回复：To 天水18

This is only my personal experience:

I think most of Chinese medical graduates had some clinical experience before they started their residency in the States. However, the chinese medical graduates usually don’t have enough knowledge about issues like teen sex or pregnancy related problems, drug related problems, ethnic and legal topics, sexual transmitted diseases, social worker related issues, and over the counter medicines. For me, these issues were harder to deal with than regular diseases such as HTN and DM simply because we did not have enough education in chinese medical school. I don’t think there is any shortcut other than spending more time work on it.

Other than those issue, as a chinese medical graduate, what you are lacking is america hospital experience—the “routines”.

America medical students started their clinical rotations since second year. That’s why I said that they probably know those routines better than you do. My way of dealing with it is:

1) Don’t stop answering open questions just because you have an accent. They know you are foreigner they don’t expect you to speak perfect English (someone even told me that my accent is sexy.(^-^)), but they do expect you to know medicine. They don’t know you know it unless you let them know you know it.

I understand it may look like a battle sometimes because all america residents are very aggressive and competing with the answers. If you are slow in response, you might have to know the patient a little bit a head of time and prepare for the answer earlier. Usually it’s too late to answer a question already if you are not prepared because your American counterpart sure have down so. If someone speaks up ahead of you, you need think about what the next question it might be and try to give an answer quicker next time.

2) I can’t stress enough how important to get alone with nurses and the social workers because they have been there for years and know all the habits and specials for each attending. They are not going to come to you first because they don’t know you. They would love to see you getting into trouble if they think you don’t respect them.

On the other hand, they don’t ask much. Their work is usually underpaid and underappreciated. They are usually mistreated by many doctors in many occasions. If you treat them a little bit better, most of them are ready to give their hearts to you. You don’t have to be afraid to let them know that you don’t know everything. They know you are green and everybody like to show off sometimes even as a nurse. They don’t need much other than what they deserve, such as remember their names, a sincere eye to eye thanks for their help, spend some time talk about their families, send some thank you flowers when you finish a rotation and you may come back for another one in the future (I did it once and the response was phenomenal). They helped me so much and gave me all the little tricks to survive the first a few months.

3) Communicate better with your attending and senior residents if there is any problem.

Don’t shy away because your language problem. Sometime you need stand up for yourself so other will respect you. In the second week of my residency, I ordered a small test and didn’t know that I had to do it myself. The attending found it was not done next and yelled at the chief resident, the chief off course was not happy and gave me a hard time in frond of everybody. I was so sure that I couldn’t let it go just like that because I knew how to do it and I have done it several times in the past. I just didn’t know that I had to do it myself in an america hospital. I found the chief resident later that day and explained why it was not done. It was not because I did not know how to do it. It was because in the place I came from, I only had to write an order and the nurse would do it. We concluded that we need better communication in the future so I would get more familiar with the system and got the job done. The chief resident never gave me any hard time again.

4) Pick up only the right fight that you know you can win if you have to but you need to be careful not hurting your senior’s feeling.

5) Admit frankly if you did anything obviously wrong. You probably have heard the line popular among medical students and residents: “I’m sorry. I was wrong. It won’t happen again.” You need to be so ready to say it without even thinking sometime and say all three sentence together if you say it. It’s OK to let your senior feel that he or she is superior and fulfill his or her ego.

6) Read some newspaper about sports so you can talk with other people. Sport is the most common topic in America just like weather in England.

7) Help other residents if you can so they will return their favor.

8) Skillfully ask people around you if you need help. It’s better to look bad in frond of nurses or fellow classmates then look bad in frond of your senior or attending who might write your evaluation.

9) Ask smart questions to your chief or attending to let them know you know something and also let them show off a little bit.

I am going to stop here and got to go back to my work now.

所有跟帖： 

• Thanks 天水18 -pgy12005- ♀ (247 bytes) () 08/05/2005 postreply 15:18:57

• 回复：Thanks 天水18 -天水18- ♀ (469 bytes) () 08/06/2005 postreply 07:16:40

• nice try, but still a fake -doremifa- ♀ (4259 bytes) () 08/06/2005 postreply 18:55:11

• 回复：nice try, but still a fake -天水18- ♀ (154 bytes) () 08/06/2005 postreply 23:49:20

• a fake doesn't offer explainat -doremifa- ♀ (525 bytes) () 08/07/2005 postreply 08:03:52

• It is true they do have photos -ofchief- ♀ (58 bytes) () 08/07/2005 postreply 10:18:31

• 回复：回复：nice try, but still a fake -pgy12005- ♀ (538 bytes) () 08/07/2005 postreply 12:34:55

• a question for pgy12005 -doremifa- ♀ (507 bytes) () 08/07/2005 postreply 14:44:00

• 回复：a question for pgy12005 -天水18- ♀ (1316 bytes) () 08/08/2005 postreply 09:32:08

• 回复：a question for pgy12005 -pyg12005- ♀ (458 bytes) () 08/08/2005 postreply 16:06:48

• thank you for your direction -doremifa- ♀ (149 bytes) () 08/09/2005 postreply 17:53:45

• Have you checked out those -pictures?- ♀ (0 bytes) () 08/17/2005 postreply 15:00:49

• not yet, I am waiting for the -doremifa- ♀ (72 bytes) () 08/17/2005 postreply 17:22:37

• pgy12005 is IM resident, what -doremifa- ♀ (90 bytes) () 08/17/2005 postreply 17:40:46

• what's wrong with that? -pictures?- ♀ (0 bytes) () 08/17/2005 postreply 19:32:34

• it's none of your -business!1- ♀ (129 bytes) () 08/18/2005 postreply 12:35:37

• just answer questions, I hope -doremifa- ♀ (77 bytes) () 08/18/2005 postreply 18:11:53

• I know what is 分身术 -doremifa- ♀ (0 bytes) () 08/18/2005 postreply 18:26:18