top student at medical school

Chapter 4 Clinical Routine (Please add to your favorites and read on!)

After graduating with a master's degree, Fang Ziye could easily secure a permanent position and a small amount of talent recruitment benefits by working at a prefecture-level city hospital.

Although the Affiliated Zhongnan Hospital of Wuhan University is not a top-tier hospital, Wuhan University is a well-established 985 university, which makes it highly competitive for graduates seeking employment in some prefecture-level city hospitals across China.

But climbing higher won't be easy.

Pursuing a doctorate isn't something you can just do whenever you want!

This opportunity to study is extremely precious!

In order to study, write papers, and read literature, Fang Ziye, like other students, moved out of the dormitory.

While you're staying up all night reading papers, others might be too tired to go to sleep after their shift.

They simply don't fit together.

Having personal time is very important for learning.

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[Note: Free Knowledge Points can be used to actively upgrade skills. Knowledge Points are gained based on the physician's weight during the treatment process. Knowledge Point Benefit Details: +0.5, +0.2, +0.1... +0.1]

[Current knowledge points balance: 0.1!]

Fang Ziye looked at his only remaining 0.1 points of free knowledge points, lost in thought.

This is what I produced while training my skills in the practice room. And the efficiency seems to be a little bit faster than before. In the past, it took about two hours to produce 0.1, but today I produced 0.1 in just one hour!

In the ward, studying patients' medical records and revising medical orders can also yield some output.

But the biggest output came from a time when I was performing surgery with my mentor. When my mentor asked me to cut out a lesion, the output was quite high, a huge amount of 0.5!

Fang Ziye had been using this panel for almost half a month, and it took him various methods to accumulate 5 knowledge points.

Through observation and statistics, it was found that the efficiency of knowledge acquisition is clinical > medical records > outpatient clinic > practice room.

"If only some more lesions could be removed," Fang Ziye muttered to himself.

But he quickly shook his head.

My own teacher, the only surgery he is authorized to perform in the department is minor surgery. Although he is called a senior attending physician, the only surgery he is authorized to perform is a slightly simpler bone defect.

Of course, these simpler bone defects are also cases that hospital directors in prefecture-level cities rarely dare to handle.

Other, more difficult surgeries are performed by associate professors, while the most challenging ones require professors to finish them off.

When the professors took the stage, the associate professors assisted, and even their own teachers could only manage a few opportunities. Then there were the attending physicians and doctoral students, who were fiercely competing for the seats…

……

The next day.

After handing over the class, Fang Ziye's teacher, Yuan Weihong, went to teach his class. He is currently a functional laboratory teacher for undergraduate students at the Second Clinical College of Han City University, and he needs to teach three small classes. Most of his time is spent on teaching.

During the ward rounds, Fang Ziye was just a lowly henchman!

Fang Ziye and his mentor Yuan Weihong both followed Professor Deng Yong.

Professor Deng Yong took the lead, followed closely by Associate Professor Xie Jinyuan. Although his teacher was not present, there was attending physician Qin Geluo, who cheerfully stepped in to take his teacher's place and endure the scolding.

Professor Deng Yong's two doctoral seniors, one a second-year doctoral student and the other a third-year doctoral student, quickly followed behind the group of senior doctors and began explaining the patient's basic condition. They were the chief residents of the group.

Fang Ziye and Li Yuanpei are the two with more seniority, and because of the departure of the third-year graduate students, they are qualified to follow behind the doctoral students.

Behind the two were Shu Lang and Gong Ziming, both second-year master's students, and Jie Han and Zhu Yunwen, both first-year master's students.

In addition, there's Lan Tianluo, Fang Ziye's little resident trainee who follows him around like a shadow.

The group of twelve people can be said to have gathered all the basic elements of a surgical team except for interns.

Fang Ziye's job was to report detailed data on the patients under his care, record some medical orders that needed to be revised, listen to Professor Deng Yong and Associate Professor Xie Jinyuan discuss some complex cases, and also put Professor Deng Yong's two doctoral seniors in a difficult position by having them report on the current research progress in the treatment of one or two diseases. Indeed, for master's students like Fang Ziye and Li Yuanpei, the most frequent questions from the professors were about the current treatment principles.

Treatment principles and research progress in treatment are two separate areas.

One is the existing treatment methods, and the other is a promising new treatment option...

Professor Deng Yong, with his upright posture and a rather large mole on his chin, nodded after hearing his doctoral student's report: "You have read some books, but your understanding of the progress in treatment is not thorough enough."

"While bone transport is a popular topic in the treatment of bone defects, a new type of material has emerged that may allow bone cells to regenerate within the material, thus replacing traditional bone transport techniques..." Professor Deng Yong explained with great familiarity...

Fang Ziye's explanation was like listening to gibberish; he was half-confused.

In clinical practice, understanding the diagnosis of a disease is quite difficult. It requires a solid foundation and a deep understanding of current treatment principles and methods. It takes a lot of time and effort. Only after thoroughly understanding all the current treatment methods in the world can one be qualified to look forward to research progress.

The complexity of the medical knowledge system.

It can be summarized in eight words.

Advising someone to study medicine is a sin that will be struck by lightning!
……

After finishing his rounds, Fang Ziye, having served as the assistant, reached the 'peak of his life.' The newly recruited resident physician, Lan Tianluo, quickly and enthusiastically said, 'Brother Ye, I'll go change the dressing first. You go back and write the prescription.'

"Today isn't a surgery day, shall we go to the practice room early?"

Fang Ziye nodded and agreed.

After Lan Tianluo ran off, Yuan Weihong's first-year graduate student, who was also Fang Ziye's direct junior, hesitated slightly and said, "Senior Fang, could you help me revise the medical order? My aunt came to the outpatient clinic, and I'd like to take her there..."

Jie Han is Fang Ziye's junior, a first-year graduate student. He started clinical practice on the same day as Lan Tianluo, but because Jie Han is a master's student and a student of Yuan Weihong, the chief resident assigned him two separate beds.

That's how it is in large teaching hospitals. Forget about operating room opportunities; even clinical beds are highly sought after. There are far more applicants than available beds. If you're unwilling to do something, there are plenty of people who will delegate your tasks.

The assigned bed is actually your only chance to become an assistant in the operating room.

After serving as an assistant many times, your superiors will take a liking to you and you'll have solid basic skills. Your superiors might reward you with suturing and skin cutting once or twice, which is when you'll truly be considered to have entered the ranks.

Even professional master's degree graduates, with their medical qualification certificates, can work and manage patients independently, but the authority to make medical orders still rests with their superiors. Resident physicians and junior master's degree graduates only need to change the medical orders according to their superiors' instructions.

Unless there are very special circumstances—

For example, his junior fellow apprentice, Jie Han, handed the patient in bed 11 over to him.

The instructions from my superiors were to discontinue the postoperative pain medication for patient 11 and switch to oral celecoxib. Postoperative anti-infective medications were also to be completely discontinued, and the postoperative anticoagulant was to be changed from low molecular weight heparin sodium to rivaroxaban for prophylactic anticoagulation therapy.

However, after carefully reviewing the patient's blood test results, Fang Ziye discovered that while the painkillers and anticoagulants could be discontinued, the antibiotics not only could not be stopped, but needed to be upgraded!

Even with this discovery, Fang Ziye dared not take the initiative to administer the medication, but instead reported it to the authorities.

"Brother Luo, come and take a look. This patient in bed 11 is the one who had bone transport surgery last Friday. Her blood test results this morning were not good; her white blood cell count suddenly spiked to 23."

"Shouldn't we call the pharmacy department for a consultation?"

Brother Luo is Qin Ge Luo, the attending physician in the department, whose seniority is lower than that of his teacher, Yuan Weihong.

Upon hearing this, Qin Geluo ran over to take a look.

The blood test results didn't come out until 8:40 in the morning, and it wasn't even 8:40 when we did rounds. The previous inflammatory markers were close to normal, so it wasn't because Jie Han was careless.

Qin Geluo immediately made a phone call, saying during the connection: "Ziye, go check the wound condition, send in a bacterial culture and drug sensitivity test immediately, and also send in a routine microscopic examination of the exudate to see if there are any pus cells in the area!"

"Ask the patient again if they had a high fever period, and hand it over to the doctor on duty today. If they have a high fever, draw blood for culture immediately!"

Infection is the greatest enemy of surgery, and everyone fears it because once an infection occurs after surgery, the treatment process becomes extremely complicated.

……

(End of this chapter)