医学生日记2016年5月25日 --- 开始妇产科见习

医学生日记2016年5月25日 --- 开始妇产科见习

阿山 （庞静译）

12周的手术见习终于结束了，草坪也变得更绿了。妇产科见习开始了。入门介绍之后，我上了第一个夜班。以后的12个星期，我每天工作的最长时间都不会超过12小时，那些没经历过手术见习的同学都觉得很长，但对于我们手术见习后的同学，这听上去就像天堂。

入门介绍就是常规性地介绍规章制度和对我们的要求。还有两个学生带来两个箱子，箱子里装的都是练习缝合的东西。我们同学让他们带来还的。见习主任看了一眼箱子里的东西，转向我们，用一种很平静但又失望的语气说：“我很恨那些不按规定做事的人，给其他人弄出更多的活。” 前两个在妇产科见习的学生把针放在箱子里，针头没盖上（任何人打开箱子都可能被扎到），箱子里的练习线上到处打着结（任何人要去解开这些结就知道多烦了），他们还箱子的时间晚了，而且场合也不对。见习主任问带箱子来的同学谁让他们带来的。很明显，她很不高兴。俩个同学很为难，他们想保护他们的朋友，嘴里胡乱答着一些没用的话。见习主任打断他们说：“打住！你们没问题。我并不是跟你们生气。我是生他们的气。告诉我他们的名字，我们好继续。” 名字说出来之后，我们见她拿出学生名单，在那两人名字旁边写了几句。之前她说过她总是带着名单，随时做记录，写见习评语时放进去。

入门介绍另一件值得一提的是教学助理又来了。我们课堂上学胸检和腹部检查时他们来过。这次还是同一批人。他们受过特殊培训，专门教学生如何进行胸检和腹部检查。我们对他们进行检查，他们一步一步教我们怎么做，帮助我们找到子宫颈，子宮，和卵巢。在检查过程中，他们还教我们怎么说，怎么站，怎么动，用多少力，患者感觉如何。我总是觉得这些人很伟大，一般人很难想象人们为了培养一个医生所付出的长时间的努力。

我这星期都是夜班，第一次是星期二夜里。我下午5:30到达，从白班学生那里拿到报告。三个学生上白班。他们每人看了一个病人，全天只有一个孕妇生产。总之，一天很无聊。夜班情形全变了。我和另一个同学上夜班。我们每人都看了三个病人，三个孕妇生产。我同学参加了第一个，还帮着取出胎盘。我遇到第二个孕妇，最后一分钟她要求产房里不能有男性，我错过了这次机会。我同学在她生的过程中接着婴儿。第三个生产的孕妇要求学生不能在场。第一天值班不能看到生产的过程，我有点失望。但是住院医告诉我甭担心，这是极少见的情况。大多数到校医院来的病人都知道这是教学医院，有很多学生参加他们的治疗。当夜所有事平息之后，住院医让我们凌晨三点就回家了，把值班时间缩短了三个小时，让我们多睡了一点觉。

我白天大部分时间都在睡觉。下午有课，我们告诉白班的同学我们夜班的所见所闻。他们很嫉妒，因为他们第二天白班还是很无聊。

刚开头，我觉得我在妇产科很有趣。

Wednesday May 25 – Starting Ob/Gyn

Finally, 12 weeks of surgery is over and already the grass is greener on the other side. We had our orientation day to ObGyn and I took my first night shift. For the next 12 weeks, my longest work day will not be longer than 12 hours, which to students who have not rotated through surgery, sounds really long, but for us surgery veterans, sounds like heaven.

The introduction day was mostly routine reviewing expectations and policies. Of minor note, two students brought in two boxes that contained suture practice kits that our classmates had told them to return for them. The rotation director took one look at the kits, turned her head to the group of us, and said in a very calm and frustrated tone: “I hate when people can’t follow instructions and create more work for other people”. The two previous ObGyn students had left sharp needles unsecured in the box (so anybody opening it could be stabbed), left the practice rope tied up in knots (anybody trying to undo tangled rope will understand that frustration), and had returned the kits late and to the wrong location. Our rotation director stared down the two students who had brought the kits in and asked who were the students that had given them the two kits. It was very obvious that she was extremely displeased with them. The two students very awkwardly sputtered some nonsense jumble, desperately attempting to protect the identity of the two offenders. The director cut them off with: “Stop, you are not in trouble. I am not unhappy with you. I am unhappy with them. Now tell me their names so we can move on”. After the names came out, we watched her pull out her student roster and write comments next to both students. Earlier she had just explained to us that she keeps a roster with her to constantly write comments that she will include in each student’s final evaluation.

Otherwise noteworthy on orientation day, we had the gynecologic teaching assistants come in again. They had come in once previously for our class to teach us the breast and pelvic exams. This time was the same. They were all trained to teach students how to conduct breast and pelvic exams. We performed the exams on them, with them walking us through the process of learning specific maneuvers that helped us find the cervix, uterus, and ovaries. As we were doing all this, they were teaching us what to say, how to stand and move, and how much pressure to use to help make the patient comfortable. I always think these people are very remarkable and it’s odd to think about the lengths people need to go to train new doctors.

I start with one week of night shift, and my first shift was Tuesday. I came in at 5:00 pm and got the update from the day shift students. There were 3 students on the day shift. They each got to see 1 triage patient, and there was only 1 birth the entire day. So in summary, it was an exquisitely boring day. That quickly changed for the night shift. I was on with one other student. Throughout the night, we each saw 3 triage patients. There were 3 births over the night. The first one, the other student got to participate in and delivered the placenta. I had met with the second mother, but she requested last minute that there be no males in her room, so I missed that opportunity. The other student got to catch the baby as she was pushed out. The third patient requested no medical students. I was a bit disappointed at not being able to see a birth during my first shift, but the residents reassured me that this was the minority of cases. Most patients coming to University Hospital know that it is a teaching hospital and that there will be students participating in their care. After everything had calmed down for the night, the resident team even sent us home at 3:00 am, cutting our shift short by 3 hours so we could get some extra sleep.

I spent most of the day sleeping. This afternoon, we had a lecture and we got to tell the day shift students what we saw overnight. They were all so jealous because it was the second day in a row where things were slow.

With this start, I think I’m going to enjoy ObGyn quite a bit.