top student at medical school

Chapter 170 Status in the Martial Arts World (Please Subscribe)

"Okay, I won't say anything else, but regular check-ups are still very necessary. You must come," Fang Ziye instructed the middle-aged man.

"I'll definitely come to Dr. Fang. After I get the results from the follow-up check, I'll go to Minzu University Hospital," he said, still indignant.

These are things that Fang Ziye can't control.

Twenty minutes later, Fang Ziye reassessed the results of the X-ray after the middle-aged man's repositioning and then reassured him about some precautions. He also wrote down the post-discharge instructions clearly before letting the couple leave.

"Brother Ye, is this guy really going to cause trouble for Minzu University Hospital?" Guo Yunlei, who was on duty nearby, asked.

Fang Ziye was editing a message for Dr. Wu Xuanqi, which was the result of the X-ray follow-up after the manual reduction, while replying to Guo Yunlei: "We are just doctors, we just need to do a good job of receiving patients who come to our hospital and our department."

"After a patient leaves our facility, it is their freedom to make their own choices."

"As long as we don't slander, comment on, or entice our brother hospitals, we can have a clear conscience."

As long as there's no favoritism or backstabbing between sister hospitals, normal communication is perfectly acceptable.

For example, right now, after Fang Ziye contacted Dr. Wu Xuanqi about the patient's follow-up MRI and postoperative outcome, Dr. Wu Xuanqi, who had already stepped down from the stage, was speechless.

"He's really lucky; he encountered such a rare non-comorbid symptom."

“A moderate posterior shoulder dislocation without fracture, rotator cuff injury, or joint capsule rupture is certainly very rare, and there may not be any reported precedents.” Wu Xuanqi was speechless not because the middle-aged man was going to cause trouble, but because he felt that the man was too lucky.

Fang Ziye immediately understood Wu Xuanqi's meaning: "Thank you for your modesty, Senior Brother Wu. Otherwise, this case report would have been yours."

"However, I was lucky. The patient agreed to have an MRI done at our hospital, so my junior colleague didn't hesitate to accept it."

It would be a tremendous waste not to publish a case report for a case with a probability of less than one in a million.

Fang Ziye contacted Wu Xuanqi for two reasons: first, to inform Wu Xuanqi that the patient might cause trouble.

More importantly, this patient's diagnosis and treatment were both conducted at Enshi Central Hospital, and the initial consultation at Minzu University Hospital was only the first visit.

According to the rules, this medical record should belong to the Central Hospital.

Therefore, Fang Ziye informed Wu Xuanqi in advance that he had already taken a liking to this case and would write a case report, so that he would not repeat it and waste the other party's time. This was also a way of asserting his sovereignty.

“Junior Brother Fang’s research instincts are really sharp. My junior brother just said that he could write an interesting case report,” Wu Xuanqi said.

"Senior brother, the reason why people have a heightened sense of smell is usually because they've been hungry for too long," Fang Ziye explained.

"Haha, Xiao Fang, you're quite interesting." Wu Xuanqi actually laughed.

……

After the chat ended, Wu Xuanqi clapped his hands at everyone in the department: "When you're on duty in the future, please pay attention. If there are any patients with dislocations or fractures transferred from Enshi Central Hospital, you must not handle them yourself. Call me."

Upon hearing Wu Xuanqi's sudden remark, Song Yi, who had been hanging around with him at Enshi Central Hospital but hadn't officially enrolled yet, rolled his eyes a few times before asking, "Senior Brother Wu, do you mean it's because Ziye is at the Central Hospital?"

"The patients he missed diagnosing were either problematic or malicious?"

Like Fang Ziye, Song Yi has not yet enrolled in school. However, the difference is that after completing his residency training and graduating, Song Yi went directly from Kyoto to a prefecture-level city hospital in Enshi in order to gain more practical experience.

Within his mentor's school, there was a very capable senior brother who was currently doing very well at Enshi Central Hospital. The teachers at Tongji Hospital, who wanted to value and cultivate Song Yi, naturally wanted Song Yi to learn about some basic trauma surgery diseases in advance.

The rare case of posterior shoulder dislocation we encountered today was treated jointly by Song Yi and Wu Xuanqi.

The two were still discussing that if the patient went to the other two hospitals and they acted rashly and started the repositioning procedure, it could potentially cause a medical dispute. So Wu Xuanqi officially signed his name on the medical record.

Otherwise, Wu Xuanqi would not normally write in a very formal style.

Anyone in the trauma surgery department of Enshi City would hesitate upon seeing Wu Xuanqi's name.

"That's pretty much the idea, especially for you, Song Yi, don't underestimate him."

"I see that this Ziye is even faster than you in terms of manual repositioning skills and learning speed of theory, so don't be careless," Wu Xuanqi earnestly instructed.

With Song Yi's arrival, his position as chief resident can be temporarily put on hold. In most cases, Song Yi takes over as the assistant chief resident, receiving patients and handling some emergency consultations.

"Okay." Song Yi nodded.

His memory of Fang Ziye was also exceptionally vivid. When Fang Ziye was at Zhongnan Hospital, his suturing skills were already unbelievable. Now, half a year has passed since then.

Back then, professional assessments didn't include a procedure for manual repositioning, so who knew how skilled Fang Ziye was?

However, it was quite interesting to encounter Fang Ziye, a competitor of the same age, again in Enshi. At least for now, even in Enshi, there was a hint of the competitive atmosphere that existed in Kyoto.

Song Yi is more used to this competitive atmosphere and doesn't want to just give up.

……

"The food is here, Senior Brother Fang." Guo Yunlei, a second-year student living with Fang Ziye, referred to himself as the junior brother.

"Then let's eat. Yunlei, how much is this meal? I'll transfer it to you." Fang Ziye was still organizing the details of the discharge medical records under his supervision.

He didn't want to overstep his bounds for the time being, focusing instead on managing the medical records and prescriptions within his own group, and he didn't really see himself as a superior managing all the resident physicians.

Guo Yunlei has sparse eyebrows and a fierce appearance, but he doesn't have a big beard.

And its most distinctive feature is its rather full and sturdy buttocks. While serving food, it unconsciously wiggled a little, which looked just a bit provocative, but not effeminate.

"Senior brother, you're joking. It's just the cost of a meal, not much at all. Let's eat." Guo Yunlei didn't bring up the matter.

"Let's split the bill. You can treat me next time. It's not right for me to just come into the department and eat and drink for free." Fang Ziye said, transferring thirty yuan to Guo Yunlei.

Seeing Fang Ziye's resolute expression, Guo Yunlei returned the money. Then, while opening the lunchbox, he said, "Senior brother, you don't need so much. Eighteen yuan a serving."

Fang Ziye transferred eighteen yuan to Guo Yunlei, and after seeing that Guo Yunlei accepted it, he didn't cause any more trouble.

During the meal, when Fang Ziye looked at his knowledge points again, he realized that the case he had just seen had indeed provided a lot of new insights.

"+12!"

Although 12 knowledge points is not much, a simple manual reduction of a shoulder dislocation would at most add five or six knowledge points, but in his case, it has doubled.

Clearly, his situation is a very special case.

Current knowledge points balance: 1122.1!

It's better to focus more on clinical practice.

Thinking this way, Fang Ziye decided to first upgrade all the skills required for the osteotomy and orthopedic surgery to a certain level.

The prerequisite skills for osteotomy and orthopedic surgery include osteotomy, manual reduction, experience in operating orthopedic internal fixation devices, bone shaping, and bone harvesting and grafting.

After all, at Zhongnan Hospital, a prerequisite for Fang Ziye to be allowed to perform routine clinical procedures is that he must have a certain level of expertise in osteotomy and reshaping surgery.

Otherwise, you can only rely on seniority.

Fang Ziye naturally had to consider whether he could continue to stay in the clinical setting after returning home, where he could gain more practical experience.

"Osteotomy skill level 0 1/10".

Well, osteotomy is indeed a high-level procedure. If we have to talk about surgical levels, there may not be a single osteotomy procedure, but it is generally at least in the category of level three surgery.

Add points —

But the result was...

Knowledge Point 10.

Osteotomy Level 0 5/10!

Fang Ziye: "..."

"No, let's be reasonable, okay? How can you expect me to swallow your knowledge points? We agreed on a one-to-one exchange!" Fang Ziye immediately stopped eating.

But upon closer reflection, Fang Ziye suddenly realized something.

The difficulty of suturing is completely different from that of osteotomy. If the knowledge points required for both were the same, the advanced nature of osteotomy would not be apparent.

Okay, I'll add it.

Fang Ziye spent 60 knowledge points to upgrade his skill to level 2 (0/50) of Bone-Cutting Technique!

To reach level 3 in osteotomy, at least 100 knowledge points are required, so Fang Ziye didn't touch it for now.

Instead, they continued to try allocating points to other skills.

Then Fang Ziye discovered that the ratio of knowledge points consumed by bone shaping and bone grafting was actually not exaggerated, just a 1:1 ratio.

This puzzled Fang Ziye a little. Why was that?

After thinking for a while, Fang Ziye still couldn't get a stable answer. He could only say that the osteotomy procedure was more difficult than osteoplasty or bone grafting.

This series of actions, which only added three level 2 skills, consumed more than 100 knowledge points.

Since the application of osteotomy and orthopedic surgery will be available next year, Fang Ziye plans to add points to this final skill next year.

Currently, as long as you level up your osteotomy skills to a certain level, it will be enough to handle the skill competitions where you can make money.

Fang Ziye really wished he had 10,000 or even 100,000 knowledge points so he could have complete freedom to allocate them.

Then, just like in the novels I'd been recommended to read before, once I returned to Zhongnan Hospital, I punched my teacher, Professor Deng Yong, kicked my advisor, Li Guohua, blew on Yuan Weihong and he instantly became a Yangtze River Scholar; then, with a single gesture, Professor Deng Yong was immediately appointed as an academician...

Sweet dreams are always good, but Guo Yunlei felt a little uneasy seeing Fang Ziye's slightly smug smile.

"Senior brother? Is it something you don't like?" Guo Yunlei asked when he saw that Fang Ziye hadn't touched his chopsticks for almost half a minute.

Fang Ziye, whose mind had been wandering, withdrew his "divine sense": "No, I was just thinking about some things."

"Oh, I thought it was because the food I ordered didn't suit your taste," Guo Yunlei said with a fawning smile, behaving very politely.

"Of course not, I'm not a picky eater." Fang Ziye quickly shoveled rice into his mouth.

With knowledge points, there are many things to learn. He needs to continue acquiring knowledge points related to clinical patient management and refining medical orders, and start on a legitimate and sustainable path to gaining knowledge points.

Ideally, we should upgrade basic cell experiments and animal experiments to level five as early as possible.

Then let his senior fellow students give his teacher a fair explanation.

Yuan Weihong doesn't need Fang Ziye to stand up for him, but Fang Ziye can dump all the related workload on Yuan Weihong.

Whether or not an apology is needed is Yuan Weihong's choice; whether or not he can get others to apologize voluntarily is a matter of his own power.

If Yuan Weihong were now an Outstanding Young Scientist or a Distinguished Young Scientist, even his senior mentors, if they dared not apologize, would at least not sleep peacefully every night, because once the truth came out, if Yuan Weihong hinted at anything, what awaited them was an abyss.

"Senior, Kai said he's in charge of the pre-competition training for orthopedics in this year's skills competition. He told me that if you also want to participate and think highly of him, you can contact him privately." Guo Yunlei said this halfway through the meal.

"Huh? Did Master Kai really say that?" Fang Ziye was a little incredulous.

Huang Kai is the pillar of the younger generation in the department. Is it really appropriate for him to be so polite?

“Yes, it really was Kai who came to me this morning and said that, back when you were still making rounds, Senior Brother.” Guo Yunlei said, while watching Fang Ziye’s expression.

I was extremely envious.

Fang Ziye, although a PhD, is not the same PhD in the department. He has only been in the department for a few days, yet he has already gained recognition in both professional and theoretical aspects.

Even Huang Kai, an associate chief physician, speaks rather cryptically when facing Fang Ziye.

Such a status in the martial arts world is something Guo Yunlei has always dreamed of, but has never been able to achieve.

"That's great! I've never participated in a competition before. Let me know when you're all meeting up."

“We started in March, but we don’t have the training rooms that large hospitals have. We only have a functional laboratory training room, which Director Zhang borrowed from the hospital for a temporary period of time,” Guo Yunlei explained.

Almost every hospital has its own clinical skills training room, but the skills training rooms in prefecture-level city hospitals are not as large or standardized as the training rooms in Zhongnan Hospital.

The training rooms at Zhongnan Hospital, especially the orthopedic training room, are comparable to the best in China. In terms of equipment and senior professors, they are no less than those of other university-affiliated hospitals.

……

There weren't many emergency patients coming in in the afternoon.

There are two fractures, both of which are fractures of the lower segment of the fibula and a very small avulsion fracture of the suprapatellar bone. Only plaster cast immobilization is required.

With this procedure, Fang Ziye no longer needed to personally handle the matter. After instructing Guo Yunlei, Guo Yunlei happily went to get his cast applied.

During this time, Fang Ziye went through all the medical orders for the more than twenty patients in his group.

Several issues can be summarized as follows: First, the Enshi Central Hospital does not pay much attention to postoperative medication.

The fundamental principles of the structure, such as anti-inflammatory, analgesic, and preventative anticoagulation, are sound.

However, in terms of the duration of treatment, apart from timely discontinuation of anti-inflammatory antibiotics, there are still significant problems with the use of analgesics, anti-swelling medications, and prophylactic anticoagulants.

For example, patients who had surgery on Saturday are still using heparin calcium for prophylactic anticoagulation today.

In fact, such patients can switch to oral anticoagulants one or two days after surgery, once they are able to get out of bed and move around.

Painkillers are also an option.

At Zhongnan Hospital, for patients with large trauma, intravenous analgesia is used for a maximum of three to five days after surgery, followed by oral celecoxib for pain relief. However, here, even on the fourth day after surgery, for a routine minor fracture, intravenous analgesia is still being used.

Fang Ziye did not make direct corrections. Instead, he treated the patients under his care according to the principles he had summarized by reviewing the literature, marked the corresponding medical orders, and then discussed them with Wu Guonan, Xue Tao, and others before suggesting corrections.

Offering suggestions is something they should do; making corrections is their own choice.

Fang Ziye wouldn't act like a new official making a splash or anything; there's absolutely no need for that.

However, if it were at Zhongnan Hospital, and his two junior colleagues or Professor Deng Yong's junior colleagues were using the medication in this way, Fang Ziye would reprimand them.

It was around 4:40 PM.

Director Wu Guonan, along with Deputy Directors Shen Tao and Xue Tao, returned to the ward one after another.

On the way back, the group was still discussing the progress of today's surgeries. They said that except for one fracture patient who underwent manual reduction, which took about six attempts to achieve, the others went very smoothly.

Several people returned to take another look at the patients who had undergone surgery that day, a habit of Dr. Shen Tao after completing a surgery.

Seeing this, Fang Ziye followed suit and went to check the rooms.

The first ward round after surgery mainly involves asking about the patient's recovery from anesthesia and the pain level at the affected area, in order to avoid the very rare occurrence of anesthetic accidents and poor surgical quality.

After finishing his rounds, Fang Ziye shared his summary and suggestions on medication for patients in the department that day with Xue Tao and Wu Guonan.

But when Fang Ziye said that, Shen Tao's gaze towards Fang Ziye became thoughtful, as if there was something in his eyes.

To Shen Tao's surprise, Associate Chief Physician Xue Tao immediately said after listening, "Change it, definitely change it."

"Dr. Fang, your suggestion is definitely the most scientific." As he spoke, Xue Tao's thick eyebrows furrowed together, and his tone was subtly ingratiating.

Shen Tao was secretly taken aback, thinking to himself, "This Xiao Fang's status in the group and department is quite extraordinary. He's only been in the department for such a short time, yet he already has such influence."

No wonder Yuan Weihong has revived his nickname "One Leaf of Beihai," emphasizing his carefree and unpretentious nature.

(End of this chapter)