Samir C. Grover, M.D.

1/8 If you're a med student or resident in 2026, you need an AI stack. Not one tool. A stack. 94% of the public thinks docs should be trained on AI limitations. 85% think it should be mandatory in med school. Here are the 7 layers I'd recommend. 🧵 samirgrovermd.substack.com/p/the-ai-stack…

Some experts do not think OpenClaw is relevant to AI in healthcare. They are wrong. OpenClaw represents us phase shifting in the way we relate to AI systems again. We are moving past promting a chatbot to ask a question so that we can do the work. We are moving past prompting an AI agent to go off and do a defined task itself. We are arriving at providing an AI agent with an objective and it continuously prompting itself to go off gather information and take actions that advance its objective. In medicine, this will look like an agent scouring a panel of active pateints for care gaps, lab trends, or treatment optimizations. Continuous clinical inference — always on is future of all AI knowledge work, medicine included.

@alandrummond2 Yes. But it wasn't funny. There was so much to make fun of in our healthcare problems...and they chose referrals? I'd have gone with naming "rooms" after hallway parts. Funny and true. Like getting lost looking for room "LS2". Light switch 2.

I love this show and Hallway "Medicine" needs to be called out for its fundamental absurdity. Satire is a valuable tool in that regard.

I have been watching @DrBloodandGuts give some version of this🩸talk for years and I will *STILL* listen to it every time it enters my orbit. He has perfected it. No notes 📝 vumedi.com/video/from-red… #GITwitter #MedTwitter #GIFellow #Hemostasis #Endoscopy @VuMedi

Sal Khan was one of the first people on Earth to see GPT-4. OpenAI called him in the summer of 2022, months before ChatGPT existed, and showed him what was coming. He couldn’t sleep that weekend. By March 2023, Khan Academy launched Khanmigo, an AI tutor built on GPT-4, the same day OpenAI unveiled the model to the public. They were a launch partner. While every other education company was figuring out what ChatGPT meant for them, Khan Academy had already been building for seven months. The “obsolete” platform now has 120 million yearly learners. Khanmigo, their AI tutor, grew 731% year over year in the 2024-25 school year, reaching 2 million users. In classrooms alone, adoption went from 40,000 students to 700,000 in a single year, with projections past 1 million for 2025-26. Their teacher tools are free in over 70 countries. In January 2026, Khan Academy signed a deal with Google to put Gemini (Google’s AI) into new Writing Coach and Reading Coach tools for middle and high schoolers. They’re now working with both OpenAI and Google. A peer-reviewed study published in PNAS (one of the top scientific journals in the world) in January 2026, with researchers from Stanford and the University of Toronto, found that more Khan Academy usage is directly linked to higher student test scores. Sal Khan wrote a whole book in 2024 called “Brave New Words” arguing AI would save education. Sam Altman wrote a blurb for it. His TED Talk making the same argument was one of the 10 most-watched of 2023. In October 2025, he was named TED’s “vision steward.” Khan Academy is now the AI education company. That 731% growth happened while students spent 7.7 billion minutes learning on the platform in 2025.

@raghu_venugopal @22_Minutes I mean the bigger issue is that it wasn't funny lol

Shame on you. On behalf of every real ER doctor and nurse who's struggled with overcrowding and long wait times, and on behalf of every Canadian and their family who's suffered the inadequacy of our ERs at times. I'm a huge CBC fan. You disgust me. @22_Minutes

The AI stack for the medical student or resident open.substack.com/pub/samirgrove… via @Samir_Grover

Last chance! We are almost at the end of accepting rolling applications for Summer of Vibes, the innovative and immersive summer student program at @SHNcares. Work with me, @joshualandy, and a team of clinicians, developers and education experts to build, test and research products to meet gaps in clinical medicine and medical education. Work at a major clinical site of the new Scarborough Academy of Medicine, soon to be the fifth academy of the University of Toronto #medicalschool. Get tons of exposure, experience, meet cool new friends, colleagues and mentors. We'd love to hear from you if you are interested. Spots are limited. More details here 👇 summerofvibes.ca @CaptainAV

Any academic physicians give talks? Create a folder with all of your prior talks. Have any of them been recorded? Put that in the folder. Give Claude Cowork or Codex access and it becomes a talk draft generation machine. Custom for your voice.

@TorontoIDDoc Bro lol

#ThePitt missed a golden opportunity to have that lady who came with bad constipation being looked after by Ogilvie to have a diagnosis of Ogilve’s.

8/8 COST Start with one subscription (Claude Pro or ChatGPT Plus). Add OpenEvidence (free). Add NotebookLM if you have institutional Google access. Don't pay for everything at once. The stack will keep changing. Your judgment is what compounds. Full article 👇 samirgrovermd.substack.com/p/the-ai-stack…

7/8 BUILDER + INCOMING Claude Code, Codex, Replit: you can build what med ed doesn't have yet. Yourself. With the best programming language - English. We built 20+ apps with undergrads at SHN last summer on Replit. The clinician-developer phenotype is real and already here. And watch the virtual patient space: programmable practice systems where educators set the disease, tone, hidden agenda, and rubric. Penn Medicine, MCW's ChatClinic, and our SharpenEDU are all building here. sharpenedu.com

1/8 If you're a med student or resident in 2026, you need an AI stack. Not one tool. A stack. 94% of the public thinks docs should be trained on AI limitations. 85% think it should be mandatory in med school. Here are the 7 layers I'd recommend. 🧵 samirgrovermd.substack.com/p/the-ai-stack…

Anyone who's familiar with the Dune novels will recognize these as Mentats, minds trained to run advanced programs and computations in a world without computers. Fascinating stuff!

Vibe research coding at 2026 😅

Had a great time at the Asia-Pacific Gastroesophageal Cancer Congress in Okinawa, Japan. Wonderful discussions, excellent science, and a chance to connect with colleagues from around the world. Mata ne, Okinawa!