a weekend intensive course for medical students at the Imperial College of London, showed that although it's steep, medical students can do it. Students from the study would go on to develop long term projects that combined medicine and programming.

- Less time to focus on education.
Counter = it can be a hobby, people make time for hobbies all the time. With step 1 being p/f, even less incentive to put all your eggs on the basket of "academic excellence", and focus on more "holistic" development. Also, I learned python on my own since the start of the school year, just dedicating 30 minutes of time that I would've used for netflix and youtube to learn, and it's actually quite enjoyable! I've also been keeping up quite well in classes, on top of other extracurricular commitments.


Some examples of doctors who combined medicine and coding:
Philippe Westerlinck MD, rad onc. Created Cancer Risk Calculator app to let patients assess their own risks for cancer based on self-reported genetic factors, environmental variables, and other health metrics.
Michael Abramoff MD PhD, ophthalmology. Created IDX-DR, an accessible machine to be used in PCP clinics that uses machine learning to assess diabetic retinopathy (leading cause of vision-loss globally, that could be easily treated if screened on time) and refer if needed.
Andrew Bastawrous MD, ophthalmology. Created PEEK, which is a smartphone app that uses the phone camera for easy vision screening.


I'm thinking if this is the right direction for future doctors, it might be something worth implementing, at least in my school, as an optional elective. But please, point out where I'm wrong, show me new evidence, I would like to hear your thoughts. Feel free to DM me if you want to talk more, or if you have exciting projects/ideas in this specific field.
This is been discussed before in these fora and the answer is not a snowball's chance in hell.

If you like coding, then by all means, stay true to that. Everyone needs a hobby.
 
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@Goro It makes sense for the implementation of coding into med school curriculum to be "not a snowball's chance in hell". But what do you think about the utility of coding for future doctors?
 
This is been discussed before in these fora and the answer is not a snowball's chance in hell.

If you like coding, then by all means, stay true to that. Everyone needs a hobby.
Lol "Oh I forgot I have a coding small group to go to in-between my TBL and PBL sessions today... also--don't forget our ethics and professionalism group presentation for tomorrow!"
 
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@Goro It makes sense for the implementation of coding into med school curriculum to be "not a snowball's chance in hell". But what do you think about the utility of coding for future doctors?
No it doesn't. We have a heard enough time keeping up with progress in Medicine. Save coding for the IT people.
 
I can’t think of a single way coding would help me deliver better patient care as a clinical physician. Spanish or religious studies would be much more valuable.

If you want to design EMRs and work for Epic, then coding is helpful. But the MD is then probably then a waste of time money-it’s better to just go the computer science route if your goal is coding/working on EMRs, work in tech, etc.
 
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“My new primary care doc is great. I’m not sure how much he knows about medical stuff, but he’s a whiz at JavaScript. You should see the web application he built for me the other day.”
 
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The thing people dont understand when they advocate for "doctors to learn programming" is that you cannot just produce valuable code overnight. You need to learn over time, have successful and unsuccessful projects. You have to actually learn how to be a computer engineer. So this idea that I am just going to "pick up" computer programming and develop an actual program that can be used in patient care is ridiculous. A doctor with no background is capable of fumbling around in R or making some EPIC macros possibly.

You can develop a strong base in just 6 months and after that, just learn more depending on what project you are doing.

Not true at all. Computer science students whose job it is to learn programming are pretty useless after a full year of introductory programming. A fresh graduate from a 4-year CS program is also pretty useless. Computer science is its own field, just like medicine.
 
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There’s value in learning R if you intend to do any kind of research in the future.
 
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There’s value in learning R if you intend to do any kind of research in the future.

Or you find a statistician like every other productive researcher.
 
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Or you find a statistician like every other productive researcher.

There’s value in knowing how the program works and being able to manipulate your data sets on your own, and statisticians don’t grow on trees. Anyway, I wasn’t suggesting that they teach R in medical schools...that would be a nightmare on top of the current curriculum, but if someone wanted to explore learning it as a hobby it could be useful in medical school and in future practice.
 
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If you go into research, aye. You need R, Python, Matlab. They are somewhat easy to learn since you don't have to go deep into them. When you need something too complex you consult with a bioinformatician. I'm taking some online courses (Coursera) right now and all seems fine and dandy :)

If you aren't doing research it's useless in your day to day life.

That being said. My school added mandatory bioinformatic and -omics workshops in MS3. I was long gone by then
 
It’s fine as a hobby, but there is a reason society specialized into different careers. If you want to go back to the 1800s when everyone was a farmer/builder/blacksmith/veterinarian/etc be my guest.

If you want to design EMRs and work for Epic, then coding is helpful. But the MD is then probably then a waste of time money-it’s better to just go the computer science route if your goal is coding/working on EMRs, work in tech, etc.

I used to work for epic and they program with M. I don’t know of anybody else that uses that language so kinda useless.
 
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There's no value in physicians learning coding. Source: I used to be a software engineer (C/C++).

There is value in physicians being comfortable with technology, but I have yet to encounter any current medical student for which that is not the case.
 
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Ditto. I code and a med student. They are completely separate in their skills and requirements.
 
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I don't think it should be a requirement but at least there should be optional concentrations. I know some schools do that.
 
You can't be prolific without knowing how to run your own stats. No productive researcher relies on a statistician. First, you can't design a study if you don't know how to eventually analyze it. Second, even if you did hire a statistician , it is going to be you writing the paper at the end of the day. If you couldn't analyze it on your own, how do you expect to interpret it. And if you constantly depend on a statistician to interpret it for you, then you won't be productive.

I have published 15 papers and from working with residents, those who don't know stats will not prosper as researchers and won't reach true prolific heights as an attending (25+ per year)

this is wrong. maybe in your experience, but as someone doing fellowship in an academic center, there are statisticians and research assistants around abundantly to do this exact thing for you. In fact, I have heard many of my academic attendings talk about how you need a statistician on your panel as nobody is going to take a research project seriously if there isn't someone dedicated to the analyzation.

you may have a lot of experience, but to say that you won't be productive, you are just flat out wrong. The entire hospital is damn productive.

And there is absolutely no utility in physicians learning coding. There should be work groups including both physicians and coders, but if I was an administrator and a physician said, "I can do this, I know how to code," I would say, "nope, I want it done right and if you are a better coder than physician, I need to replace you as a physician." it isn't about being afraid of computers. It is because it is a complete and utter waste of my time.

Now as a hobby, sure. But only as a hobby.
 
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It can be an engaging hobby but it has little to no utility.

However, I do think that my plan to pick up blacksmithing so I can make my own IV needles might have legs...
 
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this is wrong. maybe in your experience, but as someone doing fellowship in an academic center, there are statisticians and research assistants around abundantly to do this exact thing for you. In fact, I have heard many of my academic attendings talk about how you need a statistician on your panel as nobody is going to take a research project seriously if there isn't someone dedicated to the analyzation.

you may have a lot of experience, but to say that you won't be productive, you are just flat out wrong. The entire hospital is damn productive.

And there is absolutely no utility in physicians learning coding. There should be work groups including both physicians and coders, but if I was an administrator and a physician said, "I can do this, I know how to code," I would say, "nope, I want it done right and if you are a better coder than physician, I need to replace you as a physician." it isn't about being afraid of computers. It is because it is a complete and utter waste of my time.

Both of you raise good points. I think it depends on how big your group is and what type of research you're doing.

My group consists of 4 MDs, 3 Psychologists, 1 Biologist, 1 Nurse, 1 Bioinformatician. We're a small research group in a giant academic hospital. So we run the stats by ourselves or collaborate with other departments and groups.

However, we just finished a multicenter clinical trial (4-5 years). Since we are the main center and main authors of the trial, we have to legally outsource the stats to a different entity to avoid bias and manipulation.
 
How many papers did you publish this year? I'm curious if you are productive. Also, my last two projects literally required me to know R and Python. Data science is useful for physicians. Languages outside of R, Python, and MATLAB are most likely not. Residensts literally me give a crapton of projects literally because I know stats and they do know it.

I also really doubt your entire hospital is productive. I go to a top 5 medical school and work with neursurgery attendings. There are quite a bit of neurosurgery residents who are not even productive and this is the most prolific department in the entire school.

I don't give a crap about publications and hope to have exactly 3 publications my entire lifetime due to required projects. I am a clinician. But as I said, I work in an academic hospital where everyone around utilizes statisticians because that is their job. not a single person in all the fellowships that I am aware of argues this type of coding. They say, "get your IRB approved, get a statistician to do the analytics, and write your manuscript." Because I am a physician. It is similar to BLS. I am required to know how to do chest compressions and show that I am proficient in it, but in a code, I am the last one doing chest compressions because a tech can do those and that isn't why I went to medical school.

and you say residents give you a crapton of projects because you know stats and they don't. Is this a source of pride for you? you don't see that this is obviously work the resident doesn't want to do so they dump it on the medical student?

we aren't arguing the benefit of learning those languages. Could some people have benefit? sure. but to say that physicians should learn whatever the hell you are talking about is asinine. My research mentor publishes around 20-30 projects per year and doesn't do coding. he has a close relationship with those that know better than he does.
 
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There’s a reason statisticians have jobs. They know how to not only analyze data far better than us, but they can design the study correct in the first place. It’s what they do for a living. As the child of a biostatistician, I know how important they are. So much research is meaningless because a statistician wasn’t consulted from the start. I can’t tell you how often my folks looked at a study and told me how useless it was because of poor design.

That’s not to say us MDs shouldn’t know stats, and that we absolutely need statisticians for everything. But if we want a meaningful study that people take very seriously, then we generally need a good (not just any) statistician. We’re never going to be as good at stats as someone with a PhD in stats, just as they will never be as good at medicine as us.

Stats is certainly something worth learning in medical school. All of us should have some basic competence so we can analyze the literature. Researchers certainly need better understanding.
 
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As someone who doesn't take research seriously, then I don't believe your words are really valuable on this topic. You have to work with people who are prolific and have to be prolific to understand what skills are important.

Also, it is a source of pride and they are very easy papers for me. It's not work that they don't want to do but rather work they can't do or do with a high degree of struggle and likelihood of making an error. I'd also hardly call it dumping if I'm getting a lot of papers out of it and can finish the papers quickly. I've published 15 papers already and I'm only an MS1. You've published only 3 and you're a full fledged physician, so I'm fairly confident my words are more valuable when it comes to this issue of being prolific.

I'm also curious how prolific the fellows at your hospital are. Guarantee that the vast majority of them haven't published more than 3 or 4 this year. Like I said before, you can't design high quality studies without knowing stats, you can't write high quality papers if you don't know stats, and your projects will be delayed if you don't know stats.

Congratulations on performing undesirable technical tasks for residents and getting your name printed on pieces of paper as compensation. That's a sign that you'll be a truly superb physician one day. Keep up the good work.

Now that the congratulations are out of the way, I have to ask... Do you realize that this is a thread about whether coding will/should become a necessity for physicians in general, not specifically the minority of physicians who aspire to become prolific medical researchers? Most physicians choose to play exclusively clinical roles, you know; they don't publish academic papers and have no desire to do so.
 
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And I though the ERAS 21 panic thread had the most angst on this site...
 
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Regarding the contentious side discussion about running stats, (and, disclaimer, I personally despise doing research): My wife is an exceedingly prolific early career researcher with a few grants. She does work with statisticians for most if not all of her projects, but she has found that it has greatly enhanced her workflow and productivity to be adept in R and stats, to the point where she has done a master's that included some stats heavy courses to build up on that.

Again, due to her bizarrely high level of productivity, this is mostly because she works so much more quickly than everyone else that it helps her just to get some numbers hammered out on her own so she isn't waiting too long on the stats person to catch up; YMMV on that, it certainly doesn't apply to most people
 
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Knowing stats helps rather than simply deferring everything to statisticians.

Coding is a useful hobby. Knowing R helps.

/debate
But is in no way worth being a mandatory thing for physicians to learn..
 
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The vast majority of stats that someone has to run doesn't require a PhD. But regardless if you do hire a statistician, a MD who knows stats working with a statistician, will have more firepower.

And exactly, those folks who designed poor studies didn't know how to run stats on their own. That just shows my point.


Disagree. @RangerBob makes good points. I have a graduate degree in epidemiology, the bulk of which was epidemiology methodology and biostatistics courses. It “seems“ easy to run statistics because yeah you can have some basic knowledge about statistics and put some data into R, run some stat, and get output that looks like it make sense. You can probably get it published too because a lot of science with bad stats gets published. That doesn’t mean it was the right design or analysis. That was actually an activity we did in class, here’s a paper published in a peer reviewed journal, did they do the right design and analysis?

Even with all of our grad school training our professors said, ”you still should consult a statistician when doing research because we’re going to teach you just enough to be dangerous.” You don’t know what you don’t know. There’s a lot of nuance in these things. Also, utilizing a statistician doesn’t mean you can’t do the analysis yourself, but you consult that statistician for input on critical decisions.

On the topic at hand, epidemiology, data science, and bioinformatics could be useful for the interested research minded folks. I don’t think it should be mandatory.
 
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Just read a reddit thread on automating some EMR stuff using Stepwise. Not real coding, but I'm 100% going to give this a shot when it's time.

It works really well for CPRS, Cerner.

Epic has option to make Order Panels where you can just type/say “Doc Smith Meningitis” and it populates all the orders and just sign with one click.
 
I think this thread had evolved/devolved into a few different discussions.
1. Should "coding" (aka programming) be a required physician skill set? No.
2. Should physicians be comfortable with basic statistics? Yes. That's why it's on the Step 1.
3. Should physicians be trained to be statisticians? No.

And finally, the programmer snob in me would like to say that using R or Matlab or writing macros is not "coding". As such, they can be picked up as needed without much difficulty. R might be a useful tool for helping to learn statistics, but not as an end unto itself.
 
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No definitely the second way. Nobody outside medicine actually understands it, its all just idealized nonsense, which is why you see all the political ads all the time predicting the end of health care if either side wins. People dont have health IQ anymore because insurance companies made it complicated so they believe CNN or FOX news.

Even as an optional elective I doubt it. It just isn't related to medicine in the slightest, and then you gotta bring on a professor for a class maybe 5 people actually want to take. Its much less common for people to want to add on to medical school coursework. Even the decent electives already offered at my school are barely attended cuz of this. People want to do the minimum that they need for boards and get out.

It would be the equivalent of offering a business minor elective, tangetially related to medicine but not the point of medical school.

Yeah we had an elective course that seemed somewhat interesting, and I think 7-8 people took it out of 170.
 
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Even with all of our grad school training our professors said, ”you still should consult a statistician when doing research because we’re going to teach you just enough to be dangerous.”

This. I have a math degree and did a lot of stats work. I understand stats pretty damn well. We still have a statistician onboard for our project because, you know, that’s what they do for a living.
 
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This. I have a math degree and did a lot of stats work. I understand stats pretty damn well. We still have a statistician onboard for our project because, you know, that’s what they do for a living.

I think the idea is knowing stats personally + having a statistician nearby help. Not that knowing stats replaces the need of having a statistician. Rather than wasting time waiting for stats to be done, having the knowledge would be helpful for a quick check.
 
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I think the idea is knowing stats personally + having a statistician nearby help. Not that knowing stats replaces the need of having a statistician. Rather than wasting time waiting for stats to be done, having the knowledge would be helpful for a quick check.

Yeah it’s helpful because you can take part in it and even do some of it, but I would still have a statistician onboard if only just to bless it at the end.
But would you agree that having that stats/maths background has been pretty valuable nevertheless when it comes to research?
Well most of my research has been in math/stats, so yes lol. But the project I’m doing now is pretty stats heavy and it definitely comes in handy. Our statisticians are onboard to make sure we don’t put out any garbage.
 
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It is a Turing complete language. I have used R for machine learning. Pretty sure I was programming.

wereyouthough.jpg
 
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I think this thread had evolved/devolved into a few different discussions.
1. Should "coding" (aka programming) be a required physician skill set? No.
2. Should physicians be comfortable with basic statistics? Yes. That's why it's on the Step 1.
3. Should physicians be trained to be statisticians? No.

And finally, the programmer snob in me would like to say that using R or Matlab or writing macros is not "coding". As such, they can be picked up as needed without much difficulty. R might be a useful tool for helping to learn statistics, but not as an end unto itself.

Dude what? R is a programming language. Same with MATLAB. There's literally a lot of modules and applications that are MATLAB based and widely used in research and updated by programmers.
 
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If any of us actually wanted to do coding we would’ve gone into CS... /thread
 
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If any of us actually wanted to do coding we would’ve gone into CS... /thread
Yep.

And if you end up doing lots of research and want to learn coding you can.

I am a 100% clinical outpatient FP. Coding classes would not benefit me in any way that I can see.
 
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Dude what? R is a programming language. Same with MATLAB. There's literally a lot of modules and applications that are MATLAB based and widely used in research and updated by programmers.
Yeah. If MATLAB isn't a programming language, then neither is Python. I've done some cognitively demanding tasks with MATLAB which parallel the exertion I've used with other languages. If it meets the Turing criteria, it's a programming language. Plain and simple

That's my bad. Since it is Turing complete, like DOS batch files and BASIC, you're both elite hackers.

Seriously though, your defensiveness on this topic reeks of insecurity. Who even cares? I threw shade at R as a joke. Let it go.
 
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Surprising... when I control-f this thread there’s nothing about the garbage peddled by Andrew Yang.
 
Yeah. If MATLAB isn't a programming language, then neither is Python. I've done some cognitively demanding tasks with MATLAB which parallel the exertion I've used with other languages. If it meets the Turing criteria, it's a programming language. Plain and simple
That's my bad. Since it is Turing complete, like DOS batch files and BASIC, you're both elite hackers.

Seriously though, your defensiveness on this topic reeks of insecurity. Who even cares? I threw shade at R as a joke. Let it go.

Both of you chill. An argument about who is the programmiest programmer is completely unnecessary.
 
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