My medical skills add experience

Chapter 14 Here Comes the Opportunity to Use Diagnostic Medicine

This is the examination room temporarily changed from the meeting room of the school's ten thousand people meeting room.

Tuya Medical College is actually a provincial medical unit integrating medicine and education.It includes two parts: Tuya Hospital and Tuya Medical University.

What's more interesting is that the hospital and the campus are connected together.

For example, this conference room for ten thousand people is often used by hospitals to hold staff meetings.

At the moment, the inside is full of interns from our hospital and medical personnel from all walks of life.

Tuya recruits regular trainees, as long as they have a bachelor's degree or above and are under the age of 35, they can apply.

Including nursing, general practice, and medical technology three aspects of regular training students.

The training period is 36 months.

The medical technology here does not refer to surgical skills, but laboratory, radiology, B-ultrasound room, electrocardiogram room, electroencephalogram room, gastrointestinal endoscopy room, these examination departments.

Why is it said that Tuya's number of regular trainees is very popular?
Because as long as you have completed 36 months of regular training here and can meet the standards in the final exam, you can get a training certificate from Tuya Hospital.

This is a very valuable document.

Even after the regular training is over, it is very popular to return to the original hospital, or go to the city-level or county-level hospital if you fail to obtain the qualification to stay in the hospital.

Attending physicians and resident doctors in second-tier, third-tier, and third-tier hospitals in some counties and prefecture-level cities often regard Tuya training as a kind of further study.

The examination room was very quiet, and all the candidates were answering the questions silently.

Recruitment is divided into three parts: written test, interview and physical examination.

It's just a written test right now.

More than 7000 candidates, more than half will be eliminated in the written test.

Among the candidates, there are intern doctors in their 20s and social medical staff in their 30s.

Of course, there are no masters like postgraduates and doctors.

In terms of academic qualifications, Zhou Can's undergraduate education is unremarkable.

Compared with medical skills, hehe, I'm afraid it is enough to crush the heroes.

"All candidates please pause, I have an important announcement to make."

Deputy Section Chief Hu held a microphone in his hand and shouted loudly.

Candidates looked up at her standing on the stage, and Zhou Can next to her.

Some of Zhou Can's classmates or colleagues have already recognized him.

"Brother Chan, what happened?"

Several roommates were worried about him.

Class monitor Yang Chan silently prayed, "Students from rich families are just unreliable, but please don't cause some trouble to discredit your alma mater."

Her impression of Zhou Can was actually not very good.

"Let me introduce to you first. The boy standing next to me is Zhou Can, who is also an examinee. When he rushed to the examination room in the morning, he met a patient with chest tightness and angina pectoris. After a brief inquiry, when he When it was diagnosed that the patient was probably suffering from acute coronary heart disease, and he was not accompanied by his family members.”

Deputy Section Chief Hu's voice echoed throughout the conference room.

She has both voice and emotion.

"Dr. Zhou Can was faced with two choices. Either leave the patient alone and immediately rush to the examination room to take the regular training examination. Or send the patient to the emergency department to save the patient's life, and then be late for the examination. Even if he leaves the patient alone , and don’t have to take any responsibility. But if you are late for the exam, according to the regulations, you will immediately lose your eligibility for the exam.”

Everyone fell into short thinking.

How would they choose?Ask yourself, I am afraid that the vast majority of people will put their own interests first.

Especially this kind of major interest choice related to the future and destiny.

Very few people can be selfless.

On the contrary, it is human nature to be selfish.

"But do you know? Dr. Zhou Can would rather lose the qualification for the exam, and resolutely chose to send the patient to the emergency department for treatment. In the end, because of his professional introduction, the doctor on duty diagnosed the cause in time and won precious time for rescuing the patient."

Candidates were deeply moved by this and were full of admiration for Zhou Can.

A gentleman carries things with great virtue.

Those who are virtuous are more likely to be respected from the heart.

"Zhou Can is just an ordinary intern in our Tuya Hospital, but he has explained with his actions what is called great love and what is called medical ethics first. After learning about his heroic deeds just now, I am very shocked. Ask for instructions After becoming the leader of the hospital, everyone agreed that this kind of behavior should be highly praised. I announced that Zhou Can would be exempted from all penalties for being late for the exam and would be given full marks for medical ethics."

As soon as the words fell, the audience burst into thunderous applause.

A perfect score in medical ethics is definitely the highest honor given by Tuya Hospital since its recruitment.

It will become a monument in Zhou Can's career.

He also had an unprecedented smile on his face.

"Thank you to the leaders of the hospital for their praise and affirmation. I am not a hero, but just an ordinary medical worker. It is the duty of a doctor to save lives and heal the wounded. Thank you everyone."

Zhou Can's words to save lives and heal the wounded, it is the bounden duty of a doctor, touched every candidate present.

Yes, curing diseases and saving talents is the original intention of every medical practitioner, and this is what they should pursue.

For them, it was more like a baptism of the soul.

The mind becomes pure and sublimated.

The audience burst into thunderous applause again, which lasted for a long time.

"Zhou Can, take your seat and take the exam. You are allowed to delay handing in the paper."

Deputy Section Chief Hu said to him with a smile.

"Thank you!"

Zhou Can only felt that his feet seemed to be stepping on a vast light, and life could be so wonderful.

A good man lives a safe life, and the world has not failed him after all.

His seat is in the back.

When passing by monitor Yang Chan, she smiled brightly and gave Zhou Can a thumbs up.

Zhou Can smiled and nodded in response.

Follow the number, find your own seat and sit down, and there is a tablet computer equipped with the hospital on the table.

Directly enter the candidate's name, ID number, select the department to apply for, and then you can answer the question.

Provincial top tertiary hospitals like Tuya have very high requirements for recruiting regular trainees.Gui Peisheng in the clinical medical department is required to take general practice theory.

In other words, the test questions that appeared included not only surgical questions, but also internal medicine, pediatrics, obstetrics and gynecology, ophthalmology and so on.

Theory has always been Zhou Can's strong point.

When answering the questions, I saw him move his fingers like flying, and he quickly answered difficult medical questions one after another.

……

Although Zhou Can's answering speed was faster than most of the candidates, he entered the room too late after all. Before he finished answering the test paper, the loudspeaker announced that it was time to hand in the test paper.

Candidates submitted their answer sheets one after another.

Zhou Can received special care and could submit the papers later.He continued to concentrate on answering questions.

Not long after the candidates handed in the papers, Deputy Section Chief Hu took the microphone and began to announce the results.

"Thank you very much for the active participation of all the candidates. Now the test results are out. You can check your results, and you can continue to participate in the interview if you get an A or higher. Candidates with a score below A, I regret to tell you that they will be eliminated. You can leave the venue in an orderly manner, and make persistent efforts when you return, and you are welcome to continue to participate in Tuya's regular training recruitment next year."

Now it is all computer-based grading and scoring.

Efficiency is amazing.

It only took a few minutes from the time when the candidates handed in the papers to when the results came out.

The candidates who were eliminated got up and left dejectedly one by one.

Ten minutes later, there were nearly [-] candidates, but now there are only about [-] left.

Almost eliminated 60%.

This is only the first hurdle, and the next part of the interview is the most difficult.

"Next, let's invite our judges to enter."

As soon as Deputy Section Chief Hu finished speaking, many doctors and nurses entered the examination room one after another.

There were three groups of judges.

Then there are workers carrying props needed for various interviews into the venue.

"Candidates for regular training in the medical technology department, please sit here."

This department mainly conducts various examinations and pathological tests on patients.

Most of the instruments brought in by the workers are for the candidates of the medical technology department.

There are quite a lot of candidates applying for the medical technology department, at least 800 or so.

What they have to do in the interview is to read B-ultrasound films, CT films, X-ray films and so on.Then complete the operation of the Doppler ultrasound machine and make a clear video on the spot.

Of course, the filming location is randomly designated by the examiner.

"Candidates from the nursing department come to the front."

Most of the female candidates flocked away, and there were not many girls with super good looks.Tuya Hospital recruits a large number of nurses every year.Nursing is basically a career that eats youth.

Many nurses are older and either return to their families or switch to other jobs, such as health managers and so on.

Only a very lucky few can be promoted to head nurses, or take a back seat to engage in relatively easy tasks.

For example, follow the doctor's order, open the computer, take medicine, manage the warehouse, organize data and other tasks.

Generally speaking, nursing is a job that eats youth.

There is a lot of turnover of people.

Basically all hospitals are similar, often recruiting nurses.

About 700 candidates apply for the regular trainees of the Nursing Department.

Not all girls, but also boys.

However, relatively speaking, the number of boys is very rare.

The remaining more than 1500 candidates applied for the standardized training of all departments.

It can also be seen from this that the profession of doctors is the most popular.Because with the continuous growth and improvement of medical skills, the older the doctor is, the higher the income and the higher the status.

Doctors are a growing profession with a bright future.

The competition for standardized training for general subjects is the fiercest, far surpassing the two subjects of nursing and medical technology.

More than 1500 candidates are gearing up and waiting.

"Good morning, candidates. Let me start the first part of the interview, the pathological diagnosis. I will play the role of the patient and give a series of symptoms. You can prescribe the examination plan through the tablet computer. Remember, do not prescribe the examination plan indiscriminately. Check, if you don’t check, you will be deducted points.”

The hearts of all the candidates tensed up.

No one expected that the first question in the interview would be the diagnosis of a real person.

Those social candidates in their 30s are better off. Many of them have worked as doctors in county-level and city-level hospitals for several years or even more than ten years, and have rich experience in clinical diagnosis.

For interns, it can be a bit fatal.

Their clinical diagnosis experience is still very little, and they have never been alone.On weekdays, it is more on paper.

Now asking them to make a diagnosis in person, they are naturally a little flustered.

"I suddenly felt chest pain, I couldn't breathe, and I felt that my physical condition was not good, so I rushed to the emergency department of the hospital for medical treatment. You are the doctor on duty. What kind of examinations will you do for me? Please write the order on the tablet. Checklist. Note that if the order of checks is reversed, the score will be halved."

There is a stricter process for the examinations that doctors should do after seeing a patient.

First of all, it must be a physical examination, such as palpation, inspection and so on.

The next inspection items are like peeling cocoons.

For example, after the routine blood test, I feel that it is necessary to take an electrocardiogram again. When applying for a checkup, I should prescribe the routine blood test first, and then perform the electrocardiogram.

After some serious thinking, all the examinees issued examination applications one after another.

"time up."

The time given by the examiner is only about 10 minutes.

This undoubtedly increased the difficulty of the test.

However, in actual consultations, when encountering emergency or critically ill patients, the reaction time left for doctors will be shorter.

"Below, you can view the scores and inspection results of the inspection items."

At this time, Zhou Can finally completed the written test.

He submits the answer sheet.

The results are almost instant.

A.

Scores should be between 90-95.

If the score is above 95, the grade should be A+.

However, with such a difficult test paper, the content of the test almost covers internal medicine, surgery, obstetrics and gynecology, pediatrics... all medical departments.He can get an A, which is already very good.

He also roughly listened to the exam questions given by the examiner just now.

Now that you have passed the written test, go on to the interview.

"The patient has chest pain and is out of breath?"

First of all, you must check for heart disease.He quickly prescribed three tests including physical examination, routine blood test, and electrocardiogram.

submit.

"Congratulations, all the inspection items are correct and you get full marks."

Zhou Can smiled slightly.

The pathological diagnosis has been upgraded to the third level, which is already at the level of a resident doctor.If an examination can still make mistakes, then his third-level pathological diagnosis must have been bought with money.

He quickly checked the results of various inspections.

Physical examination showed a heart rate of 122 beats/min and a blood pressure of 97/49mmHg.

The heart rate of a normal person is within the range of 60-100 beats per minute, but the patient's heart rate is obviously too fast.

The systolic blood pressure of normal people is 90-140mmHg, and the diastolic blood pressure is 60-90mmHg.The patient's blood pressure was markedly low.

An adult male in his 30s, in the prime of his life, had blood pressure so low it would cause shock.Besides, if the blood pressure is too low, the organs of the whole body cannot get enough blood oxygen, and the metabolism of cells will be hindered.

A little longer, the organs will be overwhelmed and shut down.

The patient died.

Read on for blood test results.

Wow, troponin is so high.

significantly higher than normal.

Zhou Can couldn't help thinking of a terrible disease, acute myocardial infarction.Mr. Cui, who was rescued in the morning, was quite similar to this disease.

Acute myocardial infarction is also a type of coronary heart disease.

If not treated in time, the mortality rate is extremely high and the prognosis is poor.

Based on the results of the previous two inspections alone, it is difficult to conclude.Then look at the most important ECG.

It can be clearly seen that the electrocardiogram has changes similar to myocardial infarction.

The human heart, under normal conditions, is capable of continuous discharge.The electrocardiogram is to monitor its discharge and convert it into ripples for doctors to use for diagnosis.

When a piece of myocardium is necrotic, or a blood vessel is obstructed, causing the myocardium to lose its vitality.

Ripple peaks in the ECG will be evident.

Doctors can roughly determine which blood vessel is blocked based on the electrocardiogram.

"Fuck, it's really an acute myocardial infarction."

Based on the results of the three examinations, Zhou Can preliminarily deduced that the patient was probably suffering from acute myocardial infarction.

It's just that he faintly felt that something was wrong.

What Dr. He said to him after his appointment yesterday echoed in his ears again.

"Medicine is a rigorous discipline, and I never draw conclusions easily. Diagnosis must be based on the patient's medical history, condition, gender, and various examination data to make a comprehensive diagnosis."

At this time, the examiner said with a blank expression, "I believe that after reading the diagnosis results, you have already made a judgment in your mind. Please fill in the diagnosis results."

Many candidates have begun to fill in the diagnostic results with confidence.

Zhou Can frowned tightly, always feeling that something was wrong.

But no reason could be found.

(End of this chapter)