Medical Misfits

Ulrich Nitsche is a medical doctor, a surgeon, researcher and clinical reviewer at Tüv Süd, where he’s also a department manager. He studied medicine in Innsbruck (Austria) and went on to work as a surgeon at the University Hospital of the Technical University in Munich, where he also did research. He did his doctorate thesis, PhD and habilitation in Munich. He also finished his specialization to become a surgeon in Munich.

He went on to work at Tüv Süd as a clinical reviewer three years ago and is now the department manager of the clinical center of excellence there. While working at Tüv Süd, he still works as an emergency physician from time to time, that means he is dispatched in ambulances with paramedics.

• Why he chose to become a surgeon
• How life is working as a surgeon: Seeing great improvement in patients, but also long shifts and very little free time
• How living 30-40 minutes from the hospital meant it was sometimes easier for him to not come home and sleep at the hospital instead
• What caused his decision to switch to an “office job” at Tüv Süd, and how the transition from operating theatre to office job felt for him
• Why he decided against other job options in consulting and the pharmaceutical industry
• What a typical workday for him looks like and what the hell a “clinical reviewer” does
• Differences working in the industry vs. in hospitals: Less strict hierarchy, more flexible work hours
• How he ended up still working as an emergency physician while working at Tüv Süd

• Ulrich on LinkedIn.
• Tüv Süd Medical Devices & Healthcare - The Tüv Süd landing page for their medical devices team.
• Tüv Süd Jobs page filter by either searching for “clinical reviewer” or “klinisches review” to find jobs for physicians.

Zoe Lee is a medical student at Keele University in the UK. She’s also a part-time Community Associate at Melon, an EdTech startup which aims to boost Gen-Z’s microlearning process. Besides those two things, she also recently joined a Healthtech fellowship program at BiteLabs Healthtech, where the goal is to get together in groups and build a Healthtech product within a few weeks.

• What Zoe is currently doing in her third year of medical school, and why she chose to study Medicine
• Getting her first tech startup job at Melon: How she applied, how many other applications she sent out and her small “hack” for (maybe?) improving your chances
• What she does at Melon and what it means building a community and creating content for TikTok
• How she manages to do juggle her tech startup job with her studies in medical school: Remote work, flexible work hours, time off for studying and more
• We discussed whether good “quality” work is rewarded more in tech startups vs. in the hospital
• What’s more fun: Whether working at a tech startup or as a doctor?
• Her experience joining the BiteLabs Healthtech Fellowship
• Her interest in writing and what she would do if she wouldn’t have to earn money
• What advice she would give to other medical students / junior doctors who are interested in exploring other opportunities or working in tech

• Zoe on LinkedIn.
• Zoe wrote this article about how she landed her tech startup job as a medical student.
• Zoe recently posted on LinkedIn with a link to resources she curated on Melon for “breaking into tech with a clinical background”
• Melon, the startup for which Zoe is working part-time, building their Community
• Company TikTok account of Melon for which Zoe creates videos
• The BiteLabs Healthtech Fellowship, a for-profit fellowship in which groups build a product in Healthtech in a few weeks.

Stephen Gilbert is a veterinarian and professor for regulatory science at the University Hospital Dresden. Before that, he worked as a regulatory affairs manager specializing in clinical evaluation at Biotronik in Berlin, a large and established medical device manufacturer, and then for at Ada Health, also in Berlin, as director of clinical studies and clinical evaluation. Initially, after graduating as a veterinarian in 2001, he worked as a veterinarian and veterinary surgeon for around 10 years in the UK. In addition to studying veterinary sciences a the University of Glasgow, he did a Master’s Degree in Biomathematics, Bioinformatics and Computational Biology at the University of Leeds, and followed that up with a PhD in computational biology.

• Why he stopped working as a vet: “List-based” work vs. “project-based” work
• Learning self-sufficiency as a vet while having to perform all sorts of operations after graduating
• How he was involved in handling the food and mouth disease outbreak and how that relates to project management
• Transitioning into “wet lab” scientific research and simulations
• How he joined Biotronik, a medical device manufacturer based in Berlin, and worked there to acquire the first-ever CE certificate for a medical device under the new Medical Device Regulation
• The benefits of doing a Master’s degree and/or PhD as a doctor and which sort of program / research area to look for
• We both talked about the German system of doing a “Dr. med” research degree
• What does a Professor of Regulatory Science do? And what is Regulatory Affairs?
• The “implant files” which led to the uncovering of implants which caused harm in patients and their effect on subsequent medical device regulation
• Are we over-regulating medical devices? Do we even have any data to answer that question?
• AI in Healthcare: Chances and risks of ChatGPT and large language models (LLMs)
• LLM medical software currently on the market, their features and considerations whether they are medical devices

• Why Johan first worked as a doctor but then left the hospital because working as a doctor doesn’t scale and it’s hard to have a larger impact
• Why it’s hard to change a hospital from inside
• His first job (scholarship) after leaving the hospital which was about identifying problems in hospitals and how to solve them
• Building his first own Healthtech company producting wearable sensors for patients in hospitals
• Being a professional poker player, doing that during medical school, and what made him stop
• How the knowledge of poker is useful in other aspects of life
• Why he didn’t aim for good “grades” in exams
• What a product manager actually does and how to learn it
• Why many doctors underestimate their usefulness
• “The rise and fall of Europe’s largest telemedicine provider”
• Working at Kry while it grew from 60 to 1.200 people
• In which areas you could build successful Healthcare companies now
• What he’s doing at his own company, 4scale, now
• The pros and cons of venture capital (VC) funding for startups

• Johan on LinkedIn.
• Johan on Substack where he publishes his writing: Big world - Small world and Mini mental models.
• 4scale Ventures: Johan’s company which he co-founded. They support companies to reach their ambitions on growth efficiency and leadership. They also invest in companies and offer consulting and coaching.
• womanly: The female health ecommerce startup which Johan is currently building.
• Kry: Telemedicine company where Johan was the director of product. Kry is available in Sweden, Germany, Norway, France and the UK (slight correction here as I didn’t mention the UK in the podcast).

• How she got her first job in digital health already during her studies
• Why she decided to continue working in digital health upon graduating versus working in a hospital
• How it’s like to work from Bali: Surfing, productivity, time zone differences, coworking spaces
• Why working in a different time zone makes her more productive
• An example of a study they did in Tanzania which compared mid-level healthcare professionals using software versus physicians without software (with very interesting results)
• How a typical work day looks like for her
• How she had to start managing people a few months in to her job
• Why she’s considering going back to work in the hospital to work as a physician in Dermatology some time in the future

• Fabienne on LinkedIn.
• Ada Health: Where Fabienne currently works. A healthcare company in Berlin developing a symptom checker. Note that Matthew Fenech, a prior guest on this podcast, also worked at Ada Health, and I also worked there as Ada was my first consulting customer back in 2020.

• How he got into evoluationary biology
• How become the first doctor to join the Max Planck Institute for Evolutionary Biology as a researcher
• His research on modelling cancer in software
• Why he moved back from the US (doing research at the Cleveland Clinic) to Germany
• How he managed to leave research to join the startup industry, getting his job at Bulbitech
• What he did at Bulbitech: Detecting diseases through eye movements
• Why writing skills are so important

• Luka on LinkedIn
• CancerSim: The software (python package) which Luka co-developed for the simulation of cancer.
• Bulbitech: The startup Luka worked at, building software for detecting diseases through eye movements.

• Paulina on LinkedIn.
• Dama Health: Paulina’s startup which aims to help women and their clinicians in choosing the right contraceptive.
• Post on Dama Health on the website of the Imperial College Accelerator: We briefly talked about accelerator programs and Paulina mentioned that the Imperial College Accelerator was quite helpful for their company.

• Matt on LinkedIn.
• Una Health: Matt’s startup developing a diabetes app.
• Ada Health: Well-known healthcare company in Berlin developing a symptom checker. Matt worked there as the Medical Safety Lead which was his second job. Also, the two of us met there as Ada was one of my first consulting clients when I became self-employed.
• Future Advocacy: A think tank and Matt’s first job out of the hospital.