今日，咱们来聊一聊美国的急诊科医师的日子，他们是否也有医教研的压力？他们的日常日子又是怎样的呢？
Dr. 宋：侯医师，咱们的节目经投票选出了许多很好的论题，其中之一就是美国急诊科医师的日常日子，咱们今日谈谈这个论题怎么？
Dr. Hou, many good topics have 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. 侯：当然。
Sure.
Dr. 宋：作为布列根和妇女医院的学术型急诊科医师和危重医学专家，您能够和咱们共享一下您典型的一周作业时刻表吗？
As an academic emergency physician and an intensivist at Brigham, could you kindly share with us your work schedule in a typical week?
Dr. 侯：没问题。
Absolutely.
Dr. 宋：您能先和咱们聊聊您的临床时刻表吗？
Could you tell us your clinical schedule first?
Dr. 侯：作为哈佛大学隶属医院的学术型急诊科医师，咱们每年的临床作业要求为 1196 小时，每周分配 26 个临床小时，每年为 46 周，预期将留下 40 小时/周的作业时长的 1/3 用于教育和研讨。与非美国学术型急诊科的临床作业要求比较，咱们的临床小时数好像较低，但它与大多数美国学术型急诊科一起。
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 leave 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 .
在布列根，咱们的急诊科作业班次大多为 9 小时； 因而，全日制学术型急诊科医师将每周作业 3 个班次，每年为 46 周。就我个人而言，我的急诊科临床作业许诺是 0.5 FTE（或全职等效），因而我在急诊科中每周均匀作业 26 小时，为期 23 周，而我的其他 0.5 FTE 分为 0.3 FTE，这代表了我的 8 周外科 ICU 临床作业许诺和 0.2 FTE，这代表了我用于临床研讨的「买断」时刻。
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 average 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. 宋：那么研讨方面，你都做些什么呢？
S: So for research, what do you do?
Dr. 侯：我参与的研讨项目主要是脓毒症和急性呼吸困顿综合征（ARDS）的临床实验和研讨。我曾是前期感染性休克协议化护理（ProCESS）实验以及许多美国国立卫生研讨院（NIH）和商业临床实验和研讨的中心课题担任人。现在，布列根是美国国立卫生研讨院赞助的急性肺损害防备和前期医治（PETAL）网络的一个中心，我是新英格兰组急诊肺损害（ALIGNE）临床中心的一起课题担任人和 PETAL 网络督导委员会 成员。别的，我也是 PETAL 网络实验的中心课题担任人。
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. 宋：那教育部分呢？
How about teaching part?
Dr. 侯：我的教育包含专科训练医师、住院医师、医学生、医师助理学生、大学生在急诊科和 ICU 等临床环境以及教室的见习。关于咱们的外科 ICU 专科训练医师，我在星期一和星期二参与他们的教育会议；关于咱们的急诊科住院医师，我参与他们的教育课程，并在周二下午参与了死亡率和发病率（M＆M）会议和伤口会议；关于医学生来说，我参与的是他们的方针结构化临床考试（OSCE）和专题讲演。
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. 宋：谢谢您。除了临床、教育和研讨作业外，您还有其他使命吗？
Thank you. In addition to clinical, teaching, and research efforts, are there any other duties or obligations?
Dr. 侯：是的，最重要的使命之一是对咱们的训练生和咱们的初级教员进行导师辅导。此外还有基金申请和发表文章。
Yes, one of the most important obligations is Mentorship to our trainees and our junior faculty. in addition, we have expectations regarding Grant application, and of course, Publications.
Dr. 宋：你每年需求参与的学术会议是怎样的？
How about academic conferences that you may need to attend every year?
Dr. 侯：我通常会参与学术紧迫医学学会（SAEM）年会和重症医学会（SCCM）大会，特别是当我的搭档，住院医和我有文章摘要的大会讲话。
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 have abstracts to present.
Dr. 宋：
那么，在典型的一周里，您每个星期都会统筹这些学术使命的不同组合，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. 侯：是的，这就是美国典型的学术型急诊科医师的作业时刻表。
Yes, this is what a typical academic emergency physician’s work schedule in the US.
中美医师介绍
美国医师：侯全益医师，哈佛医学院急诊科讲师, 布列根和妇女医院急诊科医师，外科 ICU 重症监护专家。
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.
我国医师：宋瑞医师，曾在我国和新加坡担任内科住院医师，现为自在作家，一起在波士顿进行自闭症相关临床研讨。
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.
假如你是医学英文爱好者，欢迎回复加群，补白：医院+医学英文，参加医学英文爱好者群中，还会有单词小笔记送出！
References
Protocolized Care for Early Septic Shock (ProCESS)
https://clinicaltrials.gov/ct2/show/NCT00510835)
Prevention and Early Treatment of Acute Lung Injury (PETAL) Network
http://petalnet.org/
Reevaluation Of Systemic Early Neuromuscular Blockade (ROSE)
https://clinicaltrials.gov/ct2/show/NCT02509078)
Vitamin D to Improve Outcomes by Leveraging Early Treatment (VIOLET)
https://clinicaltrials.gov/ct2/show/NCT03096314)
Crystalloid Liberal or Vasopressors Early Resuscitation in Sepsis (CLOVERS)
https://clinicaltrials.gov/ct2/show/NCT03434028).
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