During many years of studying then practicing clinical medicine, I have always been extremely curious about the origin of Western medicine, expecting for a chance to visit, roam, wander and discover. Thanks to the high attention paid by our leaders of hospital to the talent construction, this year I was so fortunate to gain a precious opportunity to study abroad and embark on a journey to fulfill my dream -- Department of Cardiology, Salford Royal(NHS Foundation), Manchester, UK.
"Stones from other mountains can be used to attack jade". It's a great honor to report some personal experiences and insights to all leaders.
1. NHS (National Health Service)
The British national medical service system was founded in 1948, undertaking the responsibility of ensuring the public health care throughout the UK since then, advocating and abiding by the principle of universality. In a report released by the global authoritative rating agency Commonwealth Fund in 2013, NHS was rated as the best medical system in the world and one of the most important parts of the British social welfare system. All taxpayers and residents in the UK enjoy free medical and health services provided by NHS.
The NHS expenses are fully covered by British government, which is the world-famous free medical treatment for the whole society, bringing high satisfaction, followed by harmonious doctor-patient relationship in the UK. On the contrary, the whole medical system is not highly motivated and relatively inefficient.
2. British Doctor Training System
Each medical student is obliged to participate in 2-year foundation training (FY1, FY2) before graduation, then after passing entrance examination to 2-year CT (Core Training), which acquiring to rotate in all clinical departments. Later comes to ST (Specialty Training) for 3-9 years, which is equivalent to attending physician in China. The occupational orientation of surgery, internal medicine, pediatrics and other specialties will be determined during this phase and then become the attending physician after rigid assessment.
Each specialized department has weekly professional training and quarterly death case discussions, including core technical operation processes, criterions, indications and complications, and the latest progress in the specialty, adhering to the concept of "Learning from Patient Safety Incidents”, the training plan is carried out strictly. The lecturers are either consultants or senior rotating doctors who are well prepared, rigorous. The audiences all actively participate in the discussion, teaching and learning, and benefit from one another a lot.
From the beginning, I was at a loss to deal with all kinds of problems in an unfamiliar environment, and then I gradually get used to that and became able to integrate into and even present a team discussion. In the process of overcoming difficulties, my social as well as professional ability improved significantly, visions broadened and insights expanded.
3. Strict Management of Diagnosis and Treatment Process
The British rigorous style is reflected in all aspects of medical practice.
At the national level: The UK has the world's largest national funded guideline development project, the National Institute for Clinical Excellence (NICE), as an independent institution providing national guidance to promote health and disease prevention and control, NICE has developed many guidelines, covering various clinical fields.
At the hospital level: Various levels of hospitals often refer to NICE guidelines and develop corresponding guidelines based on their own characteristics, and upload them to a public system called Microguide for medical workers. As long as you input the name of the hospital, you can query all the guidance documents of the subordinate departments of the hospital, which is quite convenient for references.
At the clinical department level: Each department has a specialized protocol, a pathway and a checklist. Specific to details of daily routine work, the diagnosis and treatments of all diseases have clear processes, guidelines and norms, and medical and related personnel strictly follow them. Some of them may seem tedious or even wasteful to us, but we should make full preparation according to the specifications, so that patients' safety can be guaranteed to the maximum extent, which once again embodies the idea that medical quality is the most important thing.
4. Humanistic Care and Harmonious Doctor-Patient Relationship
British medical staff pay great attention to the protection of patients' privacy and fully respect their personal wishes. At the beginning of each bed unit ward round, there are medical and nursing staff who are repeatedly pulling the bed curtain and keeping their voice down during communication. If other medical and nursing staff in the department want to enter the bed curtain isolation area, they must obtain the consent of the doctors, nurses and patients inside before.
During routine physical examination, the exposure should be minimized as possible, especially for the private parts, which are only accessible to the examiner or consultant. During the communication, it is heavily emphasized to avoid being high as much as possible. The eyes are at the same level as the patient, and they often squat or even kneel down. All the details make people feel that sincere care about the patients from the bottom of heart.
The core concept of "Patient-Oriented Goal by Serving and Making Patients Satisfied " penetrates into every pore of diagnosis and treatment processes and every medical staff's heart.
5. Summary
Although the culture and economy context are absolutely different between UK & China, the concept of Patient-Oriented is completely the same and constant pursuit. Some novel and advanced ideas, such as humanistic care, bedside teaching, process management, quality control, all are worth learning.
However, it should be fully realized that "Oranges change with their environment". Only by adjusting measures to local conditions and taking advantage while avoiding disadvantages, can they blossom and bear fruit in the soil of the motherland.
6. Appreciation
Time flies and the three-month study in the UK has come to a successful end, which not only broadened my vision in the professional field, more deeply understood the roots of Western medical tradition, but also established sincere friendship with my partners and colleagues of Salford Royal (NHS) at the same time. No matter where you are, listen, understand, learn and communicate with a sincere heart, you will naturally get a sincere response.
Once again, I would like to thank our president, director and all the leaders of Central Hospital of Xiangtan City for providing such valuable opportunity for further study, as well as the support, understanding and contribution of family, colleagues and friends.
Peace of mind is home. With your warm care and support, I will continue to step forward for higher level and self-accomplishment.
