The practical assessment was held in an office on the fifth floor of the general administration building.
Yu Zhiming walked into the somewhat sparse office and saw five sets of desks and chairs arranged on the eastern side. At each set sat a man in a white coat, around fifty or sixty years old.
These five men had a few things in common: salt-and-pepper hair, lean builds, and stern, unsmiling faces.
There were no nameplates on their desks, so Yu Zhiming couldn’t match the five men before him to the five expert examiners Dr. Qi had described last night.
To the left of the door, there were two more sets of desks and chairs, occupied by two men in white coats who looked to be in their thirties.
In the center of the room was an examination table.
Yu Zhiming took a few steps to the examination table, came to a stop, and bowed to the five experts.
"Good morning, sirs!"
"I’m from the Liyang County People’s Hospital in Lu Province—"
"Alright, that’s enough. No need for introductions."
The long-faced man sitting in the center of the five interrupted, "Dr. Yu, we have your file. We’re already familiar with your basic information."
Without pausing, he continued, "Dr. Yu, first, name three types of surgeries you can perform as the lead surgeon that would best demonstrate your skill level."
’They might schedule a practical surgical assessment based on my answer,’ Yu Zhiming immediately guessed.
In this country, surgeries were managed by a tiered system.
There were four tiers in total. From Tier 1 to Tier 4, the surgical difficulty increased progressively.
Generally, county and township hospitals handled Tier 1 and Tier 2 surgeries, while Tier 3 and Tier 4 surgeries were primarily handled by tertiary hospitals in provincial capitals and major cities.
In recent years, the surgeries Yu Zhiming had learned and performed at the county hospital, such as hernia repair, appendectomy, and C-sections, were all considered Tier 2 surgeries.
He rarely had opportunities to learn or practice more complex Tier 3 surgeries at the county hospital.
However, when surgeries like hernia repair and appendectomy were performed laparoscopically, their difficulty increased by a level, classifying them as Tier 3.
And Yu Zhiming happened to be quite skilled with a laparoscope.
He quickly sorted through his options in his mind and replied in a clear voice, "Sir, the surgeries I most frequently lead at the county hospital are laparoscopic hernia repair, laparoscopic appendectomy, and laparoscopic ovarian cyst removal."
The long-faced man nodded slightly at Yu Zhiming’s answer, then raised a hand to point at a camera in the upper corner of the room.
"Dr. Yu, this entire assessment will be recorded on audio and video. If you have any objections afterward, you can request to review the footage."
After a brief pause, the long-faced man continued, "We’ve heard that you are particularly skilled in auscultation and percussion."
"Next, we would like you to give us a detailed demonstration."
"In a moment, a volunteer will come in. You will need to examine him and report any damage to his internal organs."
"The rules are..."
The long-faced man raised his voice slightly. "You are not allowed to ask the volunteer any questions, aside from inquiring about pain response."
"You are not allowed to use any instruments other than a stethoscope."
"You are not allowed to lift the volunteer’s clothes."
"You have a thirty-minute time limit."
The long-faced man paused deliberately before asking, "Dr. Yu, do you understand the requirements?"
Yu Zhiming nodded. "Sir, I understand."
After receiving the confirmation, the long-faced man gestured to one of the young men in a white coat sitting by the door.
One of them stood up and left, returning in less than a minute with a tall, thin, middle-aged man in a patient’s gown.
The tall, thin man lay down on the examination table.
Yu Zhiming put on surgical gloves. After the long-faced man announced, "Time starts now," he began to examine the man.
He didn’t use the stethoscope that was set to the side, nor did he ask the man about any pain. He started with a preliminary examination, a series of taps and presses from the man’s chest down to his lower abdomen.
After the initial examination, Yu Zhiming was secretly stunned.
’Where on earth did they find such a specimen?’
’How could one person be this injured?’
Surgical repair scars for two perforations in the left lung;
Two bypass grafts on the heart;
One-fourth of his stomach resected;
The right kidney atrophied to half the size of the left;
An enlarged liver;
No appendix;
And obvious surgical scars on his duodenum and cecum.
Yu Zhiming couldn’t help but wonder what this man had been through to have sustained such extensive internal injuries.
Considering he was also missing a rib and had multiple healed fractures throughout his skeleton, Yu Zhiming guessed the man must have suffered at least one catastrophic accident.
’To survive so many internal injuries... this guy’s vitality is comparable to a cockroach’s...’
Yu Zhiming calmed himself and began a more detailed examination of the tall, thin man...
Nearly ten minutes later, Yu Zhiming finished his percussion and auscultation examination and straightened up.
"Sirs, I have completed the examination. As for the volunteer’s internal organ damage..."
Yu Zhiming asked, "To describe it more intuitively and accurately, may I use a diagram to illustrate?"
After a brief discussion among themselves, the five expert examiners agreed.
Sketching was considered a fundamental skill for a doctor.
After all, there were times when a doctor needed to use both illustrations and text to clearly explain an issue and make it understandable to others.
Yu Zhiming’s sketching ability, while not necessarily outstanding among doctors, was quite good.
At the very least, his sketches were clear and comprehensible to his peers.
Back at the county hospital, whenever he encountered a diagnosis he didn’t understand or a problem he couldn’t solve, he would often sketch his findings to consult with senior doctors at the hospital.
If he couldn’t find a solution at the county hospital, he would even have the patient take the sketch with them when transferring to a larger hospital for further diagnosis.
His colleagues at the county hospital all said that the symptom sketches Yu Zhiming drew were more concise and clear than imaging scans.
This was one of the reasons he’d earned the nickname "the Human CT Scanner."
Because the tall, thin man had numerous internal injuries, and because Yu Zhiming was particular about detailing the damage, it took him nearly an hour to sketch out all of his findings, even with simplified drawings.
Fortunately, the experts didn’t rush him, nor did they show any signs of impatience.
Yu Zhiming also keenly observed something.
After looking at his sketches, the way the expert examiners looked at him had changed.
Their formerly businesslike scrutiny was now tinged with inquiry, curiosity, and appreciation.
’I’ve shown them a glimpse of my true skills and earned their initial approval,’ Yu Zhiming thought.
Greatly encouraged, Yu Zhiming began the second round of the assessment with even greater confidence.
The second round involved five patients of various ages and genders.
The requirement was to diagnose each patient’s primary illness and propose a treatment plan within a fifteen-minute time limit, using only inquiry, percussion, and auscultation.
After careful examination, Yu Zhiming found that the volunteer, who was nearly seventy, had coronary heart disease and chronic obstructive pulmonary disease.
The ten-year-old child had vitamin D-deficiency rickets and an atrial septal defect.
The twenty-five-year-old female volunteer had lupus, as well as hepatitis caused by the lupus.
The forty-year-old male volunteer had gallstones and moderate liver cirrhosis.
The last one was a woman who was eight months pregnant. She had hydronephrosis and gestational hypertension.
None of these patients’ conditions were considered rare or complex diseases.
Under Yu Zhiming’s meticulous examination, they were all quickly diagnosed, and he proposed treatment plans for each.
However, while examining the last patient, the pregnant woman, Yu Zhiming also diagnosed her fetus with a nuchal cord, wrapped once around its neck.
A single nuchal cord isn’t a major problem; it just requires paying closer attention to fetal movement and heart rate.
But this was a rare opportunity to show off, and Yu Zhiming naturally wasn’t going to let it pass.
He adjusted the fetus’s position for the pregnant woman on the spot.
As expected, this caught the attention of the experts.
Yu Zhiming humbly told them that in addition to percussion and auscultation, he was also extremely skilled at adjusting fetal position.
He claimed he could use manual techniques to effectively correct issues like fetal malpresentation causing difficult labor, nuchal cords, and even umbilical cord torsion.
To Yu Zhiming’s considerable disappointment, however, the experts didn’t seem to react positively to his little extra performance.
After all, when he had cured a case of fetal umbilical cord torsion at Jinling Gulou Hospital, Dr. Xi Zhen had been thoroughly shocked.
’Maybe they think I’m just bragging?’
The long-faced man, his expression calm, gathered the diagnostic reports and treatment plans Yu Zhiming had written.
"This concludes the morning assessment."
"Dr. Yu, at two o’clock this afternoon, you will perform a laparoscopic hernia repair surgery under our supervision..."