Chapter 14: Trials of Duty and Dedication

This is an exam hall hastily converted from a conference room that can hold ten thousand people.

Tuyu Medical College actually functions as a provincial-level medical institution integrating both education and healthcare. It comprises Tuyu Hospital and Tuyu Medical University.

What’s even more interesting is that the hospital and campus are interconnected.

For instance, this grand conference room is frequently used by the hospital to hold staff meetings.

At this moment, the room is packed with interns from the hospital and medical professionals from all walks of life.

Tuyu is recruiting standardized trainees; as long as you have a bachelor’s degree and are under 35 years old, you can apply.

This includes standardized trainees for nursing, general practice, and medical technology.

The training period is 36 months.

Here, ‘medical technology’ doesn’t refer to surgical skills but to departments like clinical laboratories, radiology, ultrasound, electrocardiography, electroencephalography, and gastrointestinal endoscopy.

Why is a trainee position at Tuyu so coveted?

Because if you complete 36 months of training here and pass the graduation exam, you will earn a training certificate from Tuyu Hospital.

This certificate holds significant weight.

Even if you don’t secure a permanent position after training and return to your original hospital, or move on to a municipal or county hospital, it still stands out.

Some attending physicians and resident doctors from second- and third-tier hospitals in small counties and prefecture-level cities even see training at Tuyu as a form of advanced study.

The exam hall is very quiet, with every candidate silently focused on their papers.

The standardized trainee recruitment consists of a written test, an interview, and practical evaluations.

Right now, it’s only the written exam.

Out of over seven thousand candidates, more than half will be eliminated during the written stage.

Among the candidates are young interns in their twenties as well as seasoned medical professionals in their thirties.

Naturally, there’s no shortage of exceptional candidates like graduate students and PhDs.

In terms of academic credentials, Zhou Can’s bachelor’s degree might not be outstanding.

But when it comes to his medical skills, he can easily outshine many.

“Attention all candidates, please pause for a moment—I have an important announcement to make,”

Deputy Director Hu announced loudly into the microphone.

The candidates looked up toward her on the stage, as well as at Zhou Can standing beside her.

Some of Zhou Can’s classmates or colleagues had already recognized him.

“Zhou, what’s going on?”

A few roommates expressed their concerns.

Class monitor Yang Chan silently prayed, “Spoiled kids are always unreliable—please don’t get into any trouble that might tarnish our alma mater.”

Her impression of Zhou Can had never been very positive.

“Let me introduce the young man standing beside me. His name is Zhou Can, and he is also a candidate. This morning, on his way to the exam hall, he encountered a patient suffering from chest tightness and angina. After a brief inquiry, he diagnosed the patient with what was likely acute coronary syndrome, and the patient had no accompanying family,”

Deputy Director Hu’s clear, impassioned voice echoed throughout the large conference room.

She spoke with genuine emotion.

“Faced with two choices, Dr. Zhou had to decide: either abandon the patient and rush to the exam hall or escort the patient to the emergency department, potentially arriving late. Even if he had abandoned the patient, he wouldn’t have been held responsible. However, being late would automatically disqualify him from the exam.”

Everyone fell into a brief moment of reflection.

Putting themselves in his shoes, they wondered: What would they choose? Most would likely prioritize their own interests.

Especially when it comes to choices that affect one’s future.

Few people can truly be selfless.

In fact, self-interest is human nature.

“But guess what? Dr. Zhou chose to forfeit his exam qualification and resolutely escorted the patient to the emergency department. Thanks to his professional intervention, the on-call doctor quickly identified the problem, buying crucial time to save the patient.”

The candidates were deeply moved and filled with admiration for Zhou Can.

A person of noble character earns respect naturally.

Those with deep virtue are more likely to command sincere admiration.

“Zhou Can is just an ordinary intern at Tuyu Hospital, yet his actions exemplify what true compassion and medical ethics are all about. I was deeply impressed by his heroic deed. After consulting with hospital leadership, we unanimously decided to commend this act. I hereby lift all penalties for his tardiness and add full marks for his medical ethics.”

The moment her words fell, the room erupted in thunderous applause.

Full marks in medical ethics is the highest honor Tuyu Hospital has ever awarded in its trainee recruitment.

It will stand as a milestone in Zhou Can’s career.

A smile like never before spread across his face.

“Thank you to the hospital leadership for your praise and recognition. I’m not a hero—just a humble medical worker. Healing the sick and saving lives is our duty. Thank you, everyone.”

Zhou Can’s simple remark about saving lives touched every candidate in the room.

Indeed, healing the sick is every medical professional’s true calling and passion.

For many, it’s almost like a cleansing of the soul.

Their hearts become pure and elevated.

The room burst into applause once more, a sound that seemed to last forever.

“Zhou Can, please take your seat and begin the exam. You are allowed extra time for submission.”

Deputy Director Hu said with a smile.

“Thank you!”

Zhou Can felt as if he were walking on rays of light—life could indeed be so brilliant.

Good people are blessed, and the world never fails those who do good.

His seat was located at the back.

Passing by class monitor Yang Chan, who beamed and gave him a thumbs-up.

Zhou Can smiled back and nodded.

He found his assigned seat by its number; on the desk lay a tablet provided by the hospital.

Simply by entering his name, ID number, and selecting his exam department, he could start answering the questions.

At a top-tier provincial level three-A hospital like Tuyu, the requirements for trainee recruitment are extremely high. Clinical trainees are required to master general medicine theory.

This means the test includes not only surgical questions but also topics from internal medicine, pediatrics, obstetrics and gynecology, ophthalmology, and more.

Theory has always been Zhou Can’s strong suit.

As he answered questions, his fingers flew over the tablet; complex medical problems were swiftly solved.

……

Although Zhou Can’s speed outpaced most candidates, he still entered the hall too late. Before he could finish, the loudspeaker announced that time was up.

The candidates began submitting their papers one after another.

Receiving special consideration, Zhou Can was allowed extra time. He continued to focus on his answers.

Soon after everyone had handed in their papers, Deputy Director Hu took the microphone to announce the results.

“Thank you all for your enthusiastic participation. The exam scores are now out. Candidates scoring ‘A’ or above may proceed to the interview round. Unfortunately, those below ‘A’ have been eliminated. Please exit in an orderly fashion and keep up the effort—hope to see you again next year in Tuyu’s recruitment.”

Now, the scores were being tallied by computer.

The efficiency was astonishing.

From the moment papers were collected to when results were announced, only a few minutes had passed.

One by one, the eliminated candidates left the room with heads hung low.

Within just over ten minutes, the original pool of nearly seven thousand candidates had shrunk to roughly three thousand.

Almost 60% had been eliminated.

And this was only the first round; the subsequent interview phase would be even tougher.

“Now, please welcome our panel of judges.”

Barely had Deputy Director Hu finished speaking when several doctors and nurses started entering the exam hall.

There were three groups of judges in total.

Soon after, workers began bringing in various props needed for the interview.

“Candidates for the Medical Technology department, please sit over here.”

This department mainly involves conducting various tests and pathological analyses on patients.

Most of the equipment the workers brought in is intended for use by the medical technology candidates.

There were quite a number of candidates applying for the Medical Technology department—at least around 800.

During the interview, they were required to interpret ultrasound images, CT scans, X-rays, and more, and then operate a Doppler ultrasound machine on the spot to produce a clear video.

Of course, the examination area would be randomly assigned by the examiners.

“Candidates for the Nursing department, please step forward.”

Most of the female candidates flocked to the front; many of these strikingly beautiful young women were among the numerous nurses recruited by Tuyu Hospital every year. Nursing is largely a career that relies on youth.

Many nurses, as they grow older, either return to family life or transition to other roles such as health management.

Only a very few lucky ones advance to become head nurses or move to less demanding roles.

For example, handling medical orders, operating the computer, retrieving medication, managing inventories, or organizing records.

Overall, nursing is a profession that largely depends on youth.

There is high employee turnover.

Almost every hospital routinely recruits nurses.

Approximately 700 candidates applied for standardized trainee positions in the Nursing Department.

And it wasn’t exclusively female—there were a few males, too.

However, males were relatively rare.

The remaining 1,500-plus candidates applied for general medical training.

This further demonstrates that the medical profession remains highly desirable. As one’s skills grow, doctors not only earn more but also gain higher status.

Doctors belong to a career of growth, with bright prospects.

The competition for general medical training is far more intense than for nursing or medical technology.

Over 1,500 candidates readied themselves, determined and prepared.

“Good morning, candidates. We will now begin the first part of the interview: Pathology Diagnosis. I will act as the patient and list a series of symptoms. Using your tablet, please select the appropriate tests in the correct order. Remember, randomly ordering tests or over/under-ordering will cost you points.”

A knot formed in the candidates’ chests.

None expected that the first interview question would involve a live diagnosis.

The social candidates in their thirties had an advantage; many had served for several or even over a decade in county or municipal hospitals and possessed rich clinical diagnostic experience.

But for the interns, this was daunting.

They had little clinical diagnostic experience and had never independently attended to patients—mostly just theoretical practice.

Now, being tasked with a live diagnosis naturally caused some panic.

“I suddenly experience chest pain and shortness of breath, feeling that my condition is deteriorating. As the on-call doctor attending to me, what tests would you perform? Please use the tablet to list the tests in proper sequence. Note that if the order is incorrect, you’ll lose half the points.”

After a patient is admitted, there is a strict sequence of examinations the doctor must follow.

It always starts with a physical examination, such as palpation and observation.

Subsequent tests are ordered in a methodical, step-by-step process.

For instance, after completing a blood test, if an electrocardiogram is deemed necessary, the test order should list the blood work first and then the ECG.

After careful consideration, the candidates began submitting their test orders.

“Time’s up.”

The examiners had allotted only about 10 minutes.

This undoubtedly raised the difficulty of the exam.

However, in real cases involving emergencies or critically ill patients, doctors have even less time to react.

“Now you can review the scores for each test and the corresponding results.”

At that moment, Zhou Can finally completed the written exam.

He submitted his paper.

The results were out almost instantly.

A.

His score was estimated to be between 90 and 95.

If he had scored above 95, his grade would have been A+.

Considering the exam’s difficulty—the content spanning internal medicine, surgery, obstetrics, pediatrics, and more—even an A was exceptional.

He had also caught most of the examiner’s instructions.

With the written exam now behind him, he prepared to tackle the interview.

“Patient experiences chest pain and severe shortness of breath?”

He quickly ordered a physical exam, a blood test, and an electrocardiogram.

He submitted his order.

“Congratulations, all test orders are correct. Full marks awarded.”

Zhou Can smiled slightly.

Achieving a level-three score in pathology diagnosis was already at the level of a resident doctor. If he had made a mistake, his level-three diagnosis would have been meaningless.

He swiftly reviewed all the test results.

The physical examination showed a heart rate of 122 beats per minute and blood pressure of 97/49 mmHg.

Where a normal heart rate is between 60 and 100 bpm, the patient’s rate was clearly too fast.

Normal systolic pressure is between 90 and 140 mmHg and diastolic between 60 and 90 mmHg. The patient’s blood pressure was notably low.

A man in his thirties, at the prime of life, with such low blood pressure, was at risk of shock. Moreover, insufficient blood flow deprives organs of oxygen, impairing cell metabolism.

If prolonged, organ failure is inevitable.

The patient died.

Next, he reviewed the blood test results.

Whoa, the troponin levels are extremely high.

They were significantly above normal values.

Zhou Can couldn’t help but think of the dreadful condition—acute myocardial infarction. The case from this morning involving Mr. Cui was strikingly similar.

Acute myocardial infarction is a type of coronary heart disease.

If not treated promptly, the mortality rate is extremely high and the prognosis is poor.

However, based solely on the first two tests, it was difficult to be certain. He then checked the crucial electrocardiogram.

Clearly, the ECG showed changes characteristic of a myocardial infarction.

Under normal circumstances, the heart continuously generates electrical signals. The ECG monitors this activity, translating it into waveforms that assist in diagnosis.

When a portion of the heart muscle dies or a blood vessel is blocked, the waveform peaks change significantly.

Doctors can roughly determine which vessel is obstructed by analyzing the ECG.

“Damn, it really is an acute myocardial infarction,”

Zhou Can, based on the three test results, preliminarily deduced that the patient very likely had an acute myocardial infarction.

Yet, he felt that something was slightly off.

He kept recalling what Dr. He had told him yesterday during rounds.

“Medicine is a rigorous discipline. I never jump to conclusions. Diagnosis must integrate the patient’s history, condition, gender, and all test data,”

Dr. He’s words echoed in his mind.

At that moment, the examiner, with a blank expression, said, “I trust that after reviewing the results, you have formed your own diagnosis. Please record your conclusions.”

Many candidates began confidently writing down their diagnostic impressions.

However, Zhou Can furrowed his brows, feeling that something wasn’t right.

But he couldn’t pinpoint the issue.