01 August 2025
Following a rigorous selection process, Moorfields Eye Hospital optometrist, Josie Carmichael, will start a year-long NHS Fellowship in Clinical AI on 13 August.
Healthcare professionals from a diverse range of clinical specialties apply for the fellowship, with successful applicants completing an immersive project in clinical AI, alongside workshops, online learning and networking.
Carmichael spoke with OT about the fellowship, as well as her PhD research exploring optical coherence tomography (OCT) and the role of AI.
What has your career journey been to date?
I qualified in the summer of 2017 and have been working in the hospital eye service since my pre-registration year. I completed my pre-reg training at Manchester Royal Eye Hospital, then joined Moorfields Eye Hospital later that year to undertake a residency position.
What was the focus of your PhD?
My PhD thesis explored how OCT is used in optometric practice and how that understanding can inform the design of AI decision support tools. I looked at referral accuracy, how optometrists make decisions with OCT, and how AI influences trust and behaviour. The project combined qualitative and quantitative methods, grounded in a human-computer interaction approach. A key focus was on designing AI that fits into real clinical workflows and supports, rather than replaces, clinical judgement. While focused on optometry, the findings have wider relevance for AI in clinical imaging more broadly.
Why did you decide to apply for the NHS Fellowship in Clinical AI?
I applied for the NHS Fellowship in Clinical AI because it felt like the natural next step after my PhD. My long-term goal is to become a clinical AI lead and play an influential role in shaping and delivering AI projects within the NHS. I'm especially passionate about being an advocate for clinical AI within the optometry community, where awareness and adoption are still emerging. What excites me most is the opportunity to gain experience across the full AI lifecycle and contribute to a field that is evolving rapidly and reshaping how we deliver care.
What was your reaction when you found out that your application had been successful?
It definitely took a moment to sink in. I knew this was a highly competitive process and such a rare opportunity to be part of something at the forefront of healthcare innovation. I felt incredibly grateful and excited for the chance to contribute meaningfully to a field I really believe in. It’s a real privilege to be part of a programme that’s shaping the future of clinical AI in the NHS.
Can you describe what this fellowship will involve?
The Clinical AI Fellowship is a 12-month programme where I will work two days a week embedded in an NHS clinical AI team at King’s Hospital. Within the team, I will be actively involved in a real-world project that focuses on developing, validating, and implementing an AI tool in a clinical setting. The work is multidisciplinary, so I will collaborate closely with data scientists, clinicians, and technical teams. Alongside the project work, there’s also structured learning like Python and applied AI, as well as monthly group workshops with AI experts. It will be a really immersive way to understand not just the technical side of AI, but also the regulatory, ethical, and practical considerations involved in making it work safely and effectively in the NHS.
I’m really looking forward to the opportunity to work in a clinical area outside optometry and ophthalmology. Having spent my career so far in that field, I’m excited to gain insight into another part of the NHS and see how clinical AI is being applied in a completely different context, in my case, cardiology. I think that kind of cross-specialty exposure will broaden my understanding of both healthcare and the challenges of implementing AI in varied settings.
I’m also looking forward to learning from the other fellows, who come from a wide range of clinical backgrounds. I know they will bring diverse perspectives, and the group teaching sessions will allow us to share ideas, explore each other’s projects, and understand how AI is being used across the system.
What questions are you interested in exploring?
The project I will be part of at King’s Hospital focuses on the use of natural language processing to evaluate how representative randomised controlled trials in cardiology are by comparing trial populations to a real-world cohort. It aims to help ensure that clinical trial populations are inclusive and representative, so I’m particularly interested in exploring questions around representation in clinical research and how AI can help uncover and address disparities. I’m also interested in how we can use natural language processing to extract meaningful information from unstructured clinical data in a way that’s reliable and scalable.
More broadly, I want to explore what makes AI tools clinically useful, not just technically accurate, and how we ensure that they can be successfully integrated into real workflows. I’m curious about how clinicians perceive and interact with AI in practice, what kind of transparency and evidence they need to feel confident in using these tools, and how we evaluate safety and effectiveness once they’re deployed. Ultimately, I’m interested in how we design and implement AI systems that support both individual patient care and system-level improvement.
What other roles will you be balancing while you complete the fellowship?
The fellowship will take up two days per week. For the other three days I will be working in clinical roles at Moorfields Eye Hospital as well as continuing my role as a digital clinical safety officer with the digital clinical services department at Moorfields. I have worked in this role since 2023, and it will complement the fellowship as it involves ensuring that digital health technologies are safe for use in clinical practice. As part of the role, I oversee clinical risk management, ensuring systems comply with standards.
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