? Hospital doctor training personal summary
? The time is running out, the white horse passes by. In the blink of an eye, in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine six months of training life has been successfully concluded. Counting the six months of short time, I cherish. Because I know that the hospital selected me to go out for further study, in addition to the needs of the hospital business development, but also contains the leadership of the hospital's full trust in me and ardent hope, I also take this further study as a valuable learning opportunity. Through this six-month training and learning, not only improve my own business and technical level, but also make me open up the vision, expanding the idea, so that I have benefited from life, but also a clear sense of their own shortcomings. The following is my opportunity to talk about some of their own insights on this refresher course.
? Affiliated Hospital of Chengdu University of Traditional Chinese Medicine is the most complete clinical Chinese medicine disciplines in southwest China, the highest level of comprehensive service set of medical care, teaching, research in one of the three grade A comprehensive hospital of traditional Chinese medicine, the national demonstration of traditional Chinese medicine hospitals, the national Chinese medicine clinical research base construction units, but also the national Chinese medicine clinical trial research (gcp) centers, the National Center of Chinese medicine eye medical center, the National Center of Chinese medicine emergency medical center as well as the National Administration of Chinese Medicine, Chinese medicine, Chinese medicine, Chinese medicine, medical center, and the national Chinese medicine administration. It is also the National Chinese Medicine Clinical Trial Research (gcp) Center, National Chinese Medicine Eye Disease Medical Center, National Chinese Medicine Emergency Medical Center, and the State Administration of Traditional Chinese Medicine (SATCM) Clinical Base of Chinese Medicine, Combined Traditional Chinese Medicine and Western Medicine Emergency Clinic and Infectious Disease Clinical Base. My department of cardiovascular medicine is the cardiovascular base of the National Center for Clinical Trials of New Drugs and the key specialty of Chinese medicine in Sichuan Province. The department mainly uses both Chinese and Western medicine to diagnose and treat various cardiovascular diseases, and at the same time, the department also carries out the interventional treatment of coronary heart disease and structural heart disease, cardiac electrophysiology examination and various pacemaker implantation.
? Over the past six months, under the careful guidance of the substitute teacher, I have mastered the cardiovascular system such as hypertension, coronary heart disease, arrhythmia, heart failure, myocarditis, cardiomyopathy, valvular disease and other kinds of common diseases, multiple diseases diagnosis and treatment, and in the ccu of cardiovascular various acute and critical illnesses of treatment and resuscitation process has a certain degree of familiarity with and mastery; I also mastered the cardiovascular disease of the interrogation method, I have also mastered the methods of questioning and consultation of cardiovascular diseases, the key points of physical examination and the accurate and rational application of routine medicines, and I am able to independently complete the operation of electrocardiogram machine, master the key points of reading electrocardiogram, and accurately issue the report card; at the same time, I have observed and learned the various kinds of interventional treatments, such as coronary arteriogram and stent implantation, permanent pacemaker implantation, electrophysiological examination of the heart, and radio frequency ablation.
? In the process of further study, I was not only impressed by their exquisite medical technology, but also by their scientific and standardized departmental management, especially in the implementation of their core medical system. As a famous Chinese medicine tertiary teaching hospital in Southwest China, their three-level physician checkup system is reflected to the fullest extent. My cardiovascular department is divided into three medical groups, and the residents are all above the title of attending, each medical group has a deputy director or above to check in every day, and the director and deputy director of the department fix the business check-in every Monday and Thursday; in addition to the routine morning check-in, each medical group often organizes its own check-in in the afternoon; in the process of checking in the room, they analyze and comment on each patient's condition in detail from the perspective of evidence-based medicine, so that each participant in the room check-in can be more satisfied with the patient's condition, and the patient's condition is more stable. In the process, they analyze and comment on each patient's condition in detail from the perspective of evidence-based medicine, so that every doctor participating in the room check can "know what is true and what is not true"; if the patient develops symptoms other than those in their own department in the process of treatment, they will immediately invite the relevant departments for consultation; every Monday, Wednesday and Friday is the time for them to carry out interventional therapy, and pre-operative discussions will be held in the afternoons of Tuesday and Thursday; every Monday afternoon is the time for death discussions, and every Wednesday afternoon is the time for death discussions. Every Monday afternoon is the time to discuss the death, Wednesday afternoon is the time to discuss the difficult and critical cases; Friday afternoon is the time for business learning lectures; they also pay special attention to the doctor-patient communication system, each patient will be admitted to the hospital by the treating doctor personally write a doctor-patient communication record, which contains detailed records of the patient's condition and diagnosis, the proposed treatment program and some complications that may arise in the treatment process; critical patients in the treatment process repeatedly and repeatedly communicate with the patient's family members. In the process of critical patients in the treatment of repeated communication with the patient's family; interventional surgery patients in addition to the routine signing of surgical consent, there is a preoperative conversation record; in addition, the department also has a special medical teaching secretary, responsible for the quality of the department's medical records and teaching arrangements.
? As a Chinese medicine hospital, Chinese medicine special treatment is one of their major features. The cardiovascular department carries out Chinese medicine treatment programs generally include moxibustion treatment, auricular acupuncture point treatment, Chinese medicine foot bath, Chinese medicine collapsing impregnation, acupuncture and other Chinese medicine treatment programs, with the former three predominant; moxibustion treatment is the use of purchased coronary heart moxibustion, strong kidney moxibustion, analgesic moxibustion, etc., and a course of treatment (7 days) is issued to each patient after admission; auricular acupuncture point treatment is their homemade. Their herbal foot baths were the most commonly carried out and were used by almost every patient. This is because they have a strict ratio of Chinese medicine to be used (25% of the medication ratio), so in addition to prescribing oral Chinese medicine to their patients, they also carry out Chinese medicine foot baths to increase the ratio of Chinese medicine to be used.
? As a department specializing in cardiovascular diseases, the high utilization of equipment in the department is another major feature of the department. Cardiovascular Department *** with 80 beds, but the cardiac monitor is configured with more than 40 units. Patients with heart failure and arrhythmia are routinely monitored electrocardiographically, and patients after interventional therapy are also routinely monitored electrocardiographically for 2-3 days. The department is also equipped with bedside Doppler ultrasound, and patients admitted to the hospital routinely undergo cardiac Doppler ultrasound examination. In addition, the department also has a cardiac function test room, arrhythmia and hypertension patients routinely carry out 24-hour ambulatory electrocardiogram, heart rate variability analysis and ambulatory blood pressure examination, every day the department is equipped with 24-hour ambulatory electrocardiogram detector and ambulatory blood pressure monitor will appear in short supply.
? Cardiac intervention and non-pharmacological device therapy is a major trend in the modern treatment of cardiovascular diseases. The department has an interventional catheterization laboratory, equipped with digital subtraction angiography and cardiac Doppler ultrasonography and other advanced equipment, mainly to carry out left and right cardiac catheterization and monitoring, coronary angiography, percutaneous coronary angioplasty and stenting, balloon dilatation of heart valves, radiofrequency ablation of tachyarrhythmias (supraventricular tachycardia, atrial fibrillation, ventricular tachycardia, etc.), placement of a variety of pacemakers and interventional treatment of congenital heart disease, which generates considerable medical business income for the department.
? In the department's performance appraisal, they take the medical business income created by the individual as the standard, and adopt the principle of more work, more pay, according to the distribution of work to mobilize the work enthusiasm of the department staff. At the same time, they take playing the characteristic advantages of Chinese medicine and medical quality indicators as the main content, take the quality of medical record writing, the implementation of the core medical system, the qualified rate of Chinese medicine diagnosis and treatment, the proportion of Chinese and Western medicines, the four reasonable use, the incidence of medical errors and the participation in the teaching activities, etc. as the basis for the assessment, and formulate the comprehensive assessment rules of the departmental personnel, and the monthly assessment of the departmental staff (doctors) by the department's medical and teaching secretary
? In terms of nursing work, they use nursing grouping work mode to divide nursing staff into 2 work groups, each group set up a nursing team leader. Each working group is divided into treatment groups, work groups, inspection groups, mobile groups, etc., each group division of labor and cooperation, solidarity and collaboration, so that the complexity of the nursing work carried out in an orderly manner.
? Through this six-month period of time to further study, so that my business and technical level has been greatly improved, but at the same time I also y recognize their own shortcomings, feel the grass-roots hospitals and tertiary hospitals in the software and hardware facilities between the obvious gap. At the time of our hospital to create a second-class B Chinese medicine hospital, I put myself in the process of further study, see, feel, think and inpatient internal medicine and the actual situation of the combination of the following points, hope to be able to play a certain role in promoting the development of the department.
?1, the strict implementation of the core medical system
? The implementation of the core medical system is to improve the quality of medical care, to ensure that the important initiative of medical safety. In the process of the department's routine business, should strictly implement the checkup system, consultation system, difficult and critical case discussion system, death case discussion system and other core medical system. In terms of the title structure of our hospital, now hospitalized internal medicine has fully equipped to implement the ability of the three-level physician checkup system, but due to the title of deputy director of the staff above the daily outpatient medical tasks, resulting in the implementation of the three-level physician checkup system is difficult to implement, it is recommended to designate one day a week in the morning for the deputy director of the physician in the internal medicine business of the time of the checkup, which is designated to checkup in the morning of the deputy director of the doctor does not bear the task of the outpatient medical tasks.
?2, increase the department hardware investment
? The modern diagnostic and treatment technology, in addition to the need to have a strong technical level of business, hardware investment is also an indispensable part of the facilities. Through the feeling of the study period, let me y appreciate the lack of equipment in our hospital, some times there is really a kind of "clever woman can't cook without rice," the embarrassment and helplessness, the department's emergency proportion is not high and the lack of hardware facilities have a certain relationship. In terms of the business development of inpatient internal medicine, it is recommended that the hospital laboratory carry out natriuretic peptide, n-terminal natriuretic peptide, blood gas analysis and other testing programs, and the Department of Internal Medicine to purchase cerebral function therapeutic instrument, cerebral hemodynamic detector and other equipment, and at the same time recommended the development of painless gastroscopy. In addition, the department has an existing idle ventilator, it is recommended to send people to learn to use.
?3, fully demonstrate the characteristics of Chinese medicine
? Since the creation of the second level of Chinese medicine hospital in my hospital, the Department of Internal Medicine has carried out the treatment of Chinese medicine appropriate technology. Previously, the department routinely carried out Chinese medicine appropriate technology are acupuncture, ear acupuncture, acupoints, moxibustion, gua sha, ear tip bloodletting, cupping, enema and other items. Due to the limitation of the new rural cooperative policy, the treatment programs carried out in the department now are only acupuncture, acupoint sticking and moxibustion. But no matter what kind of Chinese medicine treatment program, it has not been formed in the patients' mind is our hospital "Chinese medicine special treatment" concept, and even such as acupuncture and other invasive operation part of the patients are still very rejected. In my opinion, in terms of Chinese medicine appropriate technology treatment, we can learn from the cardiovascular department of Chengdu University of Traditional Chinese Medicine Hospital to carry out Chinese medicine foot bath treatment for most patients. The reason is that first of all, everyone has to wash their feet every day, and people are very happy to accept the addition of Chinese medicine soup during foot washing; secondly, some patients who reject oral medicines (especially oral Chinese medicines) are also willing to accept this method of Chinese medicine treatment; again, this treatment is not invasive; and fourthly, it can increase the ratio of traditional Chinese medicines while increasing the income from the treatment. In addition, the department should develop its own in-hospital preparations as soon as possible, such as their silver scape clear lung oral solution, stroke awake brain injection are very widely used.
?4, refine the department staff professional
? The hospitalized internal medicine belongs to the category of large internal medicine, the patients admitted throughout the internal medicine of various systems. Because of the hospital conditions and patient resources are limited, can not be divided like a tertiary hospital as a fine-tuned secondary departments, departmental personnel can not achieve the requirements of the section proficiency. Therefore, it is necessary to refine the professional direction of the department staff, not requiring each system of professional direction are refined, at least the cardiovascular system, respiratory system, digestive system, nervous system, endocrine system and other professional refinement of the department staff head, so that "a hundred schools of thought, each lead a end". At present, the Department of Internal Medicine has personnel in the cardiovascular and gastroenterology completed advanced study, it is recommended to co-ordinate the arrangement of personnel to further study respiratory, endocrine and neurology.
? Hospital doctor training personal summary
? A year of further study has just ended, I returned to the workplace I am familiar with. First of all, I would like to thank the hospital, the leadership to give me this valuable opportunity, but also to thank all colleagues, because of their hard work, so that I can complete my studies at ease.
? My unit of further study is the respiratory department of Tangdu Hospital of the Fourth Military Medical University of the People's Liberation Army of China, which is the first batch of master's degree-granting disciplines in China, the superiority of medical disciplines in Shaanxi Province, the National Drug Clinical Trial Institution, the Fourth Military Medical University of the grass-roots construction of the standard section, the Northwest Bronchoscopy Diagnostic and Treatment Training Center, Ventilator Training Base. Shaanxi Provincial Medical Association respiratory tuberculosis branch chairman unit and the whole army respiratory discipline vice chairman unit. Respiratory medicine *** two wards, with 80 beds, another allergic reaction disease research laboratory, pulmonary function blood gas room, bronchoscopy room, respiratory medicine intensive care strengthening ward and respiratory medicine laboratory. It is an advanced unit with the best technology and equipment in respiratory medicine in Shaanxi Province and Northwest China. The teachers here are highly ethical, knowledgeable and approachable, not only the level of diagnosis and treatment is among the best in China, but also attaches great importance to the training of the younger generation, maintains a strong talent echelon, the peach and plum all over the world.
? They are the director of the department weekly room check 1 time, three line weekly room check 2 times. The checkups feel like a harmonious atmosphere, seeking facts, emphasizing evidence-based medicine, and many principle issues have reached **** knowledge, but allow differences that do not violate the principle. Tang Du Hospital has always emphasized comprehensive treatment, the whole department from time to time to organize a joint examination room with the participation of diagnostic radiology, pathology, surgery, internal medicine, radiotherapy and other multidisciplinary departments. During the checkup, the first-line or advanced doctors will report the history of the disease; the superior doctors will carefully read the films, analyze the possible diagnosis, further examination and treatment plan. In this way, patients can be treated rationally in a systematic and planned way, and at the same time, young doctors can learn a lot of related knowledge. Reasonable and comprehensive treatment is one of the important factors for the high level of diagnosis and treatment in Tang Du Hospital.
? To develop the department, it is necessary to emphasize re-education, re-learning and the cultivation of reserve talents. I participate in academic activities mainly include: 2 times a week theoretical learning, new advances in treatment; 1 time a week intra-departmental academic discussion; irregular external academic exchanges, including lectures by famous experts at home and abroad, and domestic and international academic conferences. Long-term high-intensity, self-conscious learning and exchange is also an important factor in their longevity.
? I also have a small gain. First of all, the systematic study of the relevant basic knowledge, the latest diagnostic and treatment technology, a comprehensive mastery of respiratory and related departments of the diagnosis and treatment of common and frequent diseases, proficiency in respiratory routine operations, such as closed drainage of the pleural cavity, pleural biopsy, trans-ultrasound, ct-guided percutaneous lung penetration, basic mastery of the operation of bronchoscopy, thoracoscopy and other operational essentials.
? Once again, the collaboration of personnel from various disciplines is a guarantee to improve the level of diagnosis and treatment. Each department has technical expertise, each doctor also has technical expertise, in order to make the department's diagnosis and treatment level is guaranteed. It is not enough to have good clinicians, but there must be advanced equipment and perfect auxiliary examination in order to design an ideal treatment program. At the same time, the collaboration between various departments in the hospital is also very important, such as surgery department, pathology department, diagnosis department, etc.. The comprehensive strength of the outstanding, in order to have a high level of diagnosis and treatment.
? I was also impressed by the advanced equipment and technology. In our primary hospitals, there are many problems that we are plagued with, and with advanced medical equipment and technology, we will be able to solve them and make them clear. Nonetheless, conventional treatment is still the most commonly used means of treatment. I feel that, relying on our hospital's current technology and equipment, as long as we can standardize and rationalize the use of conventional technology, and carry out new business and new technology within our capacity, we can also make most of the patients to obtain satisfactory results.
? Further training experience and recommendations:
?1, the department to develop, the hospital to be strong, invincible in the competitive health care market, we must take the road of specialized construction, the disciplines are complete, science in the development of academic specialization, the more the disciplines are more and more detailed, it is necessary to strengthen the cultivation of talents in various disciplines, we must pay attention to the re-education, re-learning, and the training of the reserve personnel.
?2, the development of the hospital, it is necessary to strengthen the internal medicine subspecialties, surgical subspecialties, pediatrics, obstetrics and gynecology, radiology, ct, ultrasound, electrocardiography, pulmonary function room and other departments of the cooperation between the rooms, it is not enough to have good clinicians, there must be advanced equipment and perfect auxiliary examination, in order to design the ideal treatment program. In order to have a high level of diagnosis and treatment, so that more patients benefit, better improve the social and economic benefits of the hospital, and improve the hospital's visibility.
?3, it is recommended that the establishment of specialized respiratory medicine, the establishment of a strong thoracic surgery, the current epidemiology shows that respiratory diseases (excluding lung cancer) in the city of the cause of death in the 4th place, in the countryside accounted for the 3rd place, lung cancer, whether the incidence rate (1.2 million years) or the mortality rate (1.1 million years) ranked first in the world of cancer in our country lung cancer has exceeded the cause of death of 20% of cancer, according to the disease spectrum and the current situation of our hospital. According to the disease spectrum and the current situation of our hospital, in order to fight for this part of the patients and create better social and economic benefits for the hospital, it is recommended to purchase advanced equipment such as bronchoscopy and thoracoscopy as soon as possible and accelerate the training of personnel in this area to carry out new business and new technology, the thoracic surgery department and respiratory surgery department can not survive without bronchoscopy, not to mention the development. Increase and strictly grasp the use of ventilator-assisted respiratory treatment of critical patients with the indications, can save the lives of most respiratory patients, prolong life and improve the quality of life. It is recommended that critical patients (especially respiratory patients) routinely check the arterial blood gas analysis, which can be a better prognosis of the patient's condition to have a better judgment, but also improve the use of equipment. For the time being, new business such as pleural biopsy and percutaneous lung puncture can be carried out, and comprehensive treatment such as thoracic perfusion therapy for tumors can be carried out. Ventilator therapy can be carried out.
?4, it is recommended that the hospital set up a comprehensive emergency center, the establishment of emergency room, combined with the abolition of the infusion room, which is also conducive to the management of patients in the room and get better treatment, in line with the hospitalization conditions of the proposed patients should be admitted to hospitalization, and at the same time, also to the hospital to create a better economic income. All departments of the hospital medical staff rotation, emergency department doctors are not fixed, so that the emergency department doctors also learn to specialize in learning and use, so that the whole hospital medical staff to get the overall development of the hospital doctors to get emergency training, master emergency knowledge and technology.
? The above is a little bit of my hospital suggestions, if not, I hope that the leaders understand, because I am a Chinese hospital people, hospital Xing I honor, I love the hospital.
? Hospital doctor training personal summary
? In xxx orthopedic further study of a year, a year of time, not rich but very fulfilling, personal experience and empathy, really benefited greatly.
? Looking back at xxx orthopaedic one year of further study, there is a careful questioning of the history of the time, there is a serious check-up time, there is a quiet listening to the time, there is not busy with the patient to add the time of examination, there is an honest day to stand on the operating table, there is a review of books and literature and so on a scene in my mind when I write a review of the summary of the presentation in my mind. Although some of the work is already familiar, but every day and Dr. XX's clinical practice, such as room visits, medical history, physical examination and other basic things can rediscover their own shortcomings. From the point of view of the standardization of the difference is very far, so this year is not in vain, from the most basic learning, not only to learn their profound spinal joints set, but also from the clinician's point of view to regulate their own behavior.
? As a national center for diagnosis and treatment of difficult-to-treat diseases, XX often encounters many rare diseases in the field of orthopedics. When they come across a disease they have not seen before, they will consult a lot of literature and organize the whole department to study the literature and discuss the treatment plan. Although medicine is an empirical science and it is important to accumulate experience, it is even more important to respect evidence-based medicine. They will keep all the data of the cases they have treated intact, so that they can summarize the treatment experience.
? Clarify the concept of the managing doctor. In fact, the concept of the bedside doctor is the best interpretation of the clinician. Bedside doctors on the first line of hospitalization, to do their own bedside patients in charge of writing medical records and other paperwork, to complete the relevant examination and pre-operative, post-operative consultation, dealing with patients with common perioperative complications, there is a problem with timely reporting to the higher level of medical. Therefore, it is common for residents to stay behind and work overtime, because their things are tedious and heavy workload, and they will not leave today's things for tomorrow. Only when you manage your bed well every day, you are a clinician in the true sense of the word. Doing a good job as a resident can lay a solid foundation for your future career.
? It is difficult to be a technically excellent doctor, and even more difficult to be a virtuoso doctor. Orthopedic surgeons treat diseases mainly by means of surgery, so the improvement of surgical technology and surgical ability will be very important, but a good doctor not only has to have the basic level of professional and technical skills, but also need to have a sincere and responsible for the patient's heart. Although these axioms can be understood, but how many doctors can really do it? At least I have contacted xx orthopedic professor did. Therefore, I feel that the environment is very important. Discipline leader is important, a good leader can bring out a piece of excellent people.
? Although the one-year training is short, but xx rigorous and refined spirit of study and hard work style will let me be used for a lifetime.
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