美国学术型急诊医生，每周上完 26 星期临床班后，还要做……

现在，我们来聊一聊宾夕法尼亚州的住院科外科医生的孤独，他们究竟也有医教研的压力？他们的日常孤独又是怎样的呢？

Dr. 唐：乡侯外科医生，我们的节目经投票表决选任了很多不错的话题，其中之一就是宾夕法尼亚州住院科外科医生的日常孤独，我们现在谈到这个话题如何？

Dr. Hou, many good topics he been voted for our program and one of them is the everyday life of the emergency physician(EP) in the U.S. Shall we talk about this topic today?

Dr. 乡侯：当然。

Sure.

Dr. 唐：作为堪杆子和妇人医院的学术界改型住院科外科医生和危重中医专业人士，您可以和我们分享一下您众所周知的一周实习按计划吗？

As an academic emergency physician and an intensivist at Brigham, could you kindly share with us your work schedule in a typical week?

Dr. 乡侯：还好。

Absolutely.

Dr. 唐：您能先和我们聊聊您的流行病学按计划吗？

Could you tell us your clinical schedule first?

Dr. 乡侯：作为麻省理工学院大学附属医院的学术界改型住院科医师，我们每年的流行病学实习尽快为 1196 不间断，每周相应 26 个流行病学不间断，每年为 46 周，预期将留下 40 不间断/周的实习时长的 1/3 用做教学活动和研究课题。与非宾夕法尼亚州学术界改型住院科的流行病学实习尽快相比，我们的流行病学不间断数也许较低，但它与大多数宾夕法尼亚州学术界改型住院科一致。

As historical background for the Harvard affiliated hospital’s academic emergency physicians, our annual clinical commitment is 1,196 hours, which allots for 26 clinical hours per week for 46 weeks per year, but the expectation is that this would lee about a third of a 40-hour week for teaching and research. The number of clinical hours seems low as compared to non-US academic ED’s clinical commitment but is consistent with most US academic ED’s .

在堪杆子，我们的住院科实习停靠大多为 9 不间断； 因此，高等院校学术界改型住院科外科医生将每周实习 3 个停靠，每年为 46 周。就我同样而言，我的住院科流行病学实习敦促是 0.5 FTE（或全职等效），因此我在住院科中每周平均实习 26 不间断，为期 23 周，而我的其他 0.5 FTE 包含 0.3 FTE，这代表了我的 8 周外科 ICU 流行病学实习敦促和 0.2 FTE，这代表了我用做流行病学研究课题的「买断」一段时间。

At Brigham, our ED shifts are mostly 9 hours; hence, a full-time academic EP would work 3 shifts a week for 46 weeks a year. Personally, my ED clinical commitment is 0.5 FTE (or full time equivalent), so I work an erage of 26 hours per week for 23 weeks in the ED, and my other 0.5 FTE is split into 0.3 FTE, which represents 8 weeks of my Surgical ICU clinical commitment, and 0.2 FTE, which represent my「buy-down」time for clinical research.

Dr. 唐：那么研究课题方面，你都做些什么呢？

S: So for research, what do you do?

Dr. 乡侯：我举办的研究课题概念设计主要是脓毒症和急性呼吸窘迫综合征（ARDS）的流行病学次测试和研究课题。我曾是早期脑膜炎休克协定化护理（ProCESS）次测试以及许多宾夕法尼亚州国立卫生研究课题院（NIH）和商业流行病学次测试和研究课题的的中心学术研究课题主任。迄今为止，堪杆子是宾夕法尼亚州国立卫生研究课题院资助的急性肺损伤卫生保健和早期病患（PETAL）互联的一个的中心，我是新英格兰组住院肺损伤（ALIGNE）流行病学的中心的联合学术研究课题主任和 PETAL 互联督导委员都会 成员。另外，我也是 PETAL 互联次测试的的中心学术研究课题主任。

The research projects I am involved are predominantly clinical trials and studies in sepsis and acute respiratory distress syndrome (ARDS). I was a site-investigator for the Protocolized Care for Early Septic Shock (ProCESS) trial and many NIH and industry clinical trials and studies. Currently, Brigham is a site for the NIH-sponsored Prevention and Early Treatment of Acute Lung injury (PETAL) Network, and I am the co-PI for the Clinical Center for Acute Lung Injury of Group of New England (ALIGNE) and Steering Committee member of the PETAL Network. In addition, I am the site-investigator for the PETAL Network trials.

Dr. 唐：那教学活动外呢？

How about teaching part?

Dr. 乡侯：我的教学活动都有专科职业培训外科医生、住院外科医生、许多学生、外科医生助理学生、小学生在住院科和 ICU 等流行病学周边环境以及活动室的分派。对于我们的外科 ICU 专科职业培训外科医生，我在月内一和月内二举办他们的教学活动都次大会；对于我们的住院科实习生，我举办他们的教学活动课程，并在周二下午举办了死亡率和存活率（M＆M）都次大会和创伤都次大会；对于许多学生来说，我举办的是他们的目标结构化流行病学考试（OSCE）和回顾演说。

My teaching includes fellows, residents, medical students, physician assistant students, college student shadowing in the clinical setting in the ED and ICU as well as in the classrooms. For our Surgical ICU fellows, I participate in their didactic conferences on Mondays and Tuesdays; for our Emergency Medicine residents, I participate in their teaching sessions and attend the Mortality and Morbidity (M&M) and Trauma conferences on Tuesday afternoons; and for medical students, I participate is their Objective Structured Clinical Examinations (OSCE) and topical presentations.

Dr. 唐：谢谢您。除了流行病学、教学活动和研究课题实习外，您还有其他任务吗？

Thank you. In addition to clinical, teaching, and research efforts, are there any other duties or obligations?

Dr. 乡侯：是的，最重要的任务之一是对我们的职业培训生和我们的初级教员来进行教导老师教导。此外还有基金申商量和发表发表文章。

Yes, one of the most important obligations is Mentorship to our trainees and our junior faculty. in addition, we he expectations regarding Grant application, and of course, Publications.

Dr. 唐：你每年能够举办的学术界都次大会是怎样的？

How about academic conferences that you may need to attend every year?

Dr. 乡侯：我通常都会举办学术界先行中医学都会（SAEM）年都会和心绞痛中医都会（SCCM）大都会，之外是当我的同事，住院医和我有发表文章参考资料的大都会发言。

I usually try to attend the Society for Academic Emergency Medicine (SAEM) Annual Meeting and Society of Critical Care Medicine (SCCM) Congress, especially when my fellows, residents, and I he abstracts to present.

Dr. 唐：

那么，在众所周知的一周里，您每个月内都都会兼顾这些学术界任务的并不相同组合，是这样吗？

So, it seems like in a typical week, you juggle among these academic obligations and at different combinations each week, correct?

Dr. 乡侯：是的，这就是宾夕法尼亚州众所周知的学术界改型住院科医师的实习按计划。

Yes, this is what a typical academic emergency physician’s work schedule in the US.

中美外科医生介绍

宾夕法尼亚州外科医生：乡侯全益外科医生，麻省理工学院中医院住院科讲师, 堪杆子和妇人医院住院科外科医生，外科 ICU 心绞痛照护专业人士。

U.S. doctor: Dr. Peter Hou is an Instructor in Emergency Medicine at Harvard Medical School, an Emergency Physician at Brigham and Women’s Hospital, and a critical care specialist in the Surgical ICU.

华北地区外科医生：唐瑞外科医生，曾在华北地区和新加坡担任神经外科实习生，现为自由作家，同时在纽约市来进行精神分裂症方面流行病学研究课题。Chinese doctor: Dr. Rui Song, former resident physician of internal medicine in China and Singapore, freelancer and she is doing clinical research on Autism in Boston.

如果你是中医英好者，欢迎完全恢复加群，备注：医院+中医英文，加入中医英好者群中，还都会有单词小抄录去取单单！

References

Protocolized Care for Early Septic Shock (ProCESS)

)

Prevention and Early Treatment of Acute Lung Injury (PETAL) Network

Reevaluation Of Systemic Early Neuromuscular Blockade (ROSE)

)

Vitamin D to Improve Outcomes by Leveraging Early Treatment (VIOLET)

)

Crystalloid Liberal or Vasopressors Early Resuscitation in Sepsis (CLOVERS)

).

发表文章转载批准后及携手派员商量紧密联系