Innovation in Residency

by Casey Kraft, MD (@CaseyKraftMD)

I am a current plastic surgery resident at The Ohio State University. For the last 6 months, I have been working with the university to create and develop a medical device. We recently submitted the provisional patent, and are currently working on the formal patent. The whole process has been eye-opening. Below are some insights I’ve gained from the experience so far that may be of interest to other residents looking to take an idea or invention through the next steps.

Plastic surgeons are innovators. It’s what we do. I can remember multiple times as a medical student listening to lectures about plastic surgery, and one common theme arising:

“Plastic surgeons solve problems.”

For me, it’s an interesting way to sum up the entirety of a surgical specialty in 4 words, but I think most residents and attendings would agree that it makes a good point. Our specialty is not defined by “If X, then Y” types of procedures. We are guided by principles, and use these daily to come up with one of any number of solutions to various problems. Multiple times, I have seen different attendings and residents discuss a problematic wound, several proposing different methods for reconstruction, all of them equally possible and valid options. This variety and problem solving is one of the cores of plastic surgery, and for many, one of the great aspects of the field.

Taking Problem Solving Beyond Techniques:

Our training teaches us how to solve complex problems based on principles. It teaches us how to think outside the box. However, thinking outside the box applies to more than just surgical techniques in the OR. Medicine is full of dogma – techniques and best practices that have always been done that way. As we move towards evidence-based medicine however, we push ourselves to challenge these dogmas. Research is one avenue that many residents take part in to think outside the box and innovate during residency. Contributing to a growing body of evidence-based practices and challenging dogma require these same skills. Innovation in medical technology is another outlet for utilizing problem solving skills and challenging norms. Medical technology, however, is a much different beast than research or the OR. It is something many residents may not have personal familiarity with, and would be uncomfortable pursuing on their own. Despite this, I am confident that all of us have thought at one point “This could be designed better,” or “Why doesn’t a tool exist that allows me to do that.” Having recently ventured into the world of medical innovation, below are some of the best tips and lessons learned I have for other residents looking to try their hand at medical technology.

1. Find a Mentor

This should seem obvious to most, as it applies to nearly all areas of life. In other areas of medicine, such as research, it is a little easier to have a mentor from the outset. Usually research is done in collaboration with a mentor from the beginning. For technology, you may have come up with an idea yourself. Now you need to find a mentor who can help you navigate the process, without them having been a part of the initial stages. I personally thought this would be awkward, but was astounded by the support I received from faculty when discussing my idea. My approach was to find faculty who were experts in the subspecialty in which I predicted my device would have the most use, or any that I knew had their own patents who might be familiar with the process. I was surprised to learn how many faculty had some experience in technology and device innovation, and were willing to share their insights into the process of developing a technology, applying for a patent, etc. Many of these individuals have continued to mentor me as I progress through the development process, and have been invaluable for their advice in how to think about other problems, what I may be missing that other surgeons may care about, etc. Having a mentor is crucial as a resident for developing a technology, and many attendings are overjoyed to help residents with such endeavors.

2. Connect with the Institution

One important fact to keep in mind when developing a technology, is that if you are a part of a university, they own your intellectual property. This often is a disheartening fact for students or faculty to learn, and anecdotally I have seen other people decide not to pursue ventures because they do not want the university to “own” the product. These feelings are valid, but I would stress how important it is to find out more before abandoning the venture. Many institutions have this policy because they assume a large part of the risk of a technology that may not be immensely profitable. Applying for a patent alone can be an extremely expensive proposition, but one that a university would likely cover for a student, resident, or faculty member working with the institution.

My experience has been that the institution’s focus is on the learning process for the inventor. The university is more than happy to provide resources for motivated people so that they can explore their passion and gain experience in developing new technology, making the path to development seem much more navigable. This experience in and of itself is incredibly valuable for residents and those looking to work in medical innovation. That said, one should be sure to look at what percentage of potential profits the university keeps for a technology. My understanding is that this varies considerably from one institution to another, but it is important to note that it is not 100%. Everywhere I have seen has always included a percentage of profits to the inventor. I feel that many people are afraid that the university would take 100% of the profits from a good idea, and this simply is not the case.

3. Be Prepared to Learn a Lot

When developing new technology from scratch, you are going to be thrust into a multidisciplinary setting in which there are many voices and perspectives to hear. This was one of my favorite parts of the process as I learned an astounding amount about other fields and how people think. A striking example is taking something I was developing to a group of engineers for assistance in design. I was confident I had come up with a great design, but it took less than 5 minutes for this group of engineers to completely mentally deconstruct my idea and come up with several potential improvements.

Applying for a patent is another great example. Many residents, myself included, have little familiarity with the legal world. Working with legal teams from the university to create a patent application has been another great experience for learning about fields I would otherwise never be exposed to. Every lawyer I have worked with has been so helpful with explaining the patent process, what it entails, what the requirements are for a successful patent, how things need to be worded, etc. Although some people have success applying for patents without lawyers, having them explain everything to me in detail was an immensely valuable learning point.

4. Be Passionate

People will respond to your enthusiasm. If someone asks you to come up with sketches for design refinements, come back with prototypes. When people can tell that you are passionate about your idea and willing to go above and beyond to develop it, the whole process becomes much easier. Everyone I have interacted with has been excited to contribute to the design or facilitate the development of the technology, making the process faster and definitely helped improving the final result. Show others the passion you have for this innovation – you would not be taking the time to seek out these resources and pursue this often-challenging process if it had not inspired you. Part of the “sell” is the ability to light that spark of ingenuity and excitement in those from whom you are seeking help. Finally, always remember that it is a constant learning curve, and the fun is in the whole process, not just the final product.

Casey Kraft, MD
Plastic Surgery Resident at The Ohio State University

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