Dear Readers,
This week on Out of Programme, we’re joined by Dr Nick Appelbaum — a South African surgeon who was plucked out by Lord Ara Darzi, completed a PhD building medication safety tools at Imperial’s Helix Centre, spent seven years creating the first machine-readable British National Formulary, and founded Dosium — a company now deployed in NHS trusts cutting medication errors by 83%.
🎧 Watch the full episode on YouTube:
You can also listen on: 🎧 Spotify
🔬 A “Self-Help Program” - Tormented by the cognitive load of prescribing in Cape Town trauma centres, Nick built spreadsheet tools, designed syringe graduations, and filed a patent. He was just trying to make his own job easier.
🏛️ Lord Darzi Rerouting His Career - Nick came to the UK planning an immunology PhD at Oxford. A meeting with Lord Darzi in a surgical changing room at St Mary’s changed everything: “Come do a PhD in patient safety. I’ve got a design centre. You can build something.”
📚 Building the First Machine-Readable BNF - Seven years of collaboration with the Royal Pharmaceutical Society turned the British National Formulary from a book publishing system into a machine-readable knowledge backbone for Dosium’s platform.
🏥 Founding Dosium - Patient-specific, indication-specific medication orders inside existing NHS electronic prescribing systems. First results: 83% reduction in the odds of a medication error.
💡 Why Academic Projects Die - The NIHR I4I grant forced the spinout decision. Nick’s take: “Take public money and you must put commercial infrastructure in place upfront — or the project dies like any other academic project.”
Nick’s episode is proof that:
🔬 The best innovations often start as a “self-help program” — solving your own clinical frustration can lead to national infrastructure
🏛️ The right mentorship at the right moment can completely reroute your career — Lord Darzi saw something Nick didn’t see in himself
📚 Academic cover and institutional credibility are irreplaceable when building relationships with national institutions like the BNF
💡 An academic project without commercial infrastructure will die — building the entity to carry the work forward is not optional, it’s essential
As Nick says:
“Find a way to validate the economic proposition with a buyer, a CFO, find a suit, speak to the suits early on. Don’t leave the suits to the last minute — because you’re going to have a misadventure.”
🧠 Interested in building in digital health?
Applications are open for the BiteLabs Digital Health, AI & Innovation Fellowship — cohorts in both the UK and the US.
BiteLabs is where clinicians build, launch and lead in digital health. 800+ fellows · 200+ advisors · £15M+ raised · Rated 4.9 on Google.
Apply via Out of Programme and you’ll receive: ✅ Extra points on your application 🎯 A 1:1 career coaching session with the BiteLabs team 🤝 A personal session with a BiteLabs founder
🔗 Apply at bitelabs.io 💬 Use referral code: OUTOFPROGRAMME in your application form
💡 Subscribe for more stories of career reinvention:
🗞️ Substack | ▶️ YouTube | 🎧 Spotify | 🍏 Apple Podcasts | 🔗 LinkedIn
If you know someone contemplating their next move — share this episode with them!
Until next time,
Dr Jing Ouyang
👉 Follow me on LinkedIn for a behind-the-scenes look and reflections on Out of Programme.
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