USMLE超强干货集合丨美国住院医师真实Match十问

USMLE超强干货集合丨美...

      根据华人医生数据库不完全统计,在美行医的中国大陆医学毕业生有6千多人,这里也包括了一些正在做住院医的同胞。随着中美交流越来越多的大势之下,想要赴美行医的中国医生人数也在不断增加。

      通过美国医师执照考试(United States Medical Licensing Examination)是赴美从医的必经的途径,大多数中国考生通过努力也能拿到不错的成绩,最后的一关是申请住院医的过程,在match申请和面试很多技巧都是有迹可循的。例如住院医面试,每个人去面试的program都不尽相同,但是有些面试的问题和回答都是可相互参考的,下面我们邀请Dr Huang老师从自身的Match回答经验分享出来供大家参考,可收藏,也可转发给身边需要的朋友。

      Why Medicine?  

      为什么选择医学?

      There was once a time that our train was delayed, and before long we finally set off, we had an emergency broadcasting that a passenger needs help. As the only medical personnel around, I signed up and it was an old lady in her 70s, with history of diabetes, presented as lethargy, fainted with moderate dyspnea. She hadn’t eat anything in the last 8 hours, and she had 2 episodes of vomiting. With all the device at hand, I check her vitals, and did the physicals. As there was no further workup at that time, my best guess was electrolyte disturbance due to dehydration and vomits, but also cannot exclude a DKA. So I established a IV access and the patient was sent to hospital in the next stop.

      Actually, I do not have a dramatic story that direct me into medicine. You see, there are a string of experiences, small things just like this that makes my choice seems so nature. Also, the outstanding doctors that I’ve worked with; the patients that I learned so much from; and the simple joy learning the knowledge, the thinking process, differential diagnosis and so on. I just never feel tired and enjoy it, so why not turn my interest into my career. 

      有一次我跟朋友坐的火车晚点了,在出发之前,我们听到紧急广播说有乘客需要帮助,作为周围唯一的医务人员,我站出来了。患者是一位有糖尿病病史的70多岁的老太太,表现为嗜睡,因中度呼吸困难晕倒。她在过去的8个小时里什么都没吃,并且呕吐了2次。拿到所有需要的仪器后,我检查了她的生命体征,做了体检。由于当时没法进一步检查,我觉得最接近的判断是由于脱水和呕吐引起的电解质紊乱,但也不能排除DKA。所以我建立了静脉置管,然后病人在下一站被送到医院了。 

      其实把我带向医学的并不是什么戏剧化的故事。你看,在经历了一系列像这样的小事后,我的选择是自然而然的。当然也包括我一起共事过的优秀的医生,可以让我学到很多知识的患者等等;学习知识、思考的过程、鉴别诊断这些,对我来说都是简单的快乐。我感受到的从来都是享受而不是疲累,所以我觉得为什么不把我的兴趣变成我的事业呢。

      专有名词释义:Diabetes:糖尿病、Lethargy:嗜睡、Dyspnea:呼吸困难、electrolyte disturbance:电解质紊乱、DKA:Diabetic Ketoacidosis  糖尿病酮症酸中毒 、IV:Intravenous therapy 静脉治疗

      Computer skill for the medical system?   

      医疗系统的计算机水平

      Of course, I’m quite sophisticated with the basic software like words and PowerPoint. As I’m working as an USMLE instructor, so I’m expected to be able to present an interesting and organized PowerPoint every of my lessons. With the previous clinical experiences of US, I took the courses and am very handy at using the Epic system. I also working on statistical analysis software like SPSS, so I can take the advantage of the data base and make some progress on my research.

      当然没有问题,我对Words和PowerPoint这样的基本办公软件相当精通。由于我现在是一名USMLE讲师,所以我希望在我的每堂课上都能够展示一个有趣且而且条理清晰的课件。我之前有过在美国的临床经验,我有学习过相关课程并且现在非常擅长使用Epic系统。我还在继续研究像SPSS这样的统计分析软件,让我充分利用数据库的优势,可以在研究上取得一些进步。

      专有名词释义:Epic system:美国大部分医院或诊所使用的电子病历系统、SPSS:Statistical Package for the Social Sciences 社会科学统计软件包

      Tell me about USCE(United State Clinical Experience) 

      关于你的美国临床经验

      As I was a last-year student, I've got hands-on clinical experience, which is very precious opportunity for IMG, I was required to work as M4 students with same task and schedule, in both inpatient and outpatient care. Besides the basic skills and understanding to the system, I also learned how to communicate efficiently and responsibility or role in the medical team. After get familiar with the system, I started to ask for task and learn how to be an intern. The attendings and residents are very dedicated for medical student teaching. The faculty are supportive and are willing to give me more autonomy. For example, I was able to take over the newly-admitted patient from ER totally on my own.

      By the last of my rotation, I was capable of handling the work assigned to me. I even had the time and ability to supervise and oriented the M3 students. From that I can tell how much I have been matured and progressed in the last year. What I have learned will help me become a competent doctor in your program.

      在去年我还是学生的时候,我有过实践的临床经验,这对IMG来说是非常宝贵的机会,我跟M4的学生受到一样的待遇,在住院和门诊两个护理领域都有相同的任务和时间表。除了基本的技能和对系统的理解,我还学会了如何有效地沟通,以及在医疗团队中的责任或角色。在熟悉了这个医疗系统之后,我开始申请任务并学习如何成为一名实习生。医护人员和住院医师都非常专注于医学生的教学。教员们很支持我,愿意给我更多的自主权。例如,我完全可以自己从急诊室接手新入院的病人。

      到最后一次轮换时,我已经有能力处理分配给我的工作了。我甚至有时间和能力去监督和指导M3的学生。从中我可以看出我在过去的一年里有多少成熟和进步。我所学到的知识将帮助我成为你项目中一名称职的医生。

      专有名词释义:IMG:International Medical student 国际医学生、M3/M4: Third / Fourth-year medical student  美国3 / 4年级的医学生

      Any questions about this program?  

      对这个项目有什么疑问

      Every team has its culture. And I realize I tend to incorporate part of the culture or spirit from every previous educational experiences. So, how do you characterize the culture of this program, or what common feature is shared by the successful graduate from this program? What do you see the program in the next 5 years? I’m considering being a Chief resident in the fourth year as I think it will be a bright spot on resume and I am definitely interest in developing my leadership. What do you think is the most important quality for a chief?

      每个团队都有自己的文化。我发现我比较倾向于融入之前每一次教育经历中的一部分文化或精神。那么,你如何描述这个项目的文化,或者这个项目的成功毕业生有什么共同的特点?你认为未来5年的计划如何?我正在考虑在第四年成为一名首席住院医师,因为我认为这将是简历上的一个亮点,我绝对有兴趣培养我的领导力。你认为一个主管最重要的素质是什么?

      What if you got pregnant again when you were resident?  

      如果你在住院医期间怀孕了会怎么做?

      Every program is expected to be supportive if a resident gets pregnant. And it would be very inappropriate for any faculty to ask a question with the potential of sexual discrimination, like this one.

      每个项目都应该对已经怀孕的或者可能会怀孕的住院医生给予支持。对于任何一个员工来说,提出这样一个可能存在性别歧视的问题都是非常不合适的。

      What would you do if your senior resident proscribed a medication which would harm the patient? 

      如果你的高级住院医师使用会伤害病人的药物,你会怎么做?

      First, I would hold the medication if no one is around for consultation. Then contact the senior immediately. Once any adverse event arises, I would have to ask the senior to report to the authority and explain it to the patient. 

      首先,在没有人咨询的情况下我会先保留药物。然后立即联系那位高级住院医师,一旦出现任何不良事件,我将会要求那位高级医师向管理局报告并向患者解释。

      What would you do if your patients were not compliant with the treatment?  

      如果你的病人不接受治疗,你会怎么做?

      First, I would explore his/her understanding for the current condition we are dealing with. I will also explore the reason behind that led to the incompliance and list other options, for example, a long medication list could be confusing for a senior, a regular dose of insulin could be embarrassing for a teenager hanging out with his friend. Last but not least, I also keep in mind that the patients do have a right to refuse treatment.

      首先,我将探查一下他/她对我们目前所处状况的理解程度。我还将会探查导致这种不顺从的原因,并列出其他可能的选择,例如,一份长长的药物清单可能会让一位老年人感到困惑,一份常规剂量的胰岛素可能会让一位青少年和他的朋友出去玩时感到尴尬。最后但不是最不重要的是,我也要记住,病人确实有权拒绝治疗。

      What can you do for this program? 

      你能给项目带来什么 

      I take a great pleasure sharing medical knowledge and have a passion for teaching. I used to lead the international student studying group of our school and now working as USMLE instructor. And I noticed that this hospital is affiliated to xxx school which means there gonna be medical students coming over. I think I will be a great teacher when I become the senior. That’s my way of giving back to this program and I think I’m going do great here.

      我非常乐意与大家分享医学知识,并对于教学有着极大的热情。我以前是我们学校国际学生学习小组的组长,现在是USMLE的讲师。我注意到这家医院隶属于xxx学校,这意味着会有医学生过来。我想当我是高级住院医师的时候我也会是一个好老师。这是我回报这个项目的方式,我相信我会在这里做得很好。

      Why do you want to be a resident in US?

      为什么想来美国做住院医

      Based on my personal experience and insights from alumni, there is the training I desire here. And it will lay a solid fundation for my future career and a brilliant next step for my previous endeavor. It took me a long time and many efforts to be here, but I think it worth every second even just fo rthe possiblity to become a better doctor. I'm fully aware that there must be more of the challenges, but I'm a problem solver and an adaptor, and I'm ready.

      根据我的个人经验和从校友们了解,这里有我渴望得到的培训。它将为我未来的职业生涯打下坚实的基础,为我之前的努力迈出辉煌的下一步。我花了很长时间和很多努力才来到这里,但我认为每一秒都是值得的,即使是为了成为一个更好的医生。我充分意识到一定还有更多的挑战,但我是一个问题解决者和适配器,我准备好了。

      Planning for the next five year? 

      未来5年规划?

      After receiving my training which is the upmost important thing for me right now, my interest lies in hem/onc. My goal is to become a competent doctor that can care for the patients, I also wish to have the resources and ability to reach out for some underserved community. I once served in the Youth volunteer organization of our school and one of our campaign was to coordinate with the hospital and arrange free medical consultation in impoverished area. I realized that many people are deprived of their chance to change their lives because of lacking of medical care and knowledge.

      在接受了现在对我来说最重要的训练之后,我的兴趣就在于血液学/肿瘤学。我的目标是成为一个称职的医生,可以照顾病人,我也希望有资源和能力,接触到一些服务不足的社区。我曾经在学校的青年志愿者组织工作过,我们的一个活动就是和医院协调,在贫困地区安排免费的医疗咨询。我意识到许多人因为缺乏医疗和知识而失去了改变生活的机会。

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