Chapter 284 (1/2)

If you want to be a doctor in the United States, you need to complete the education at the university stage. At the same time, you also need to learn well the pre medical courses. Only with excellent graduation results, entrance examination results of medical school, social work experience and recommendation letters from teachers and professors can you be admitted to medical school.

If everything goes well, that is, the academic performance is good and there is sufficient tuition support, a college student must study basic medical courses for two years after being admitted to the medical school, so that he can enter the hospital to learn clinical knowledge with the teachers at the beginning of the third academic year, and officially become an intern like Bernard in the fourth year, Rotate in various departments of the hospital according to the length of time.

Of course, at this time, the hospital will arrange which department these people start from according to the requirements of interns, that is, if Bernard asks to start from the emergency room first, then the school will take his requirements as the first condition.

Only during his internship, Bernard still has a long way to go. He has to spend all his energy every day to prepare for the step 2 test of USMLE, that is, the MD degree test for obtaining a doctor of medicine.

This is only the first step to becoming a doctor. The subsequent resident program is also like that college students are admitted to medical school. MD who has obtained the medical doctor's degree also needs to compete with all MD's in the United States - that is, all MD's including previous and recent years to compete for resident training places.

The same as the previous medical schools facing college students, the resident training program is also a two-way choice. Major hospitals across the United States refer to the applicants' educational background (University) and work experience (the enrollment of medical schools in the United States is not different from that in the past, as long as it is a bachelor's diploma, and many college students who are not satisfied with the current situation after graduation can continue to apply for the examination) Research experience (thesis achievements at the university stage) shall be selected for admission.

However, even such a strict inpatient training program has three directions: MD inpatients and PhD inpatients, and the joint training program of MD and PhD. In short, it is clinical and scientific research, and clinical and scientific research mixed with both - that is, the doctor scientist training program Zheng Jianguo is now participating in.

Only about 500 people are enrolled in the training program worldwide every year.

Therefore, when Bernard follows Bertha to participate in the 24-hour and 36 hour shift training programs every day, Zheng Jianguo can enjoy eight early and five late every day, living a more comfortable learning experience than Wall Street financiers.

Of course, even if Zheng Jianguo can participate in this training program, he must abide by the mandatory learning process. He has been in the emergency room for more than two months. In addition to performing debridement and suture surgery for patients, he has not even entered the door of the operating room. He only attends the morning meeting every Monday as an observer.

After such a long time, Zheng Jianguo also had a personal understanding of this requirement. In the first year, inpatients mainly learned how to manage patients, that is, to track the course of disease and confirm doctors' orders in the face of hospitalized patients, which is also described by a special word in English - intern.

Intern has no right to receive patients. It needs to be a senior inpatient, that is, at least under the leadership of resident inpatients in the second year of training.

At this time, residents have greater rights. In addition to managing patients, they can also participate in the weekly morning meeting to summarize and learn about the difficult and miscellaneous diseases or medical problems that occurred last week, and can help in the operating room when they are free. That is when they will have the opportunity to contact the operation.

However, this is not absolute. With the permission of the attending doctor, that is, with authorization, for example, after Zheng Jianguo entered the emergency room, director Nathan BECKSON gave him the right to participate in the Monday morning meeting.

Unfortunately, until this time, the two attending doctors in the emergency room, Nathan BECKSON and Oliver argas, did not let Zheng Jianguo enter the operating room. Although his performance was still extremely dazzling, he only did hand suturing with the permission of Pliny at the resident stage.

Like the first two, the residents in the third year have greater rights. The chief resident represented by Bertha, that is, the chief resident - this is not recognized with the increase of training years. Only a few residents are good enough to become the chief resident.

Bertha's right in the emergency room is second only to the two attending doctors. In addition to managing inpatients, she also manages junior resident and intern, organizes teaching ward rounds and discussion of death and difficult cases at Monday morning meetings, and can also arrange surgery, consultation and scheduling. She can participate in any operation.

In addition to giving intern access to the operating room and scientific research——

This is why Zheng Jianguo found Bertha. Now she is an excellent chief resident physician. The next step is to work for another two years. When the training is completed, she can obtain the qualification of independent medical practice and become a real doctor.

Only the doctors who have reached this stage are really just doctors. Therefore, this position is only on the second floor of the pyramid of the health care system. If you want to climb to the upper floor, that is, the highest attending doctor in the system, you also need to go through different specialist training at the same time.

The reason why it is not long at the same time is that according to the scope of the Department, the lowest physician needs three years of training, while the longest neurosurgery needs seven years, which is why most of the attending doctors are over the age of 40.

Because according to the normal age of 18 years to enter the University, four years of University, four years of medical school, five years of hospitalization and three years of internal medicine specialist, they are all running at the age of 35. If there is any further delay, they are all about 40 years old.

Even if Zheng Jianguo became a resident at the age of 18, his graduation time is conservatively estimated according to the shortest internal medicine specialist training, it will take another 8 years, which is the reason why he chose the emergency room as the resident training.

As the 23 local medicine recognized by the American medical institution last year, everything in emergency medicine is still being explored and consolidated. Looking only at the emergency room of Massachusetts General Hospital, there is no ICU, we know that the construction of this medicine still has a long way to go.

Of course, as a new and emerging discipline, the inpatient and specialist training system of emergency medicine is not mature. There is no rigid plan formulated by medical management institutions like internal medicine and Neurosurgery, which is groped and carried out by local hospitals themselves.

As far as Zheng Jianguo is concerned, it's like he saw the graduate enrollment method before entering the Medical College of Qi Province, because the goal of specialist training is to focus on the research results of scientific research, that is, after getting the specialist training plan, he needs to go to the laboratory to do scientific research.