Responders were asked to rate agreement with a statement using a Likert scale of 1 to 10, where 1 indicated strong disagreement, 5 indicated neutrality, and 10 indicated strong agreement. Ten students (100%) completed the survey, and 100% of students recommended the elective for future medical students.
The three highest rated statements were (mean ± standard deviation):

- I am interested in a minor in startups & innovation (9.3±1.3).
- I am interested in a one-month M4 elective on startups (8.6±1.6).
- Rate the overall elective (8.6±1.0).

The three lowest rated statements were (mean ± standard deviation):

- I understand regulatory & reimbursement aspects of health tech (6.7±1.3).
- I will found or work at a startup (6.9±1.5).
- I understand legal aspects of health tech (7.1±1.1).

When asked about career goals, students reported the desire to pursue residency, practice clinically, and work with startups in advisory, consulting, or collaborative roles.
Students also suggested ways to improve the elective, including networking events with business, engineering, and law students, a more detailed case study of a startup from idea to market, and lectures on implementing technology in the clinic.
The business model canvas project was the least favored aspect of the course; several students requested more in-depth guidance on using the framework.

# Limitations

Our survey faced several limitations. It was only designed to gauge interest in specific topics within our elective. We measured perceptions after the course and did not survey a control group. Furthermore, our sample size was small and the survey results were self-reported. Aware of these constraints, we simply utilized survey feedback to inform future medical education initiatives.

# Next Steps

To respond to student demand at our institution for further educational opportunities related to technology and innovation, we are piloting a new project-driven elective for fourth-year medical students. Over one month, students identify unmet healthcare needs by speaking with patients, providers, payers, and other stakeholders. Students also learn from discussions with experts in engineering, information technology, product development, and business. At the end of the elective, students propose a product or process addressing the unmet need. This approach has utility both as a didactic tool and an ideation method for quality improvement projects. Creative problem-solving skills are important for clinical care, research, and more directly translational work, yet underrepresented in current medical curricula.

# Discussion

Academia can do more to support medical student and physician involvement in the creation and implementation of technologies that improve patient care. Relevant topics in business, law, and engineering should be available at least as an option in the curriculum without increasing the time required to complete medical school. Students should be encouraged to consult for, collaborate with, or intern at companies, especially early-stage technology startups. Some academic institutions have also supported startup incubators, i.e. programs to fund and guide student, trainee, and faculty entrepreneurship. Examples include StartX, associated with Stanford University, and Sling Health, a program started at Washington University St. Louis and recently expanded to our institution.
Unfortunately, medical students are tacitly discouraged from pursuing endeavors outside of clinical work, basic science, or clinical research. Changing this perception remains a major cultural challenge, yet also presents an opportunity for academic medicine to define how technology advances the delivery of healthcare. We believe medical schools should support and facilitate the pursuit of such opportunities by medical students.

# Conclusion

In summary, the IEMed elective exposed medical students to topics at the intersection of technology and healthcare, which are underrepresented in medical curricula. The elective was well-received by all participants. IEMed required only a few hours per week of faculty and/or teaching assistant time, as it drew heavily on guest speakers with relevant expertise. This model is simple, could be easily implemented at other institutions, and may contribute to the professional development of future leaders in healthcare technology and delivery.