Resident: Resident. It is a particularly well-translated word, as the name suggests, it is often because when you first become a doctor, you need to stay in the hospital often, and over time, it is like "living in the hospital", so Chinese translate "resident".
The rank of Chinese doctor currently has a resident doctor - attending doctor - deputy chief doctor - chief doctor, in fact, when the attending doctor needs to choose their own profession, become a doctor with a special direction. In the United States, doctors only have resident doctors - specialist training - to become the relevant professional certified attending physicians, the so-called chief deputy director is an administrative appointment given in administrative matters.
After entering medical school, American medical students need to complete the following "monster upgrade" process. The world's medical students are miserable.
1. Complete the USMLE STEP1 and STPE2 exams in school,
2. Apply for and match the residency program.
3. Graduated from medical school.
4. Start the residency training program and obtain a license.
5. Obtain your own professional certification.
Although at first glance it looks similar to that of China, the results of the UNITED States' match list can be described as more nervous than the "college entrance examination". Across the ocean, residents and specialists are screened entirely for entry into the National Resident Matching System (NRMP). The system's algorithm provides the most appropriate match between the hospital and the applicant, and the inventor even won the 2012 Nobel Prize in Economics. Every year in March, the medical students who put out MATCH should celebrate with the whole family.
The number of residents each year is determined by government funding, most of which comes from the Government's Medicare, which is about $9.5 billion per year. Since 1980, the number of applicants has been significantly greater than the number of residents recruited in the United States every year. In the past 2021, despite the COVID-19 pandemic, the number of people participating in the application for a resident doctor MATCH in the United States has risen to an all-time high of 48,700. 92.8% of U.S. student candidates matched to the program (down 0.5% from 2020). 54.8% of international student candidates were matched to the program (down 6.3% from 2020).
Let's take a look at what the famous Mayo Clinic Residency Program looks like.
In surgery, for example, Mayo's residency training subjects are:
Oral and maxillofacial surgery, plastic surgery, general surgery, basic surgery, thoracic surgery, vascular surgery, neurosurgery, orthopedic surgery, otolaryngology.
The following specialist training subjects in surgery are:
Abdominal Organ Transplant Surgery, Cardiovascular Surgery, Colorectal Surgery, Endocrinology, General Thoracic Surgery, Minimally Invasive Surgical Surgery, Minimally Invasive Gynecological Surgery Surgery, Hepatobiliary and Pancreatic Surgery, Extracorporeal Circulation and Heart Transplantation, Breast Surgery, Peripheral Neurosurgery, Vascular Surgery, Surgical Intensive Care, Urology And Resuscitation, Neuroradiology, Adult Reconstructive Surgery, Adult Reconstructive Surgery (Lower Extremity), Adult Reconstructive Surgery (Upper Extremity), Hand Surgery, Skeletal And Musculoskeletal System Tumor Surgery, Sports Surgery, Spine Surgery , advanced head and neck microvascular and reconstructive surgery.
For example, for general surgery residents, a five-year training cycle requires the following workload:
1. Complete more than 750 major surgeries, of which the total stage of hospitalization in the last year shall not be less than 150 cases
2. Master various endoscopic techniques
3. Grasp the latest treatment progress of various diseases in general surgery
In addition to the total surgical volume requirement, the minimum surgical volume of each specialty also has the following minimum requirements:
In addition to the above workload evaluation, resident doctors also need to evaluate from the following dimensions:
360° assessment
Six areas of competence: clinical ability, medical knowledge, professionalism, the ability to work in different medical systems and doctor-patient environments, learning and improving ability in clinical learning, and interpersonal communication skills
Unified electronic assessment
Example: Interpersonal communication skills are also graded to facilitate assessment by a doctor. Specifically, it is divided into the following five levels:
Non-conforming
Level I: Various methods are used to ensure a clear and effective communication of the underlying condition with the patient and his or her family.
Level II: Ability to communicate according to the characteristics of the patient (such as religious culture) and to provide the patient with the latest medical conditions at any time.
Level III: Ability to effectively inform patients and families of sensitive and bad news.
Level IV: Ability to process difficult information with patients according to the situation (such as informing terminal information), can help resolve conflicts between patients and families, etc.
Let's take a look at the salaries of Mayo residencies, using the 2015 salary scale as an example:
First year of residency, 52483 knives / year
Residency in the third year, 56842 knives / year
Fifth year of residency, 61775 knives / year
Of course, don't just look at the superficial salary, after all, most American medical students rely on loans to pay tuition, so almost half of the salary has to be repaid, and on average, all loans can be repaid in the 2-3rd year of residency.
Eventually, after obtaining a medical license, 20% of doctors will become academic doctors: that is, stay in the university hospital, carry out medical + scientific research and teaching management. 80% become private practitioners: private hospitals, doctor groups, private clinics are available.
Source | Jing view
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