top student at medical school

Chapter 431 Harvesting the Mid-to-High-End Market (Please Subscribe)
At 8:47, Fang Ziye closed the back door of the ride-hailing car and gestured to express his gratitude. As he turned to walk towards the hotel's main entrance, the phone in his right hand vibrated.

He picked it up and saw a message from Gong Ziming: "Brother Ye, my master asked me to tell you to thank him."

"After the patient with the dislocation underwent an MRI, it was determined to be an irreducible anteroinferior shoulder dislocation. Fortunately, we did not attempt to treat it directly."

"It's an irreducible dislocation, right? I had the same suspicion and mentioned it to you, but Professor Xie is more cautious." Fang Ziye smiled upon hearing this, and at the same time saw the notification that new knowledge points had been credited to his account.

Correcting a diagnosis will also provide some knowledge points, although only 8 points. But the joy you feel is something that 8 knowledge points cannot replace.

"Yes, I found that my master is also very receptive to advice. After the patient returned from paying the bill, he immediately admitted that he might have misdiagnosed the patient. The patient and his family looked skeptical and grim for quite a while."

“But my master’s attitude was quite sincere, and since no harm was caused, the patient and his family acquiesced.”

"After seeing the MRI results, he even presented my master with a brocade banner," Gong Ziming said casually to Fang Ziye.

"If you follow the teacher and learn more, you will learn something, more or less."

"In clinical practice, patients and their families prefer honesty rather than cover-ups. People are not machines; machines can make mistakes, and everyone makes careless mistakes."

After giving this instruction, Fang Ziye said, "I've already arrived at the venue. Let's talk again when I get back."

"Okay, Brother Ye," Gong Ziming replied politely, ending the chat.

After tidying up his newly changed long-sleeved shirt, Fang Ziye stepped into the hotel.

As the main speaker, I must dress appropriately. I could wear a tie, but Fang Ziye felt that I hadn't reached a position where I needed to dress formally, so I was too lazy to change.

It's only June, and a suit, trousers, a short-sleeved shirt, and leather shoes are already formal enough. Adding a blazer would just cause heat rash.

Fang Ziye did not wander around; he immediately went to the trauma surgery sub-venue on the third floor.

The academic venue was packed with people, and the speaker on the stage shared his "lecture content" in a calm and unhurried tone.

Some people in the audience were listening attentively, while others were whispering among themselves or chatting quietly with acquaintances and friends.

The large hall had nearly three or four hundred people, most of whom Fang Ziye did not recognize.

After walking around the back of the venue twice, Fang Ziye still couldn't find Deng Yong and Yuan Weihong. So he stood in a corner and listened to the speaker on stage sharing his experience in the diagnosis and treatment of 'diabetic foot'.

In fact, Fang Ziye didn't know what the name he shared was; it was just his own interpretation.

Suddenly, two people in the last row got up and left, seemingly to do something together. Fang Ziye immediately ran forward a few steps and grabbed a seat.

A man, who looked to be in his thirties, sat down next to him. After looking Fang Ziye up and down for a while, he focused his attention on the big screen. The two did not talk.

After carefully listening to what the speaker said, Fang Ziye realized that the speaker was Professor Tang from Xiangya No. 2 Hospital in Shashi.

Professor Tang specializes in foot and ankle surgery and diabetic foot.

Professor Tang has a straight posture, dark skin, and thick hair. He doesn't look like a medical expert, but according to his own case sharing, his team sees at least several thousand patients and performs seven or eight hundred surgeries on diabetic foot every year.

Surgery of seven or eight hundred patients a year may not sound like much, but if you know that there are only fifty-two to fifty-three weeks in a year, then at least a dozen diabetic foot patients need to be operated on every week!
For a team to handle this many surgeries in a week is already considered the limit...

Professor Tang's team currently treats diabetic foot patients with ulceration, necrosis, and early-to-mid-stage gangrene. For cases of late-stage gangrene, amputation is still recommended, a conclusion Professor Tang has reached based on his experience.

Once diabetic foot reaches the gangrene stage, the prognosis is quite poor. The best treatment plan is to control blood sugar in the early stages of diabetes to avoid developing end-stage complications that require surgical intervention.

Upon hearing this, Fang Ziye murmured softly, "Online opinions aside, even a long-established hospital like Xiangya Hospital has people who are diligently doing real work... It's not fair to generalize..."

After Professor Tang finished sharing, he bowed politely and said, "Thank you all for listening. This concludes the main content that our team has been working on recently."

Thunderous applause followed immediately, and even Fang Ziye and the young man next to him spontaneously joined in the applause.

As he clapped, the guy next to Fang Ziye asked, "Brother, which hospital do you work for?"

“Zhongnan Hospital. And you?” Fang Ziye replied.

"You're still a student?" Upon hearing this, the young man looked Fang Ziye up and down, assuming that Fang Ziye was a doctoral student.

At Fang Ziye's age, he's either an employee of a prefecture-level or county hospital, or if he's a student, he's definitely a PhD.

"No, I've already graduated." Fang Ziye didn't try to hide it.

The young man was taken aback for a moment, then gave Fang Ziye a thumbs up: "Eight-year program is really great! Top student, can we be friends?"

Fang Ziye thought for two seconds before taking out his phone and opening the scan interface.

"I'm from Yishi People's Hospital. My name is Zhong Yaozu, the 'Yaozu' in 'bring glory to one's ancestors.' It's a rather common name," the young man said after scanning Fang Ziye's QR code.

"Fang Ziye, Brother Zhong, I've saved my name in your contacts." Fang Ziye said, looking down to edit Zhong Yaozu's business card.

Upon hearing this, Zhong Yaozu flipped his hands over, opened his mouth wide, and looked Fang Ziye up and down, exclaiming incredulously, "You're Dr. Fang from Zhongnan Hospital? You did the live surgery yesterday?"

Zhong Yaozu's words immediately drew attention from a small group of people who turned their heads and stood to the side.

Fang Ziye felt at least a dozen gazes on him, and under everyone's watchful eyes, he could only nod slightly: "Yes, Brother Zhong, I've made a fool of myself."

This is a standard Chinese way of being modest in unfamiliar situations. If everyone is familiar with you, you can replace it with "Awesome, right?"

"Is this considered making a fool of myself?"

"Holy crap, I struck gold today."

"Come on, brother, let's go out for a smoke." Knowing that revealing Fang Ziye's identity might cause him a lot of trouble, Zhong Yaozu immediately grabbed Fang Ziye's wrist and ran away.

"Don't go, Fang!" A young doctor sitting to Fang Ziye's left was about to speak.

The guy in front of him patted him on the shoulder to interrupt and shushed him, saying, "Stop messing around. The more people you shout, the less likely you are to get added on WeChat."

"If we disturb the older generation at Central South University, we'll have even less chance of getting their contact information."

"Follow them. While there are few people around, don't make a fuss or call anyone. Just share your business card with those who need it."

This is a clear-headed person.

After Fang Ziye was taken to the toilet, he only used one tube of water. Zhong Yaozu offered him a cigarette, but he refused.

After politely declining, he said, "Brother Zhong, you go ahead and get busy. I'll head back to the venue now."

As soon as Fang Ziye finished speaking, several chain smokers surrounded him: "Dr. Fang, let's add each other on WeChat so we can keep in touch. We were sitting right next to you, but we didn't say a word."

"There are only six of us! Just open the QR code and we'll scan it. We'll share your business card with our friends later. Please approve it, and we'll add the hospital information in the notes."

Fang Ziye had sensed that more than a dozen people were looking at him, but only six actually showed up.

Surrounded by the barrage of questions, Fang Ziye had no choice but to open his QR code business card, feeling somewhat flattered.

Logically speaking, someone of my current rank shouldn't be entitled to such treatment. Those who are "popular" by doctors in prefecture-level city hospitals are usually associate professors.

Because doctors generally don't have much contact with professors. Those who do come into contact with them during their associate professor stage usually become associate chief physicians or department heads when they are promoted to professor.

If the junior doctor tries to add the contact information again, he might get embarrassed.

"Fang Ziye, Fang as in direction, Zi as in Confucianism, and Ye as in business," Fang Ziye politely introduced himself.

"I know, I know, Dr. Fang Ziye, those three words are already automatically entered into the input method." A cheerful guy next door grinned, his teeth showing, a cigarette butt between his teeth, the cigarette flicking up and down.

"Is everything added? I'll head back to the venue once it's done, everyone?" Fang Ziye said, and without waiting for their reply, he made his escape.

It wasn't that Fang Ziye was aloof, but rather that before he was about to give his lecture, he wanted to go to the venue to learn how other superiors organized and conducted the sharing of lecture content.

Time is short, so I can only share some key points; I definitely can't cover the technical aspects.

Even a very small technology, if explained in detail, would take more than half an hour to explain.

As Fang Ziye left the toilet, he could still hear some sounds and smells coming from afar.

"You look so young!"

“I asked a friend at Zhongnan Hospital. He’s 28 years old, a PhD, and an attending physician. The impact factor of his published articles is higher than our age.”

"Are you kidding me? Journals with high impact factors aren't like masseuses in a massage parlor."

"Brother Gong, all you care about is technicians, that's why you're still looking for technicians while others have already taken off."

"You haven't been looking for me, and I haven't seen you fly around either, have I? Old Mo, how have you been lately..."

……

As Fang Ziye gradually moved away, he noticed that the atmosphere at Zhongnan Hospital was very different from that of a prefecture-level city hospital.

Just like when I visited Enshi Central Hospital, I found that working in a prefecture-level city hospital meant less pressure to buy a house, a top-tier income in the area, and a relatively low number of surgeries.

Besides studying, all I can think about is how to kill time and find fun.

If you're working at a municipal hospital in a prefecture-level city and still want to have fun before you even have a girlfriend, then there are plenty of ways you can have fun...

Fang Ziye could have chosen to live that kind of life, but such a life would have been too wasteful.

Some people prefer a comfortable life with modest wealth and a slow pace of life in small cities.

However, if you prefer a slower pace of life, being a doctor is not a good career choice. Instead, consider taking the civil service exam or pursuing a different type of public institution job, which at least guarantees weekends off.

After Fang Ziye returned to the venue, he found Yuan Weihong and sat down in the middle of the crowd. Yuan Weihong was chatting with the person sitting next to him.

There were no empty seats next to Yuan Weihong, so Fang Ziye found a spot close to Yuan Weihong and stood to the side of the aisle, leaning against the wall as he listened to a director from a prefecture-level city hospital share his insights on the stage.

What he cooked was freshly reheated rice that had been left out for several nights.

It is a minimally invasive open reduction and internal fixation technique for fractures.

Fracture reduction and internal fixation is a field that has become quite outdated in the academic field of trauma surgery.

But no one laughed at him; daring to innovate deserves encouragement and praise.

However, there was no further support or recognition. After the speaker finished speaking, there was only symbolic applause, and the next speaker was called without further questions.

The next speaker's presentation was even worse, consisting of his understanding of standard treatment protocols for complex fractures.

If the previous one was freshly cooked leftover rice, this one is a newly arrived chef, learning from an experienced fried rice master, and hasn't even fully mastered the skills yet.

Of course, considering that he is the director of a county-level city hospital, his initiative to sign up for such an academic conference and serve as a speaker, taking this step for his own promotion, is commendable.

……

At ten o'clock, the first half of the morning session was almost over. Yuan Weihong was still chatting with someone and showed no sign of coming out, so Fang Ziye could only wait there so as not to disturb Yuan Weihong's enjoyment.

After the live surgery broadcasts of the first and second halves concluded, there was still an hour left. Fang Ziye could then consult Deng Yong and Yuan Weihong on some key lecturing techniques, which would be sufficient.

Soon after, the live surgery broadcast from the operating room of Tongji Hospital began.

It's unclear who was performing the surgery; their focus was solely on the field of effect.

However, this time the surgery brought by Tongji Hospital was no longer for a long bone fracture, but for a pelvic fracture.

Furthermore, the ischium has been exposed in the surgical field.

With the live stream confirmed to be clear and the audio able to smoothly communicate between the operating room and the conference venue, the surgeon and his assistant began a very smooth fracture manipulation and reduction procedure.

Meanwhile, someone else was explaining: "This is a relatively standard open reduction and internal fixation surgery for ischial fracture. The surgery is not complicated, but to standardize the treatment and reconstruct the ischial ring well, some small techniques are required."

"Let's quickly review these tips together..." The person giving the explanation sounded nonchalant, but in reality, it was just another form of boasting.

In a respectable family, who can complete an ischial fracture surgery in ten minutes? Even for simple immobilization, completing immobilization in ten minutes is almost showing off.

The surgeon and assistant operated very quickly, making the live video seem to be played at at least 1.2 times the speed, while the commentator methodically analyzed the progress of the surgery.

This was not Professor Duan Hong's voice, but rather that of his subordinate, Professor Duan Hong himself, who was sitting at the meeting, smiling broadly. With his double chin and thin neck, he always looked so kind and approachable.

However, his team, in addition to a very experienced commentator, also includes two experts who can quickly perform pelvic incision, reduction and internal fixation, which makes it exceptionally impressive.

Any one of these three people could probably be recruited into a prefecture-level city hospital and become a teaching instructor, making the orthopedics department of that prefecture-level city hospital far superior to other hospitals in the same city.

As the live surgery broadcast neared its climax, Yuan Weihong, having had his fill of chatting, turned around and saw Fang Ziye standing sideways in a row.

Upon seeing this, Yuan Weihong immediately stood up and carefully bowed, asking the row of people on his right to give up their seats.

Although Yuan Weihong had bothered them, no one was angry.

In such a public place, it's normal for people to need to use the restroom.

After Yuan Weihong walked through the crowd, Fang Ziye also saw Yuan Weihong. He put aside his interest in carefully watching the live surgery broadcast, stood up straight, and softly called out, "Master. Are you done talking?"

After Yuan Weihong stopped behind the last person, he swayed his hips and spun around once: "How long have you been here? Why didn't you send me a message?"

"I saw you were chatting well with the teacher next to you, so I didn't want to disturb you. I just arrived recently myself," Fang Ziye replied with a smile.

"Come on, let's go to the small demonstration room next door first, and you can rehearse it again in front of me."

"Although academic lectures are not as formal as graduation defenses, you still need to be very familiar with the content of the lectures."

"Professor Deng went to the competition venue to be a judge. Before he went, he specifically told me that he would arrive around 11:20." As Yuan Weihong spoke, he lifted the sleeve of his left hand, revealing his watch.

"I can probably explain it about two more times."

"Aren't we going to watch this live stream?" Fang Ziye was actually quite curious about Wu Xuanqi and Zhong Wenyuan's surgeries, and with Long Yuan's commentary, it was quite interesting.

"What are you looking at? We've already changed the surgical procedures that others prepared for the live broadcast. If you're still watching, then you have ulterior motives."

"Let's go, let's go..." Yuan Weihong grinned, revealing his teeth.

Fang Ziye estimated that if he were Fang Ziye, and it were someone else, the unique skill of "Floating on the Water" from Beihai would definitely be performed.

……

At 11:10, Fang Ziye walked out of the small demonstration classroom with Yuan Weihong's Apple computer.

Yuan Weihong and Deng Yong are both very experienced and never use USB drives to bring PPTs.

If you bring a USB drive, you'll need to borrow someone else's computer to copy the PPT content.

The content presented in the PowerPoint presentation contains a lot of key data from within the research group that cannot be copied by others. Therefore, for data privacy, it is necessary to use only the team's computers.

In this way, unless there's a mole within the team, there's no need to worry about data leaks. And if there is a mole within the team, no amount of prevention will be able to stop it.

Don't use the suspect, but don't use it.

When they returned to the conference hall of the trauma surgery sub-venue, Yuan Weihong patted Fang Ziye on the shoulder: "Calm down, don't be afraid, there's nothing to be afraid of."

"Just say what you want to say, and don't answer any questions from anyone, including questions from the conference host during the intermission. If you don't answer, they won't break the rules. They also won't take advantage of your lack of seniority."

"Secondly, remember to finish your sharing with proper etiquette before and after you begin. Since you are relatively junior, you should give a slight bow after going on stage as a sign of respect for your colleagues."

"Don't feel it's troublesome or embarrassing. If academicians and big shots can do it, there's nothing you, Fang Ziye, can't do."

"Third..." Yuan Weihong went on and on about etiquette to Fang Ziye.

Fang Ziye listened attentively, carefully considering every word and phrase, and did not find Yuan Weihong nagging.

That's how Yuan Weihong does things; he seems carefree and easygoing. But in reality, he rehearses and prepares extensively before each actual performance.

When it comes to my master's thesis defense, which legitimate master's graduate would actually have to defend their thesis ten times?
But that's exactly what Yuan Weihong arranged, and he patiently revised and arranged things for Fang Ziye again and again before the defense began.

At 11:17, after the previous speaker finished sharing, Professor Duan Hong, who was the chairman of the conference, picked up the microphone and began to introduce Fang Ziye to the audience after the "volunteer staff" showed him Fang Ziye's resume.

Even among peers, unless they are the most famous professors, others may not be familiar with or know them. Therefore, the conference host needs to introduce the speaker's resume before the speaker begins.

This serves as both a form of promotion for the speaker and a way to make the audience more interested.

Duan Hong’s voice was steady and calm: “The next speaker to share with us is a very young man. He is also the first young man to take the stage in our trauma surgery sub-venue academic conference hall.”

"Fang Ziye, Physician, PhD, Joint PhD Program at UCLA Medical Center, Resident Physician..."

While Fang Ziye was abroad, he didn't gain any particular benefits, but he didn't come away empty-handed either. He received a joint doctoral training program, which was slightly more valuable than going abroad.

This was also the result of the director of the foreign laboratory significantly downplaying Fang Ziye's resume.

The main reason is that Fang Ziye was unwilling to work abroad; otherwise, his resume would be much stronger...

The speaker's resume this time is slightly richer and more detailed than the chief surgeon's resume last time.

"Published a total of over 20 papers, including 9 SCI-indexed papers as the first author, and 5 papers with an impact factor of 20+. Registered one national invention patent and two provincial invention patents..."

Fang Ziye walked calmly toward the speaker's stage. With the help of a 'volunteer,' he opened the first page of the PPT and stood in front of the microphone, his heart pounding.

To be honest, Fang Ziye himself didn't know he had accumulated so much depth.

However, after careful calculation, Fang Ziye realized that due to the research group and platform, he had definitely published more than 20 articles under his name. As for the invention patent, it should be the nude mouse model with HK2 knocked out that he developed.

This equipment, developed in collaboration with the animal laboratory of Zhongnan Hospital, is not yet publicly operational. Its primary purpose is to prioritize supplying the nursing home project in Enshi.

The sanatorium will pay Fang Ziye a lump sum for labor and patent usage fees. Once it officially starts operating, Fang Ziye is expected to have a very stable cash flow.

All the provincial-level invention patents were fabricated out of thin air; it's unclear who added their own name to them, it was purely for boosting their resumes.

Of course, this resume sounds a bit like that of a 'pretty but empty-headed' academic PhD.

Duan Hong did not provide any further details.

After Duan Hong finished his introduction, Fang Ziye walked to the center of the stage, bowed, and then walked to the side of the podium to begin his formal presentation: "Good afternoon, teachers, experts, seniors, and fellow students."

"I am Fang Ziye. Today, I am here on behalf of our team to share with you a type of disease that our team has been working on recently. Let's define it as 'standard type of morbid injury'. What I will be talking about today is my personal insights on limb salvage surgery for 'standard type of morbid injury'."

At this point, Fang Ziye's second page directly showed a picture of a mangled lower limb injury: blood gushing out, flesh mangled, bone and flesh still attached, skin torn open, blood clots forming scabs...

Such a stimulating sight would likely affect the appetite of a layperson at least once they saw it.

However, in such situations, many people have actually encountered such situations to some extent and have gained relevant experience, so they naturally won't be alarmed.

On the contrary, Fang Ziye's act of releasing this picture immediately attracted everyone's attention.

Some people need to rely on skills to give lectures, but others, in the eyes of experts, only need to rely on absolute skill.

Was there no amputation?

Was the limb salvage successful?

Are they trying to cause trouble?

Everyone else has had their limbs amputated, but you're the only one who opted for limb preservation instead; that's just stirring up trouble.

Fang Ziye continued calmly, laying the groundwork: "Destructive injury is not a particularly standard diagnosis. It is rarely mentioned in textbooks and is usually replaced by trauma, multiple soft tissue injuries and ischemic necrosis."

Fang Ziye's PPT was very simple, with many pictures and few words.

There are only three simple words on the left.

Destructive damage, multiple soft tissue traumas, and ischemic necrosis.

"As we can see from the picture on the right, this patient has segmental paleness of the skin, which is a sign of ischemia."

"Muscle softening is caused by direct, violent compression that leads to localized dissolution."

"When a blood vessel ruptures and a thrombus forms, blood flow to the distal end will inevitably be obstructed."

"Neurological crush injury, segmental focal necrosis."

Fang Ziye turned to the third page, which was still mostly short and verbose.

The image on the left shows the standard treatment of amputation, while the non-mainstream treatment is forced limb preservation.

"Based on established experience, such destructive damage is the primary indication for amputation, as it can save the patient's life immediately and prevent further necrosis of the residual limb, which could lead to more serious consequences."

“Currently, the very standardized treatment is an arc-shaped amputation of the mid-thigh, shortening of the osteotomy segment, and fish-mouth sutures…” Fang Ziye showed a fresh picture of the amputation, produced by Wang Yuanqi’s standardized amputation technique.

"Amputation is certainly a treatment method. This procedure has saved the lives of tens of thousands, millions, or even more patients. It is a very mature and great surgical innovation."

"However, with the current technological advancements and improved understanding of trauma, people have higher demands for quality of life. If such diseases can be treated without amputation, it may be the next hot topic for our trauma surgery."

"In response, our team conducted a few exploratory limb-sparing surgeries for 'standardized catastrophic injuries'. After filing with the hospital's ethics committee, this exploratory clinical study is ethically sound, will not cause pain to patients, and the benefits outweigh the risks."

"First, please allow me to take a few more minutes to explain 'standardized lesion' in detail. Currently, our team defines it as 'lower limb lesion,' with the lesion located no higher than the greater trochanter of the femur. At present, there is no detailed definition of the extent of the lesion."

"The reason why upper limb injuries are not currently considered as the clinical treatment scope of 'standard injuries' is because the complexity of hand function is far greater than that of lower limb and foot function."

"Our team is only conducting clinical treatment tentatively and does not dare to give patients higher treatment expectations. Therefore, we have not yet tried to treat patients with upper limb injuries."

"Next, I will formally report on the work of our team!" After Fang Ziye's long preamble, Duan Hong couldn't wait to speak up immediately after the pause.

"How many cases has your team completed in total? Have there been any failed cases so far?" Duan Hong's question was quite insightful.

Of course, this problem was not something Duan Hong had prepared in advance, but rather something he dealt with on the spot.

If you've done ten cases and only succeeded in three, go home and do your homework. This kind of topic isn't suitable for sharing in such a public setting.

Upon hearing this, Fang Ziye's gaze tightened slightly.

But on the stage directly opposite, Deng Yong was waving his index finger from side to side, Yuan Weihong was making a shushing gesture, and Han Yuanxiao next to him was covering his mouth with his palm.

Fang Ziye simply smiled at Duan Hong and continued, "Professor Duan, we can discuss your question together after the sharing session."

After the new images appeared, Fang Ziye said, "Based on our team's experience, if we want to perform limb-sparing surgery for such severe damage, we need to break through the limitations of our previous thinking."

"In our previous understanding, trauma patients should undergo thorough debridement and removal of all necrotic tissue during emergency surgery."

"This principle also applies to destructive injuries. However, there is one more point: thorough debridement should be performed to remove all necrotic tissue and try to preserve as much 'non-necrotic tissue' as possible."

"If we strictly follow current trauma surgery principles and completely remove all necrotic tissue, the result will still be amputation!"

"Adhering to this principle, our team performed debridement on him."

"This is the result after our initial debridement. As you can see, this is the same patient, the same wound site, and the same skin defect, but the muscle tissue surface, where there was necrosis before, now has new blood supply."

"This is the debridement philosophy that our team currently adheres to, which is called the meticulous and thorough debridement philosophy. Of course, if we only achieve this step, we still cannot talk about limb-sparing surgery..."

Fang Ziye had only just begun speaking, and many people in the audience looked on with a mixture of confusion and shock...

Some people started calling for backup, some started taking photos, some started walking in from outside, and some started sending messages asking questions...

If manual reduction techniques target the low-to-mid-end market, then standardized treatments for destructive injuries definitely capture the entire mid-to-high-end market!
The Department of Trauma Surgery at Zhongnan Hospital is about to win this time!
(End of this chapter)