The Returning Doctor Wanted to Live Quietly - Chapter 347



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Episode 347. Specialist 2nd Exam (2)

If we only consider skill, then new technologies can never be introduced.

It was a sharp rebuttal that could hardly be dismissed as an emotional response.

Since surgical experience must be gained first in order to gain proficiency, it can be said to be a chicken-or-the-egg question.

furthermore.

‘If you answer that we should take a conservative approach, I’ll give you an example from a hospital you know.’

There was even additional logic that the opponent could refute.

Regularization of the first-hand experience.

After starting in CS, it spread throughout the surgical field.

He himself was given more opportunities to perform surgeries than any other hospital.

so.

‘It’s not easy.’

I thought Lee Ji-hoon’s response was sharper than expected.

When Jinhyeok didn’t answer right away, Lee Jihoon, who was quick-tempered, struck first.

“Just take the regularization of the primary care clinics that are currently being operated at hospitals you know.”

The professors all turned their heads.

Lee Ji-hoon’s attacks continued.

“It’s different from the first surgery held at other hospitals. Other hospitals? The residents perform the surgery while the professors watch.”

“… … .”

“Well, they give you a scalpel with your name engraved on it as a gift, and they throw a party where they invite the family. It’s just a kind of ceremony.”

“Hmm.”

“But what about the hospital you know? They are continuously giving opportunities to residents by saying that they are regularizing the first-hand experience.”

“So, are you taking a risk after all?”

“Yes, a kind of teaching aid. No, calling it a teaching aid would be insulting to the patient. I would call it a kind of risk-taking.”

Lee Ji-hoon swallowed hard and looked around to see the reactions of those around him.

I had to say that it was ridiculous for Lee Jin-hyeok, who had more opportunities to lead a household than anyone else, to say something like that.

He was using a generalizing style, leaving out any remarks that could be considered personal attacks.

Lee Ji-hoon continued speaking.

“Just like the case of the hospital I just mentioned, if you don’t take risks, your juniors won’t be able to grow. How can you gain experience if you don’t have the opportunity to perform surgery?”

“In the end, the same goes for introducing new technologies.”

“Yes, I think it’s important to take risks.”

The interviewers began to nod their heads at Lee Ji-hoon’s answer.

As the mood completely changed, Jinhyuk stepped forward.

“Professor Lee Ji-hoon’s argument makes sense. There is no hospital that is as open to residents as Asin Hospital.”

Although it was directed at the interviewer, Lee Ji-hoon struck back again.

“It’s strange that you admit it so easily. Earlier, you said that you have to consider everything from the patient’s condition to the surgeon’s skill level and even the surgical environment.”

“That thought remains unchanged.”

“No change? Just now… … .”

“There is a little difference.”

“What on earth are you talking about… … .”

Jinhyuk didn’t answer right away and turned his head away.

Of course, the target is the interviewer.

There were people watching the discussion with shining eyes.

“The presence or absence of a skilled doctor is the decisive difference.”

“Do skilled doctors exist?”

“Yes, there are no skilled doctors for sentinel lymph node dissection yet. However, it is routinely performed. It is all performed under the supervision of skilled professors.”

“It means that they are giving the residents a chance to take charge of the house, not just leaving it to them.”

“Yes. That’s… … .”

The professors who were there discussed thoroughly in advance and immediately intervened in situations that could become problematic.

Let’s say that high-difficulty surgeries are entrusted to surgeons who have accumulated a certain amount of experience.

Lee Ji-hoon refuted.

“After all, there has to be an experienced professor in the operating room… …. Then, doesn’t that mean new technologies can never be introduced?”

“No, that’s not it.”

“… … ?”

“Why don’t you come and study in America?”

“What nonsense are you talking about… … .”

“Why doesn’t that make sense?”

“Isn’t it common to come back and apply what you’ve presented at an academic conference? You learn in the US and come back to gain a certain level of experience. Realistically, that’s difficult.”

Lee Ji-hoon’s rebuttal.

Jinhyuk smiled faintly.

“Well, I understand that Samseon Hospital also has a dispatch system.”

“… … !”

“Didn’t you sign an agreement with UCLA and operate a dispatch system?”

“That, that is… … .”

“Oh, it’s not just UCLA. I understand that they send 20 students a year to hospitals with which they have an agreement. And it’s not just residents. Aren’t there more professors who go on overseas training?”

Lee Ji-hoon’s face turned red at Jin-hyeok’s answer.

* * *

Overseas training for specialists.

It was a kind of exchange student concept.

The process of selecting and dispatching excellent individuals for the purpose of acquiring advanced overseas medical technology.

Seoundae for one month.

Samseon Hospital for 3 months.

The hospitals that Asin knew were flexible depending on the target.

Of course, the intention was clear.

See, learn, and come back to use it.

It was not a simple investment, as it even provided support for living expenses of tens of millions of won.

“Professors who are qualified for the USMLE (United States Medical Licensing Examination). Many of them come and go during their sabbatical year.”

“that…….”

“Oh, I saw it in an academic journal a while ago. Professor Choi Hak-cheol of the Department of Surgery at Samseon Hospital. I heard you went to Johns Hopkins this time. Why did you go?”

“… … !”

“Professor Park Jeong-tae from Seo-undae went to Switzerland. Three people from Catholic went to Singapore this time.”

When Jinhyeok mentioned the movements of the surgery professors and drove the wedge in, Lee Jihoon immediately turned his head.

‘What the heck. What kind of surgeon is this, so interested in other hospitals!’

A trend that even he himself is unaware of.

There was nothing more to say.

Of course, Jinhyeok was keeping a close eye on when a strike would occur due to reinforcements.

* * *

A discussion that began with a review of surgical records.

It was nothing short of a complete victory for Jinhyuk.

After learning it firsthand and returning, I refine my skills while performing surgery and pass them on to my juniors.

There was no such thing as a classic route.

So right now.

“Okay, let’s move on to the next question.”

Needless to say, Lee Ji-hoon’s face turned even redder when he heard these words.

The reviews continued like that.

Everyone had to sweat profusely.

Because in the end, surgery is about there being no right answer.

There is no question more difficult than the question of why you could have approached something differently and not done so.

Soon it was Jinhyeok’s turn.

As if asking when she was ever pretty.

Sharp questions poured in.

“I had a right-sided colon resection. Do you think I should have a bowel cleansing procedure? Or should I skip it? I skipped it for that procedure. Why?”

“There may be a risk of SSI (Surgical site infection), but we skipped it considering the patient’s condition.”

“You skipped it even though you knew about it? It could cause complications due to intestinal bacterial infection.”

“Yes, there may be a leak at the anastomosis site, and there may be an abscess or peritonitis within the abdominal cavity.”

As Jinhyuk listed the complications of the first strike, another attack came.

“Yes. That’s what I’m saying. Isn’t it safe to do MBP (mechanical bowel cleansing)?”

“MBP eliminates bacteria and, since there is no feces, it is easy to manipulate. The risk of feces leaking into the abdominal cavity is also completely eliminated.”

“The answer keeps going around in circles. If you know so well, why didn’t you do MBP for this case?”

When Jinhyeok saw Lee Jihoon watching the conversation and feeling like he was thinking about how to attack, he smiled faintly.

Problems with bowel cleansing before surgery.

It’s been a controversial issue for decades, and it’s one that hasn’t been resolved yet.

Because both sides had a point.

So, it would be right to assume that both the professor asking the question and the person answering the question knew everything.

Jinhyuk answered.

“When comparing MBP (bowel cleansing) and non-MBP (no bowel cleansing), the complication rates were 7.9% and 6.8%, respectively, and there was no significant difference.”

“They say that MBP (bowel cleansing) actually increases the risk of complications. In other papers, the results are often lower.”

“Yes, there are many research results showing that non-MBP is high. In fact, I think this is a question without a correct answer.”

“There is no correct answer?”

“Yes, there are so many factors that affect the outcome, including the presence or absence of underlying diseases, surgical method, and even the method of anastomosis.”

A quick question and answer session.

The Q&A continued in a way that did not even give Lee Ji-hoon a chance to intervene.

It’s to the point where you just blurt out a question and get an answer right away.

Needless to say, the interviewer’s expression became even more relaxed.

Someone asked.

“Why is that so?”

“Because colon cleansing can actually cause local changes.”

“Making a difference?”

“Yes, the patient’s vitals. Even the slightest change can make a big difference. And… … .”

Jinhyuk’s answer continued for a long time.

dehydration.

sickness.

Electrolyte imbalance.

Abdominal discomfort.

Even bloating.

Let’s also mention the various symptoms that patients may experience when they have bowel cleansing before surgery.

I could feel Lee Ji-hoon’s lips tightly pursed.

In addition to that.

“There are patients who may die if they don’t have surgery right away. What should we do in these cases? Should we do a bowel cleansing?”

When I brought up the emergency patient and refuted the claim, the interviewers just snickered.

This was because it was confirmed that they were fully aware of the pros and cons of preoperative bowel cleansing, specific figures, and various controversies.

* * *

What followed was a surgical demonstration.

In fact, it was common to skip it.

A resident who has been rolling around for 4 years.

Since he had already performed simple surgeries, it was pointless to look at the surgical techniques.

So, this is one of the types of tests that will disappear in the future.

But surgeons are also doctors.

Their overflowing intellectual curiosity had to be satisfied.

When I demonstrated the vagotomy in an instant, everyone’s mouths dropped open.

I had heard about it through rumors and seen it at academic conferences, but this was my first time seeing it performed in person.

The experience of being treated like a dog in the pediatric surgery department was reflected in it.

* * *

The date of the announcement of the specialist exam results, which will be held in two weeks.

Everyone stood in front of the computer with nervous expressions.

The moment you fall, your luck is guaranteed.

Whether it was 2% or 5%, the moment the target became you, it was always on everyone else’s lips.

Jang Hyuk-jun right now.

“Eww!! It’s stuck! It’s stuck!!”

And cheered.

The other colleagues also started jumping for joy.

“Ugh, ugh, it’s stuck!!”

“Wow! It’s stuck!!”

“Me too! I got it too!!”

Those who love each other and hug each other.

They immediately approached Jinhyeok, who gave them his congratulations with an indifferent expression.

“Comrade Ramen! Oh, what are you doing without checking?”

“I’ll do it now.”

“Ah, a little. This isn’t the winner’s composure! Take a quick look.”

Even he himself was curious about the outcome.

The moment I entered my exam number, I was able to check the results right away.

A back smash came flying.

Because I proudly passed with top honors.

The moment Jinhyuk takes out his phone to tell his mother the good news.

Breaking news began to appear on the Naver X portal screen.

[In the 45th General Surgery Specialist Qualification Examination in 2002, Dr. Jinhyeok Lee of Asin Hospital was honored to pass with the highest score… … .]

[Lee Jin-hyeok! Passed the specialist exam with the highest score!]

Even though the top successful candidates are divided by department, they only report on themselves.

The back smashing of the motives that confirmed this became more intense.

Oh, are you sick?

I was happier than I was sick.

Because my mother will love it more than anyone else.

* * *

It’s already the last day of work at the pediatric surgery department.

Jinhyeok, who was preparing for surgery, hardened his face when he received a call from Oh Jiho.

“Yes? America? You want me to go to America for a bit?”

It was a call asking me to apply for a residency program overseas.