Chapter 16: The Exam of Skill and Wit

“Report, examiner: my score is 30 points.”

A tall male candidate was the first to stand up, pride evident on his face.

“Hmm, very good. What’s your name? Which institution did you attend?”

The examiner regarded him with an expression of approval.

“My name is Gao Jian. I graduated from the Imperial Capital Medical Academy with a postgraduate degree, and I interned at the Imperial Capital Renhe Hospital.”

This guy clearly had a bit of an ostentatious streak.

Confidence and pride practically radiated from him.

Yet his credentials were undeniably impressive.

The Imperial Capital Medical Academy is considered the best in basic medicine.

It far outshines Tuyu Medical College, where Zhou Can studied.

Tuyu Medical College isn’t known for its academic achievements in basic medicine – in fact, it ranks at the bottom – and focuses more on clinical practice, barely cracking the national top ten.

In recent years, thanks to the rapid development of Tuyu Hospital, Tuyu Medical College’s reputation has received a boost.

“So you’re a top student from the Imperial Capital Medical Academy, and you’ve interned at the capital’s finest hospital – no wonder you scored perfectly. Please share your diagnostic approach with us.”

After hearing Gao Jian’s introduction, the examiner looked at him with even greater admiration.

Imperial Capital Renhe Hospital stands at the pinnacle of all hospitals in Huaxia – its academic and research achievements, success with high-risk cases, and its medical team are the best in the nation.

Interning at the country’s top hospital was certainly a shining highlight on any resume.

Gao Jian scanned the room and then calmly smiled. “My diagnosis was based on two points. First, the blood test showed an elevation in troponin, which is a marker for myocardial infarction. However, serum myoglobin, the most sensitive indicator for the early stage of an acute heart attack, was essentially normal – the troponin didn’t double in value as expected.”

He paused, his gaze exuding an air of condescension.

“Next, I examined the myoglobin and creatine kinase – both showed only minor fluctuations, almost within a normal range. I began to suspect that the patient wasn’t experiencing an acute heart attack. I then looked closely at the EKG. At first glance, it did bear some resemblance to that of a myocardial infarction, but compared to a textbook case, it was missing that crucial element.”

“How can I explain this? It’s like comparing a tiger to a cat – at first glance they may look alike, but a cat is much smaller and lacks the majesty of a tiger. You wouldn’t fear a cat on the street, but a tiger in the wild would make you run for cover. This patient’s EKG is that cat pretending to be a tiger.”

Unsurprisingly, Gao Jian’s performance confirmed his top-student reputation from the Imperial Capital Medical Academy – truly impressive.

His solid grasp of medical fundamentals made Zhou Can feel decidedly inferior.

Zhou Can’s own diagnostic approach was completely different.

“From those two findings, I diagnosed the patient as exhibiting heart attack-like symptoms only. I then performed a coronary angiogram, which, as predicted, revealed normal coronary arteries. I suspected we needed to dig a little deeper. It turned out the patient had recently lost his job, gone through a divorce, and suffered a severe emotional blow – leading to his chest pain and breathing difficulties. I prescribed sedatives and recommended psychological counseling.”

This treatment plan was remarkably similar to Zhou Can’s approach.

However, Zhou Can had chosen not to prescribe sedatives since they come with adverse effects and dependencies.

If you can avoid them, you should.

It’s like drowning your sorrows in alcohol – it only makes things worse.

In this light, one can see the stark difference in teaching philosophies between Tuyu Medical College and the Imperial Capital Medical Academy.

Tuyu leans more toward traditional Chinese medicine, incorporating some of its core principles.

Conversely, the Imperial Capital Medical Academy aligns itself with the most advanced Western nations, emphasizing Western medical theories, diagnostics, and treatment methods.

Each has its own merits.

It isn’t about which is superior – both can effectively heal patients.

From the patient’s perspective, Zhou Can’s treatment is preferable. Though it takes longer for results to show and requires patients to work through their emotional burdens, as the old adage goes: “After breaking down, one can rebuild stronger.”

On the other hand, Gao Jian’s approach delivers quicker results but may inadvertently weaken the patient’s resilience, as recovery is driven by medication rather than inner strength.

Additionally, patients must cope with the long-term side effects of sedatives, such as insomnia and constipation.

In that sense, Western medicine can be quite detrimental – curing one problem only to create others.

Traditional Chinese medicine aims to address the root cause, while Western medicine merely treats the symptoms.

Perhaps one day, the healing philosophy of traditional Chinese medicine will be embraced worldwide.

“Alright, thank you, Gao Jian, for that wonderful presentation. Now, for those of you who scored below 10 points, you finally understand why your scores are so low, don’t you?”

Candidates with scores under 10 hung their heads in shame.

No one again complained that there had been a scoring error.

What a disgrace.

Gao Jian sat down, completely self-satisfied.

Judging by his smug expression, he probably thought he was the only one who had diagnosed correctly.

Among the candidates, many girls glanced at Gao Jian with admiration, and even the usually proud and ethereal Yang Chan couldn’t help but steal several more glances at him.

Talent naturally wins favor and admiration.

After all, as the old saying goes, ‘All things are mediocre except for academic achievement.’

Zhou Can, who always avoided flaunting his skills or seeking the spotlight, never cared for such matters.

Judging by the scores so far, his score wouldn’t be lower than Gao Jian’s.

However, Gao Jian’s theoretical score was likely an A+.

After all, his foundation in medicine was extraordinarily strong.

“Now, let’s move on to the second part of the interview – the practical exam in medical skills. There are four sections: anatomy, suturing, ligature, and hemostasis, with a total of 60 points.”

The examiner made sure everyone understood the true meaning of hellish difficulty.

The earlier theoretical test in pathology leaned more towards internal medicine.

Now, the focus shifted to surgical skills.

This was a test of all-around ability!

Zhou Can was thoroughly prepared, maintaining a calm demeanor.

Meanwhile, candidates less adept at surgical skills looked noticeably uneasy.

“With modern advances in medical technology, surgical techniques are becoming ever more widespread. Internal and external medicine are merging. Procedures like interventional techniques, minimally invasive surgeries, and stenting all rest on these four basic surgical skills. While internal medicine lays the foundation for diagnosing and planning treatment, surgery is the sharp tool of treatment – together, they form a dual-edged sword that conquers all ailments.”

The examiner passionately elaborated on the importance of surgical skills.

“Due to equipment limitations, the practical exam is divided into preliminary and retests. Only those who excel in the preliminaries will advance. Our staff will distribute a piece of pigskin along with a set of anatomical and suturing tools. Once you receive them, you must make a roughly 4-centimeter incision along the marked line on the pigskin and then suture it.”

At the mention of suturing pigskin, Zhou Can couldn’t help but grin.

This was his forte!

He had sutured so many pieces of pigskin he could hardly count them.

I’d wager it’s measured in tons.

Other candidates also wore relaxed expressions – cutting and suturing pigskin wasn’t a particularly difficult skill.

Every candidate in the room knew exactly what to do.

The pigskin and tools were swiftly distributed, and the candidates eagerly began demonstrating their skills.

Zhou Can received his own piece of pigskin and a set of anatomical and suturing tools.

The pigskin came with marked cutting points.

This was when his third-level incision technique came into play.

A quick glance at the markings allowed him to discern the skin’s texture and roughly pinpoint the underlying distribution of nerves and blood vessels.

When making an incision on a patient, severing a blood vessel or nerve is a cardinal mistake.

Imagine if you only intended to remove a benign tumor from someone’s leg, and a careless cut ended up severing a major nerve – the patient’s leg would almost certainly be ruined.

That would result in a disastrous medical accident.

Using his hospital doctor’s level of incision skill, Zhou Can effortlessly made a 4-centimeter incision on the pigskin.

He perfectly avoided any nerves or blood vessels.

“Huh, is there a trap hidden inside?”

He discovered that two thin red conduits and one white conduit had been embedded beneath the surface – a misaligned cut might easily sever them.

The red conduits represented concealed arterial blood vessels, while the white conduit signified an important nerve.

The examiners had clearly gone to great lengths in their efforts to select top talent for the hospital.

Next came the suturing of the incision.

This, too, was Zhou Can’s area of expertise.

He had achieved a third-level proficiency in all five basic medical skills, with no weaknesses.

His suturing was both swift and precise.

It took him only about eight minutes to complete the incision and the subsequent suturing.

After verifying his work, he raised his hand to signal completion.

The examiners were visibly astonished at how quickly a candidate had finished.

Upon closer inspection, wasn’t that the young man Deputy Director Hu had previously praised?

“Zhou Can, do you have something to report?”

“Report, examiner: the procedure is complete!”

Many candidates, still carefully cutting the pigskin, were shocked to hear that someone had already finished. They looked at Zhou Can in disbelief.

All eyes turned towards him.

Gao Jian – who had thoroughly dominated the pathology test – had only sutured about half of his incision.

Some candidates, upon hearing someone finish ahead of schedule, glanced up at Zhou Can.

“Surgery isn’t just about speed; a rushed procedure is prone to mistakes. Your score is unlikely to be high,” one muttered, lowering his head to continue suturing. This young man was too impatient – chances are, he’ll be eliminated.

This was the second time Yang Chan had heard Zhou Can’s name that day.

When she learned that Zhou Can had completed the procedure so quickly, she was initially stunned, then felt a pang of regret – his surgical skills were just average. It was unwise to sacrifice quality for the sake of being first.

What use is a name if it’s just a reputation?

Surgical performance is the true key to advancement.

She sighed softly.