Published on 18 Dec 2025
This is a VUCA world
Professor Joseph Sung
Dean, Lee Kong Chian School of Medicine
Have you heard about this term VUCA? VUCA represents four challenges to the whole world: volatility, uncertainty, complexity and ambiguity. This acronym was first coined by the US military to describe operations following the end of the Cold War, but now this term has become commonplace in the business world, or I would say, more so in the medical world. Whether we are talking about the workplace, political landscape or inter-personal relationship, our lives are becoming more VUCA by the day.
Volatility refers to the speed and magnitude of change which is higher than any previous ages in human history. Pandemics such as COVID-19 which paralysed the world within days and weeks, financial crisis triggered by interest-rate announcements or geopolitical events, disruptive technologies such as artificial intelligence (AI) models and hardware can become obsolete within months… just to name a few. Uncertainty points to the fact that the future is hard to predict, even with a lot of data. Cause-and-effect relationships are unclear. Past experience may not reliably guide decisions. How can we plan public health policy? Clinical decisions rely more and more on AI, when we don’t even understand the mechanism behind it. Will a regional conflict escalate into a wider war? Complexity depicts the situation where many interconnected variables interact in non-linear fashions. Actions in one domain can produce unexpected consequences elsewhere. The undeniable changes in climate factors and the consequences are a clear example of this phenomenon. The impact of an ageing population on the healthcare system, where workforce shortage, funding models and technology interact is another. Ambiguity describes situations that can be interpreted in multiple ways with no clear “right” answers. New problems in our age often lack precedent, rendering decision-making difficult. Ethical dilemmas arise when AI overrides human decisions in clinical decisions and high-risk scenarios. All in all, the explosion of AI has brought VUCA to healthcare more than many other industries.
How should future healthcare providers and policymakers prepare for this VUCA world? At an individual level, healthcare workers must move from “knowing” to “learning continuously”. Medical knowledge will expire faster than any curriculum. Our medical school is working hard to revamp the medical curriculum to prepare students as doctors for the future. Due to volatility and complexity, clinical training should focus on how to build judgement and not just following rules and guidelines. Humans are needed for edge cases, trade-offs and values-based decisions. Risk-benefit framing, ethnical reasoning in gray zones and clinical reasoning under uncertainty are crucial.
In the (not-so-distant) future, patient outcomes depend as much on systems (policy, technology-driven work flow, data accuracy, resource allocation). Future leaders need to think about how to map the patient journey end-to-end, understand feedback loop and how to make different disciplines work together. Health economics, implementation science and quality improvement become essential elements to advance healthcare systems. Last but not least, we should aim to develop adaptive leadership, not positional authority. Medical hierarchies, which were so immense in the past, slows down adaptation to VUCA and must be changed. Traditional healthcare systems aim for efficiency and optimisation. In a VUCA world, we need to think about resilience (ability to absorb shocks such as pandemics, workforce shortages), adaptability (rapid reconfiguration of services in the face of crisis), anticipation (early sensing rather than reacting to unanticipated changes).
VUCA describes situations where change is fast, outcome is unpredictable, systems are tangled and meanings are unclear. Medicine operates in a VUCA world because patients are different, systems are interconnected, and knowledge evolves rapidly. A previous Dean of Harvard Medicine once told his graduates at convocation: “Half of what you learn in medical school will be shown to be wrong in 10 years… the trouble is we just don’t know which half”. Unfortunately, the “half-life of medical knowledge” is much shorter than 10 years now.
Welcome to the World of VUCA.
