In the fifth month, in the Cardiology Department II, overall it was quite busy with many gains.
One of the most important gains: Don’t be afraid to make mistakes, don’t fear criticism, actively strive for opportunities to practice and perform; only then can you receive guidance and feedback from others and grow.
Teaching
The department has an excellent teaching atmosphere; everyone from instructors to the director is proactive in teaching, especially my teacher Wang Dayang @wdy337 (oh! Dayang! My superhero!). He summarized many cardiology workflows, allowing us to quickly understand related information and get started promptly, such as 心血管科住院医师工作手册. On the first day, the teacher sent this document; it contains a lot and can be overwhelming. Later, by participating in specific tasks while referring to this manual like copying it, and asking the teacher why things are done this way or that, I gradually understood some basics.
A few days ago, while listening to the podcast “More Than Money”, I wrote this reflection:
Macro is a high-level abstraction and integration of a vast amount of micro information. In this process, a large amount of information must be discarded, leaving only the most essential, and this essence benefits only advanced players. For beginners, if you only engage with the macro without accumulating this information, it looks impressive but you don’t really know how to use it. For example, the two words yin and yang in traditional Chinese medicine cannot guide practice without sufficient clinical experience.
Many clinical maxims summarize a multitude of facts, such as the phrase “see urine and supplement potassium”; behind this phrase lies physiology, pathology, and internal medicine knowledge.
When entering the department, I joked about draining the teachers; now after one month, I realize that is impossible. The teachers are like sponges full of knowledge, always able to squeeze something out. However, I have also encountered content even the teachers didn’t know, which is a small achievement 
Director Peng Wenhua of Cardiology II places heavy emphasis on teaching and arranges various learning activities, such as case presentations every Wednesday and paper discussions every Friday. He often pushes teaching secretary Wang Nina to do a good job in teaching . Director Pan Guozhong (not very familiar) once said that the teaching ability of Cardiology II is among the best in the entire hospital area; I strongly agree with this. From system design to execution by every teacher, everyone is serious about teaching. For example, teachers Liu Hao, Xie Jing, and Feng Wei next to us (I don’t know about others further away) often start discussing cases spontaneously, and I often sneak a listen.
I found that departments strong in clinical skills often also have good teaching. Or rather, because teaching is good, everyone’s overall level can improve together. One expert alone can only handle so much, but one expert combined with many juniors greatly enhances the handling capability. For example, Director Wu Caijun from Dongcheng Emergency Department (famous for asking clinically relevant questions every morning ward round), Director Lv Yan’en from Dongcheng Neurosurgery (makes students sit in front to watch scans), and so on.
But even if these teaching resources are delivered on a silver platter, whether each person can utilize them varies. From my observation, not everyone actively asks questions. I can understand the desire to pursue traditional Chinese medicine, but my current view is that both Western and Chinese medicine must be valued. Top TCM and Western medicine practitioners can understand each other. Eventually, Chinese and Western medicine will meet at the peak. Since we now have ready Western medical resources, why not learn quickly? Wait until future work? Or never learn? Relevant content includes:
- Meeting at the Peak — An Immunological Explanation of TCM’s Concept “Cold is the Body’s Recovery Opportunity”
- Vol.10 Chat with Master’s Graduates from Beijing University of Chinese Medicine on Community Hospitals and Residency Training
- Vol.8 Chat with PhD students from Beijing University of Chinese Medicine on How TCM Practitioners Navigate Residency Training
Practice is the best way to learn, followed by teaching and then summarizing; specialized study is ideal.
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Practice is repetitive, stimulating the brain in many ways to reinforce memory, so it is the most efficient. For example, “secondary prevention of coronary heart disease” — I was asked this at least three times (by a roommate, teacher, and classmate). Each time I couldn’t remember and had to check notes; the more I look, the deeper the impression. As I get familiar with medical orders, the secondary prevention concept gradually sticks.
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Teaching yourself is about questioning yourself until you clarify everything. This month I took on a task — a small departmental lecture on “Right Heart Failure”. Before this, I basically had an empty head and didn’t even understand concepts like preload, afterload, systolic heart failure, diastolic heart failure, etc. So I started to question what these concepts mean, why right heart failure occurs, how it’s diagnosed, how it’s treated. Didn’t know? Look it up! Look it up! The questions kept multiplying, but my understanding deepened. Later, I couldn’t distinguish priorities and went too broad — I even started watching teaching videos on echocardiography. At this point, the instructor rightly interrupted me and asked me to organize the most important content first. This underscores how vital an excellent mentor is — limited energy but mastering the most important content first.
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This month I received a large amount of knowledge, mostly fragmented points, such as what the teacher saw during morning rounds or questions I asked. These tidbits are often noted in notebooks and then forgotten. When encountering similar issues in the future, if I can’t find the notes, I won’t recall anything. However, some content made a deep impression — the notes I systematically organized and specialized study on. For example, early on I didn’t understand the difference between aspirin and clopidogrel as antiplatelet and anticoagulant drugs. So I first checked tutorial posts but didn’t understand, then started from coagulation mechanisms. Even after learning that, I still didn’t understand. Then I reviewed clinical drug use information, which clarified matters. I indeed spent a lot of time on this but successfully built a knowledge framework for antithrombotic drugs. When new drugs appear, I can quickly fit them into my framework, e.g., ticagrelor, understood as an enhanced version of clopidogrel — more potent, but with greater side effects.
Clinical
From patient interviews to prescribing and writing medical records, I was involved almost the entire time, developing a systematic approach to disease diagnosis and treatment. As written above, practice is the best learning method. Managing one patient every two days versus two patients a day differs greatly in information exposure and pattern extraction. Of course, excessive workload can lead to burnout; I crashed several times, not wanting to get up in the morning, nor to sleep at night, uninterested in any entertainment, let alone studying — just wanting to lie down. I know peers at Peking Union Medical College have workloads several times mine, no wonder PUMC produces top talents. A great responsibility is placed upon them… I cannot bear it and likely cannot take on great responsibility in the future.
Regarding traditional Chinese medicine, this month I began to appreciate the wonders of manual techniques. Although case numbers are not large, senior student Liu Jiayu @庸人 thoroughly demonstrated the efficacy of manual treatment, and I verified this both practicing and being treated. But as mentioned above, my current focus remains on making full use of available Western medical learning resources; if TCM can be incorporated, great; if not, no regret.
Regarding Western medicine, I read a good book at the end of this month and highly recommend it again:
Pressure
Overall, Cardiology II is strict but accommodating. Teachers, though pushy, are reasonable and caring. For example, teacher Liu Hao shared Lotus Qingwen capsules he bought from Hong Kong with students sick from colds (interestingly, Hong Kong’s drug instructions list content amounts but not all kinds; Mainland China’s instructions list all kinds but no dosages). I was late several times due to oversleeping; teachers said nothing.
However, a reminder: the overall intensity in Cardiology II is far higher than other departments. For example, strict adherence to weekly full attendance allows only half-day off for rounds; each student usually manages 1-2 patients daily; night shifts may still receive patients; on weekends, one may receive 2-3 patients a day.
Overall
Gains: 5/5
Pressure: 4.5/5
Recommendation: 5/5
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