Li Yi, a student at Capital Medical University, just celebrated his 24th birthday.
As we approached, we could clearly perceive the tiredness that the young man could not hide. After a brief greeting, he immediately felt a little more shy.
"Recently, it has been snowing in Beijing, and the number of patients with fractures caused by slipping and falling has suddenly increased, and the workload has become more." Li Yi finally squeezed out a smile.
Like most medical students, Li Yi is about to enter the stage of regular training. In the future, he will need to complete the rotation of various surgical departments of a large third-class hospital in Beijing within 33 months.
At this stage, Li Yi can only receive a monthly subsidy of 2400 yuan, which is jointly distributed by the school and the internship hospital.
Due to the large number of surgeries and patients he received by his superior doctors, his internship career was not easy.
After talking for more than half an hour, Li Yi was urgently recalled to the operating room. His task was to assist the superior physician in the work of an assistant for a minor procedure.
Hurriedly left, taking only one sip of coffee without taking care to take it away.
Spring Festival when you can't return home
The workload of these interns depends entirely on their department and the doctors at their higher level.
Some unpopular departments, such as internal medicine and dermatology, are still idle. However, Li Yi's orthopedic department is regarded as a "hot" department in their eyes, and the work is naturally more arduous, and sometimes saturdays and Sundays are temporarily called to deal with emergency departments.
The working hours are not fixed, generally starting from 8 o'clock in the morning, ending the work at the earliest to 6 or 7 o'clock in the evening, and working overtime until two o'clock at night is also a common thing.
However, when talking about the Spring Festival that just passed, this reluctant smile was also fleeting.
Due to the pandemic, intern doctors need to go through three levels of approval to return home, schools, department heads and hospitals.
Two days ago, Li Yi's hospital clearly informed that all intern doctors were not allowed to go home.
"In fact, the school's approval is not strict, but because it is a high-risk group, the main reason is that the department director will not approve us to go home." Li Yi said.
Fortunately, Li Yi was born in Beijing, and his parents both worked in Beijing. But other intern doctors are not so lucky, not only can not be reunited with their families during the Spring Festival, but also stay in the hospital to continue to work.
No regrets about the choice
Becoming a surgeon is a dream that Li Yi has had since he was in school, and he has already locked his first choice in "medical school" before the college entrance examination.
However, after getting a 650-point report card, Li Yi had to change the Peking University School of Medicine to Capital Medical University.
"It's just pure interest, and surgeons need craftsmanship." This is Li Yi's interpretation of his dreams.
Source: Figureworm Creative
Many of my classmates had already started working, and those who had been admitted to finance had even obtained a decent and high-paying job.
But Li Yi still needs to complete three years of graduate school before he can complete the full qualification after graduation.
If you want to work in a tertiary hospital in the future, you will have to study for another 3 years of doctorate.
This means that Li Yi will take another 6 years to become a "formal" doctor. At present, he can only appear in the operating room as a "medical assistant" in some minor surgeries at most.
It's a long process, and it's only 29 years old to officially enter the establishment, which may have long been opened by peers.
"I occasionally thought about giving up, but at this point, I still need to stick with it." Li Yi said, "I have never regretted choosing the profession of doctor."
"Cooper" is the only plan
In the internship hospital, he is more to grasp the specific situation of the patients in the ward at all times, and according to the condition, he connects with the doctors of various departments, and at the same time has to deal with a lot of paperwork.
Although the ability is basically competent, Li Yi still does not have the right to independently diagnose and perform surgery, and all patients need to be reported and the treatment plan is decided by the superior doctor.
For the future, Li Yi has no plans. However, he clearly knows what a grim employment situation will be in 6 years' time.
During the Spring Festival, the latest batch of proposed staff of the First Hospital of Hebei Medical University was announced, all of which were doctoral degrees. Among the 15 people to be hired, in addition to 4 from the university, followed by 3 from Peking University Health Department, 2 from Oita University in Japan, 2 from Capital Medical University, and 1 each from Peking Union Medical College, Beijing University of Traditional Chinese Medicine, Shandong University and Sichuan University.
There are 7 people from "double first-class" universities and 2 returnees, especially from Peking Union Medical College and Peking University Medical College. In the 2020 Fudan edition of the China Hospital Rankings, no hospital in Hebei is on the list, and in the North China rankings, the Second Hospital of Hebei Medical University is on the list, ranking 12th, and it is also the only hospital in Hebei to be listed. The First Hospital of Hebei Medical University was not on the list.
"I still want to stay in a top three hospital, but the requirements of such hospitals are too high." A Ph.D. is only the foundation, and it is best to have published an authoritative paper. Now the requirements of second-class hospitals are also very high, and many also emphasize that they must be doctoral degrees." Li Yi said helplessly, "It is estimated that the future job will be difficult to find, there are too many doctors!"
"I can only continue to study, first get admitted to the doctorate." This is his clearest planning path at the moment.
For the choice of departments, the group of intern doctors has long been divided into "three, six, nine and so on" in their hearts.
Orthopedics and general surgery are the first choice of popular departments for clinical interns, but they are also the most competitive. The second is the department with easy work, few doctor-patient disputes, and high patient satisfaction, such as dermatology and plastic surgery.
However, due to the more detailed division of disciplines in the medical field, even if it is a relaxed and popular department, it is difficult to enter if the major is not right.
A name that no one knows
In January 2022, Li Yi posted a photo of his circle of friends with his name on a pennant he was holding.
Despite being ranked last, he still smiled brightly.
"The patient who sent the pennant is also a young man in his 20s, and maybe everyone can talk about it." Li Yi immediately explained, "The pennants are given to the superior doctors, and usually there is no name on them, because the patients don't know who I am."
These forgotten interns in the corner actually pay the same amount of work as their superiors, but patients almost "never" volunteer to ask their names.
Loss and lack of fulfillment can accompany most interns for five or six years.
"There is no pride, but it is easier to be hit, and sometimes the mood is very low." 」 This is Li Yi's evaluation of his internship stage.
Especially in the doctor-patient relationship, intern doctors have always been a vulnerable group.
Being young is one of the reasons why it is most easily targeted by patients.
"During the internship process, you will be wronged a lot. I know I'm doing my best, but sometimes I'm still not understood." Li Yi said.
Due to the epidemic, many patients' families cannot be accompanied by hospitals, which leads to patients needing to communicate with the hospital in the whole process of treatment, and some family members do not even know that the patient has completed the operation.
This kind of information asymmetry in special periods will greatly increase the probability of disputes.
Interns need to linger between patients and their families, between superior doctors and doctors in various departments, in such a situation, and the taste may be difficult for outsiders to empathize with.
In addition, even if you are involved in the surgical process, there is no way to grasp the patient's recovery, and it is impossible to know how the patient recovers.
Unable to get a sense of accomplishment from work, but also constantly repeating boring ward paperwork, it seems too harsh for young people like Li Yi.
Take it one step at a time
However, during the internship process, it is true that you can gain experience that you cannot get in school.
"In the actual clinic, it is completely different from in the school. The former pays more attention to detail, and the book will tell you what disease and what medicine, but will not tell you how to use it. The book will also introduce the steps of surgery, but the grasp of the details is completely inaccessible from books." Li Yi said.
However, this is not enough for the intern doctors to complete the transition from campus to society.
"When I was in school, I had an infinite reverie about the profession of doctor. But after you actually get into the industry, a lot of unexpected things happen." Li Yi paused for three seconds, "Now there is no illusion at all."
Before the internship, the young man imagined income, doctor-patient relationship, and social status as a beautiful picture.
Nowadays, engaging in scientific research, dealing with complex doctor-patient relationships, and heavy paperwork have diluted the original intention of only wanting to do surgery and treat patients.
"The future can only be seen one step at a time." This is Li Yi's truest thought at the moment.
Li Yi's classmates are also in such a tangle. Back in the school dormitory, the roommates discussed their recent expertise. They will also complain to each other about the puzzling processes and interpersonal relationships in their respective internship hospitals.
For the future, I don't know when they will start to be confused.
According to Li Yi, at present, in the Capital Medical University, most of the students are from Beijing, but most of those who are not from Beijing may choose to return to their hometowns for employment after graduation.
The high cost of living, no relatives, and no relationship make them feel too much pressure, and they may be more competitive when they go home for employment.
"The first choice in the future is of course orthopedics, and it is also acceptable to change departments. No, leave Beijing and go to another city." Li Yi said, "PhDs from all over the country come to Beijing, the competition is too fierce!"
The inner volume has invaded the intern group, who will also struggle for many years in dreams and reality, stay and leave.
(Li Yi is a pseudonym in the text)
Sources | the health community
Written by | Old Zhao next door