Exploring New York Medical Center: Insights into Medical Frontiers and Future Prospects—Discoveries and Reflections of Visiting Doctors at Montefiore Medical Center, USA

Learning Experiences of Doctors in the First Observational Visit

Recently, the "International Medical Elite Talent Training Program," jointly developed by Aurora Health Intelligence and Montefiore Medical Center in the USA, was launched in New York. The first group of doctors to receive this rare opportunity conducted a short-term observational visit at the medical center. They have deeply reflected on and benefited from this learning experience.

This article presents the most direct learning insights from these doctors based on their feedback, hoping to inspire other doctors who have learning needs to prepare in advance and gain new perspectives through their experiences.

In-depth Professional Insights

Firstly, Dr. Guan Jiangfeng, a pediatric specialist from Handan First Hospital, gained profound insights into the meticulous division of specialties at Montefiore Children’s Hospital during her observational visit. The pediatric department is subdivided into various subspecialties, with each doctor focusing on their area, conducting comprehensive and in-depth clinical work. This division allows doctors to continuously delve into their specialty areas, achieving high technical proficiency and accumulating rich clinical experience and professional knowledge.

Moreover, she observed the rigorous training system at Montefiore as a teaching hospital: "In pediatric clinical work, residents undergo three years of formal rotation and training before entering future clinical positions. This three-year rigorous training lays a solid foundation for future pediatric work. If one intends to become a specialist, the residency training process also prepares for further specialist training. As a teaching hospital, Montefiore Children's Hospital places special emphasis on clinical teaching, setting different learning requirements for students of different grades and encouraging residents to actively participate in clinical work. The residency training process in the U.S. is very rigorous and fulfilling, with students being busy and engaged. Meanwhile, various states in the U.S. have legislation to limit residents’ working hours, ensuring their physical and mental health. In addition to learning clinical knowledge, through expert lectures and student presentations, clinical thinking and research spirit are cultivated." This is what Dr. Guan wrote in her observation report.

The second doctor, Dr. Xue Jie, an obstetrics and gynecology specialist, had a deeper experience of the advanced nature of the U.S. medical system and the meticulousness of doctor-patient interactions. At Montefiore Medical Center, doctors treat patients with great patience, care, and respect, emphasizing the protection of patient privacy and the accuracy and completeness of medical records. This approach to patient care greatly inspired her, making her realize that medical care is not only about treating diseases but also about caring for patients’ physical and mental health and social needs.

Furthermore, she observed that Montefiore doctors are very standardized in their diagnosis and treatment. For any disease, they refer to the latest guidelines, consensus, and relevant literature, then provide the most standard or optimal treatment plan. For any new procedure or field, there is strict training before practicing in that area. Their standardized training for doctors avoids different interpretations of the same disease, which could lead to patient distrust.

Before going to New York, she thought that Americans didn’t need to work overtime. However, during residency training, she felt the hard work of residents. Many residents start working at six o’clock, completing rounds and preparing records and reports before the attending physician starts. When there are surgeries, they usually start in the operating room at seven o’clock. There, they generally don’t have a lunch break, only a brief lunch period, and they finish work at five in the afternoon, but many residents rarely leave on time. Additionally, she found the medical record system in U.S. hospitals very complex, requiring detailed documentation. Every consultation, whether outpatient or inpatient, involves a thorough record of the patient's medical history and treatment. The progress notes are not rigid, without fixed requirements, and any situation that arises is truthfully recorded along with the corresponding handling.

Expanding New Medical Horizons

In addition to professional knowledge and skills, Dr. Guan also learned relevant knowledge in the field of genetics, understanding the principles, differences, and applications of various genetic testing methods. She gained insights into the methods and advantages of newborn disease screening in the U.S. while recognizing her deficiencies in diagnosing congenital diseases. These experiences provided her with a broader perspective and deeper understanding, which will positively impact her future clinical practice and research work.

Meanwhile, what impressed Dr. Guan particularly was the presence of a special team in the hospital—social workers. They practically help patients solve various issues, such as children being unable to attend school, facing discrimination due to illness, or having no one to care for them at home. This aspect is worth learning and emulating in our national context. Social workers not only focus on the patients' physical health but also their social and psychological needs, providing comprehensive support and assistance.

Additionally, during her visit to the obstetrics and gynecology department, Dr. Xue found that surgeries there were similar to outpatient surgeries in China. Most patients are admitted on the day of the surgery, and they are usually discharged after anesthesia recovery post-surgery. Only abdominal surgeries require hospitalization. She was amazed that even total hysterectomies did not require hospitalization, and patients had no issues with recovery. They were discharged with oral pain medications after surgery.

Advice for Future Observers

Both doctors believe that English proficiency, especially in listening and speaking, is crucial during the immersive English environment of the observational period. Whether communicating with other physicians or meeting friends from different countries, strengthening daily spoken and medical English practice before going abroad will help adapt more quickly and gain greater benefits.

Additionally, during the visit, it is necessary to determine learning goals earlier and communicate with Montefiore Medical Center to formulate a rotation plan. Dr. Guan mentioned that pediatrics involves many specialties, making it impossible to cover everything, so it is best to clarify the desired subspecialty (focused on outpatient or inpatient care or both) and the desired rotation duration in the learning expectations. Finally, the two-month observational visit is short, and the goal is not to master a specialty but to understand advanced technologies and treatment methods abroad, find the gaps between domestic and international practices, and determine the direction for future efforts after returning home. The knowledge and experience gained can then be applied to practical work to provide better medical services for pediatric patients.