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[It's two in one today]

"Qin, have you been going to Johns Hopkins Hospital a lot lately?" After class, Spacey ran to Qin Chuan's side. Pen, fun, and www.biquge.info

"yes. I went to Professor Gillian's team and studied with them. Qin Chuan didn't hide it.

"You're so lucky. Of course, that's where you excel. Gillian's team isn't easy to get into. Even a trainee doctor is not easy to get into Gillian's team. Professor Gillian seems friendly, but is very strict with his students. The fact that you were able to join her team shows that she has a very good impression of you. Spacey said with some envy.

"Actually, you don't have to worry, when you wait for the apprenticeship, there will be a lot of opportunities." Qin Chuan said with a smile.

"Of course. You don't look at who I am, I'm the future American famous doctor. Spike makes a cool gesture and gently strokes his sideburns with his hand.

"Don't be so amorous~ Okay, you are a famous doctor, not a celebrity." Qin Chuan said with a smile.

"How can a man be a celebrity? Qin, I found that you are really not a pure person. "Spike was like someone had stepped on his tail.

"Well, this time flies so fast. Before you know it, it's almost a year. Qin Chuan sighed. Here, there are three semesters per academic year, and the course schedule is very intensive, with short study time, intensive exams, continuous papers, and non-stop experiments. For Chinese students who are accustomed to a loose Chinese university education... It's still very stressful. Qin Chuan is also fortunate to have the [Genius Famous Doctor] system, if according to Qin Chuan's own level, it is really not easy to adapt to the rhythm here. Although Qin Chuan felt that he had overcome difficulties, he was able to adapt. But it's not an easy thing to do.

Medical school itself is a more difficult discipline than any other. That's why medical schools in the U.S. only admit college graduates in related majors. The degree of rigor in admissions is very different from that of American universities. Medical school is absolutely strict in and out. Because Americans value life above all else. This is also the reason why medicine is taken very seriously.

"I feel that time passes too slowly, and the sooner this painful day passes, the better. In this way, I can quickly become a famous doctor. "Spike's view is completely different from Qin Chuan's.

"Yes. It's time for the apprenticeship. Life is better. Qin Chuan nodded.

Qin Chuan did not relax his studies just because he had the [Genius Famous Doctor] system, in fact, he was more diligent than American students in the same grade. Qin Chuan didn't know if the [Genius Famous Doctor] system would leave him one day. He only knows that only when he masters it is his own wealth. Although the genius doctor is good, it belongs to an external force after all. Qin Chuan didn't like this state of being out of control. So. He needs to study hard, and strive to completely control the huge treasure trove of [Genius Famous Doctor] in his own hands.

"Qin, you have obtained a doctor's license in China, why do you still want to come here to suffer? Aren't you ready to practice medicine in our country in the future? Spike didn't quite understand what Qin Chuan was doing.

"The United States is known to have the best healthcare system in the world. The medical structure and medical education system in our country are very different from those in the United States. In our Chinese words, it is said that the stone of the mountain can attack jade. I hope to be able to make a substantial improvement through my studies at Johns Hopkins University. Qin Chuan said.

"I see. I definitely have different ideas than others. Spike has always admired this Chinese student.

Qin Chuan really worked hard, completed all kinds of studies every day, and then prepared for the U exam after class. On weekends, she travels to the hospital to participate in some of the medical activities of Gillian's team. There is hardly much leisure time. Universities in the U.S. are not a place to enjoy. This is completely different from that in China. I watched American college students on TV, but when I actually got here, I realized that most of them were Alexander.

By the end of the second academic year, Qin Chuan had actually obtained his American medical practitioner qualification certificate. It was also time to enter the hospital for probation. Medical students also have a great deal of flexibility in the course of their clinical placement. The clinical internship has two years. The internship in the first year is compulsory, including three months each for medicine and surgery, three months for women and children, one month for radiology, and one month for psychiatry. Like what. In rotational surgery, in addition to the compulsory content. There are also 3~6 weeks for medical students to choose the department they are interested in. In the fourth year, medical students only have one month of compulsory courses, one month of internship in internal medicine, and the remaining eleven months can be arranged freely. The internship did not have much pressure on Qin Chuan, after all, when he was an intern in a domestic hospital, Qin Chuan himself performed very well. Moreover, after a year of emergency department, Qin Chuan's strength is stronger than before, and I don't know how much stronger it is. Qin Chuan's current ability. Even in the United States, there are not too many people who can surpass Qin Chuan in terms of comprehensive capabilities. For Qin Chuan, to become a world-class famous doctor, the main thing he lacks most is experience.

Qin Chuan's first stop at Johns Hopkins Hospital was in internal medicine. Resident Dr. Dalins and Dr. Dylan were in charge of him, Spacey, and three other trainees, Emerson, Tarraghy, and Deborah.

"Don't expect it to be easy under my hands. There are such fantasies. Your time in internal medicine is bound to be a nightmare. "Dr. Dai Lins warned the new tenders who came to the internal medicine department with Qin Chuan to report.

Dai Linsi didn't let Qin Chuan go, and finally said deliberately: "And you, a young man from China, I often see you in the hospital." But don't think that this is how easy it will be for you. ”

"I'll try harder." Qin Chuan said very calmly.

Although Dai Linsi didn't specifically target Qin Chuan, he still deliberately glanced at Qin Chuan a few times.

Actually becoming an intern felt different from the feeling I had when I first joined Gillian's team in the hospital. At that time, Qin Chuan was more like a bystander. After becoming an intern, all interns have to appear in the hospital as a master. This is not quite the same as the intern doctors in China.

"You're here to study in the hospital, not to do odd jobs." That's what Dr. Dalins said a lot.

At six o'clock in the morning, the resident doctor began his rounds.

Spacey yawned, a little sad.

"I was so excited last night that I went to bed very late. I didn't expect the time to come soon. "Spacey was a little sluggish.

"Be careful, Dr. Dalins is not a fuel-efficient lamp." Qin Chuan warned.

"I can't help it." Spike shrugged.

Dai Lins was a little dissatisfied with Spike and Qin Chuan who were whispering: "When you are in the hospital, you should be more attentive. Even if you become a trainee like us in the future. You still need to learn and improve your skills every day. Because we are white-clad warriors who fight the Grim Reaper. ”

Qin Chuan agreed very much with Daisling's words. I spent a lot of time at Johns Hopkins Hospital, and I saw some of the things here. Qin Chuan sighed very much. In addition to the high salary and good environment that are the envy of domestic doctors, there is also a very good atmosphere here. The doctors he has seen have never been in the stock market, chatting, making phone calls, surfing the Internet and other chores during working hours. All of them devote themselves wholeheartedly, do not have to worry about medical disputes, and just carry out clinical work. They use their professional knowledge and skills to help patients reduce pain and improve their quality of life. Spiritual satisfaction is self-evident.

And when he was in China, even if it was Qin Chuan's own team, he had no way to make everyone in the team devote themselves to their work. When you have free time from work, open the webpage and read the news. Or answering the phone, it's a very common thing. Qin Chuan's team is already a very rare team in China.

Early in the morning, routine rounds began. Qin Chuan and the others followed Dai Linsi to conduct ward rounds. Of course, at this time, the targets of the ward rounds were mainly a few patients in charge of Dai Lins. After Dai Lins finished her rounds, she began to review yesterday's check-up and some of the day's treatment plans.

After a lap, it's almost more than an hour. Qin Chuan and the other trainees did not arrange things for the time being. The main thing is to follow Dalins.

At seven o'clock, Dalins began to think about the senior resident report. At about eight o'clock, the attending doctor's rounds began and continued until about twelve o'clock. End of ward rounds.

Dalins was on the eve pre-call that day, and she didn't leave work until 12 p.m.

Qin Chuan went to work on his first day. was assigned to be in charge of a patient.

"Qin, Miss Mano, I'll leave it to you to be responsible." Dalins said.

Qin Chuan took a closer look at Mano's case. He was 52 years old. Fatigue and polyuria with weight loss for more than 2 years. Since 2 years ago, there has been no obvious cause of general weakness. Increased urination (about 2000-3000ml/24h), no obvious palpitations and hyperhidrosis. Since the onset of the disease, he has a good appetite and good sleep. Weight loss of 5 kg. No previous history of taking specific medications. Physical examination: T36.8C, P76 times/min, R16 times/min, BP135/85mmHg, height 160cm. Weight 70kg. Clear, moderately nourished, superficial lymph nodes unpalpated. The thyroid gland is not large, and no bruits are heard. Cardiopulmonary examination was unremarkable. The abdomen is flat and soft, there is no tenderness and rebound tenderness, the liver and spleen are not palpated under the costals, the bowel sounds are 4 times/min, and the lower limbs are not swollen. Laboratory tests: fasting blood glucose 9.1 mmol/L, 2 hours postprandial blood glucose 13.8 mmol/L.

"Tell me what you think of this patient." Dai Linsi was ready to study Qin Chuan.

Qin Chuan nodded: "In view of the patient's gender and age, middle-aged female, and the typical clinical manifestations - fatigue, polyuria with weight loss. and laboratory results - fasting and postprandial blood glucose exceeding 7.0 mmol/L and 11.1 mmol/L, respectively. I think this patient should be type 2 diabetes. ”

"What's next for you?" Dai Linsi did not affirm or deny Qin Chuan's answer, but continued to investigate.

"I think further tests should be done in order to confirm whether a patient has type 2 diabetes. Urine glucose and ketone are checked, and C-peptide release test, GAD, IAA, glycosylated hemoglobin, blood FT3, FT4, TSH, fundus examination, urine trace protein and blood lipid test are performed. Qin Chuan replied.

"Next, after the diagnosis, how do you treat it?" Daylins asked.

"With hypoglycemic drugs, biguanides are preferred. Appropriate life coaching and proactive prevention of complications. Dietary guidance. Patients are instructed to perform appropriate physical exercise, and self-testing is appropriate. Qin Chuan recited the standard specifications of the treatment plan for type 2 diabetes.

"Well, you know the book by heart. The diagnosis is also accurate. Such an answer cannot be said to be incorrect. This patient is in your hands. Make a treatment plan for this patient and hand it over to me tomorrow during my ward rounds. Dalins said.

On the first day, he was entrusted with an important task by the hospitalized medical staff, and Qin Chuan was very envious of other students. The rest of the students were generally given tasks such as writing medical history records and checking and tracking.

"Qin. You're lucky, Dr. Dalins is really impressed with you. Why didn't a handsome future doctor like me get such a good opportunity? Could it be that Dr. Dalins's maternal brilliance always likes to take care of the disadvantaged? Spacey seemed to be a little jealous.

"I've seen someone dozing off and wandering all the time today, and Dr. Dalins has paid special attention to someone." Qin Chuan quietly told Spacey an unfortunate news.

"Wouldn't it? Qin, tell me, you're lying to me. Spacey cried.

"But don't worry, I'm sure Dr. Dalins will be considerate of us newcomers who came to work in the hospital on their first day." Qin Chuan said with a smile.

"Yes, yes, yes. She may not have performed as well as me when she first came to the hospital for her internship. That's right. Qin, why do you remember that case so clearly? Even if I asked me to turn the book, there was no way to answer so accurately. Dalins seems to be very happy with your performance. Spike's meaning is, in other words: why is there such a big gap between the same trainees?

"I have been an intern at the hospital for several years and have been the attending physician for almost a year. I've come across this kind of case. So it's very familiar. Qin Chuan explained.

"Oh, I see. Qin, when I become a resident doctor, I will surpass you. Believe me. I am the most gifted doctor of this century. Spike's words sounded more like a slogan.

While the two were talking, the pager on Dalins sounded. codeblue。

"There are patients who need first aid. Come with me! Dalins took the lead and rushed out. The patient on the call was on the tenth floor, and the doctor who was now Dai Lins was standing on the fifth floor.

Spike runs over and presses the elevator. Not enough, but Dai Lins shouted, "Take the stairs." ”

Elevators stop at almost every floor for varying lengths of time. The time to wait for the elevator is indeed not as fast as taking the stairs. Time to save patients is precious. Must grab the gold for five minutes.

Qin Chuan followed closely with Dai Linsi. Don't look at Dai Lins looks like a weak woman, climbing up the stairs, no weaker than a boy. Spike is a bit overweight, and Americans like carnivorous foods, so the general public is generally slightly obese. I climbed two or three floors. It's already out of breath. Qin Chuan naturally didn't have any problems, and he kept following Dai Linsi's side all the time. Dalins regularly participates in physical activity. She was an athlete, and she thought that by the time she reached the tenth floor, all of these interns would be left behind by her. But to her surprise, Qin Chuan actually followed.

"You're in great shape." Dalins laughed.

"It's okay, I get involved in physical activity regularly." Qin Chuan said with a smile.

"No wonder." As she spoke, her pace didn't slow down at all.

It took less than two minutes. The two of them had already climbed to the tenth floor.

However, by the time the two arrived at the ward, more than a dozen doctors had already arrived in the ward. The ward was in order. One doctor is performing chest compressions on a patient, while another doctor is waiting in the back for a replacement. There is a doctor who counts the number and practice of chest compressions and orders the injections. The rest of the doctors communicated softly. A path was consciously vacated in the ward for doctors and nurses to enter and exit.

Qin Chuan counted it estimatedly. There were more than 20 medical staff in the room. Finally, after everyone's hard work, the patient's blood pressure and pulse recovered. Qin Chuan silently withdrew from the ward with Dr. Dai Linsi.

This scene made Qin Chuan very emotional, if it was a patient from Tanshan Central Hospital, this situation occurred. There won't be so many doctors involved in the rescue. It wouldn't be so collaborative. Even if many people participated in the rescue, the scene was noisy. It won't be so orderly.

Qin Chuan feels that his team is sure to do better. However, doctors from different departments and different medical teams met together urgently, and with cooperation, I am afraid that it will be difficult to be so orderly.

Dai Lins was very unhappy with the late trainees: "If the patient waited for you to save his life, I don't think the person had stopped breathing before you arrived. I hope you are always in the emergency, and when you callblue, it means that there is a life waiting for you to save. At this time, you need to do your best to help the patient in the shortest possible time. ”

After Dai Linsi got off work, Qin Chuan and the other trainee doctors were ready to go home.

When Qin Chuan returned to the place where he lived, he no longer had the energy to enter the system to learn new things. Today's real experience in the hospital is already Qin Chuan's biggest gain today. Qin Chuan found that there was still a huge gap between his team and the medical teams of these world-renowned hospitals in many aspects.

The next day, Qin Chuan rushed to the hospital early in the morning. Spike's condition is even worse. After arriving, he stood there casually, and as soon as his eyes were closed, he fell asleep.

"Hey, don't sleep, Dr. Dylan is here." Qin Chuan hurriedly pushed Spike. (To be continued.) )

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