保研贴97期 | 上交第六人民医院超声直博
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本文总计3497字。
讲 者 介 绍
姓名：十月学姐
本科：东部地区某985
专业：临床医学
成绩：4/20
英语：四级592；六级483
荣誉：B奖、C奖若干次，“深圳杯”数学建模挑战赛一等奖、校社会实践一等奖
科研：主持上海市级大创一项
参营：湘雅医院皮肤科、上海新华医院皮肤科（夏令营）、上交六院超声科（预推免）
最终去向：上海交通大学影像医学与核医学
录取截图：
推 免 前 言
基于我当时对动手能力的认知，我将外科一票否决了，保研后经过外科系统实习的亲身体会，发觉自己的动手能力其实还不赖，整复外科和眼科真的相当不错，但终究是有缘无分了，不过这两个科室未来工作和科研的竞争都不小。我当时的目标科室是：皮肤科、辅助科室、精总。定好大致方向后，就是准备材料和寻找心仪导师了。
关于材料，我的做法是，按照时间顺序整理各类证书，梳理大学三年的经历。然后开始着手制作简历，简历最好用一页的模板，可以参考下《令人心动的offer》中的模板。如果觉得自己的经历乏善可陈，可以和了解你的朋友或者老师聊一聊，换一个视角看待自己。而且提前做简历，可以清楚地看到自己的短板，如果时间允许，尽量补救。比如说，我的六级很差，年少无知，三年前裸考过了，之后居然没有刷分，后悔不已。所以开始准备雅思考试，但因为疫情的原因，报名的场次接连取消，好在最后考到一场，勉强补救。
个人陈述一定要融入个人特色，并且熟悉你写进去的每一个点。推荐信能拿到行业大咖的推荐信当然最好，如果不能，要找跟你接触更多的，我找了历时两年的大创的指导老师、毕设指导老师、上课+PBL+实习带教老师，可以从不同的层面，多角度、综合反映你的真（yi）实（dun）情（ga）况（kua）。
导师的重要性不言而喻，因为我选择的是科研型，所以除了关注老师的学术水平如论文、基金，也要了解老师的处事风格。除了邮件往来，还是线下跟门诊、面谈效率更高。
夏 令 营
一、湘雅医院皮肤科
湘雅医院的夏令营在2020-07-27线上面试，算是开始的最早的一批，正式开始前对科室的老师做了全面的介绍，然后进入个人面试环节。5分钟的英文自我介绍后，问了些面试常规问题，有点像聊天性质的，氛围轻松，拿到优秀营员。
问题：
1.为什么选择皮肤科？
2.除了我们，还报名其他学校了吗？
3.为什么选择我们？
4.喜欢长沙这个城市吗？
……
结果：获得优秀营员。
二、上海新华医院皮肤科
因为交大系统，只允许参加一个夏令营，想来是怕我们实习请太多假，哎，一把辛酸泪。而疫情下，有些医院是否举办夏令营都是未知（such as 九院今年没举办），所以新华出了夏令营就赶紧报名了。说来惭愧，知道有个大佬和我报了同一个老师后，复习和面试准备都非常潦草，当大佬自我介绍完，我就知道我凉了，甚至英文自我介绍的时候看了好多次稿子，引以为戒。
夏令营包括笔试和面试：
笔试题型为名解、简答、中译英、英译中。
名解&简答：溃疡、皮肤的结构与功能、皮肤性病的临床表现及诊断、荨麻疹类皮肤病、重型药疹、银屑病的分类、红斑狼疮、大疱性皮肤病的分类。
英译中：一面A4纸，对特应性皮炎的认识的变化和几个诊断标准，不难。
Current status in diagnosis of atopic dermatitis in China
In China, eczema and atopicdermatitis (AD) have been traditionally considered as two distinct entities.Eczema typically referred to the milder phenotypes or to phenotypes withatypical morphology and distribution of lesions, and many dermatologists have neverrecognized that the “eczema” diagnosed clinically by them is actually milderphenotypes or phenotypes with atypical morphology and distribution of lesionsof AD. Moreover, AD, contact dermatitis, diaper dermatitis, perioraldermatitis, halo dermatitis, pompholyx, seborrheic dermatitis, etc. are notincluded in category of “eczema” in Chinese textbook of dermatology.
A diagnosis of AD is used by most ofdermatologists only when the clinical manifestations are significantly typical,such as “symmetrical and flexural dermatitis.” A substantial part of Chinesedermatologists argue that the diagnosis of AD must be restricted to thosephenotypes who stringently fulfill the Hanifin and Rajka or U.K. WorkingParty's Criteria. In particular, a positive family history of atopy isconsidered as a crucial criterium for the diagnosis of AD. In situations ofunclear information on that specific item, the cases are considered as anotherdisease and classified as eczema and not as AD. Thus, the proportion of phenotypesdiagnosed as eczema is much higher than that classified as AD (estimated 70% vs30%, unpublished data by Guo Y., Cheng R., and Yao Z.), ultimately leading to alower figure of the prevalence of AD in China. A study in 2002 conducted bydistributing 49 241 questionnaires to 10 provincial capitals showed thatthe prevalence of AD in children aged 1‐7 years was 3.07% using U.K. diagnostic criteria.
In traditional Chinese medicine,various names had been used to describe the phenotype of eczema or AD such as“infra‐auricular andretroauricular rash” and “scrotum wind,” equivalent to scrotum eczema. Somepatients with “flexural lesions of elbows and knees” have been early noticedand named “four‐flexural winds.”Obviously, this phenotype is the equivalent of AD according to the criteriafrom western countries.
It was not until Hanifin and Rajkacriteria were introduced in China in the mid 1980s, dermatologists began to payattention to focus and recognize AD as a single entity. They took great effortto recite and apply indiscriminately the criteria and made diagnosis of AD. In1989, Kang and Tian collected clinical and laboratory findings from 372 Chinesepatients with the phenotype of AD and suggested two basic features and sixgroups of minor features. It is now recognized as a summary and simplifiedversion of Hanifin and Rajka criteria. In 2001, Gu et al. evaluated thesensitivity and specificity of the U.K. Working Party criteria as well as Kangand Tian criteria in diagnosing AD in China. They used the Hanifin and Rajkacriteria as gold standard, indicating that AD is diagnosed bydermatologists strictly according to criteria at that time. Recently, a set ofcriteria for adult/adolescent AD was proposed by Liu et al. including one essential condition, that is,“symmetrical eczema (dermatitis) for more than 6 months” plus one or moreof the following “personal and/or family history of atopic diseases” and/or“elevated total serum IgE level and/or positive allergen‐specific IgE and/or eosinophilia.”These criteria automatically ruled out atypical forms of AD.
In recent years, dermatologists inhospitals carrying out clinical or basic research were pioneers in questioningthe established approach, that is, using a stringent application of the H&Rcriteria. They also addressed some key issues such as (i) the comparativeperception and the meaning of AD and eczema in China and other regions of theworld and (ii) the impact of these differences in terms of epidemiology, thatis, seemingly lower prevalence in China.
From December 2013 to February 2014,a group of well‐experiencedChinese dermatologists conducted a nationwide study in 12 metropoles to explorethe prevalence of AD in China. The prevalence of AD based on clinical diagnosisby dermatologists was 12.94% overall. However, when stringently using U.K.Working party and Hanifin and Rajka diagnostic criteria of each subject, theprevalence of AD among the same population was drop down to 4.76% and 4.62%,respectively. The detailed analysis showed that a significant number of casesof mild phenotypes could not fulfill the diagnostic criteria. This was furthersupported by the fact that when using SCORAD as a severity scoring system inthe pediatric population, mild AD accounted for 74.6% of all AD.
In summary, the stringent use of theclassical criteria of Hanifin and Rajka seems inappropriate for the diagnosisof AD in China. Whether this may also be partly due to possible differences inthe clinical phenotype related to the ethnic background needs to be furtherexplored. This has a substantial impact on epidemiology as well as many otheraspects related to basic research up to translational and drug developmentprograms in this country. On the other hand, quite a few Chinese dermatologistshave recognized the gap between Chinese and international view on thediagnostic criteria of AD, as well as the need for harmonizing the name of ADon a global level. However, there is still a long way for most dermatologistsin China to accept this uniform view on the disease.
中译英：皮肤病临床表现相关，建议掌握一般词汇及临表相关词汇。
面试：英文自我介绍+提问
结果：未获优秀营员。
预 推 免
上海六院超声科直博
面试为主：
1、在开展“大创”过程中有什么收获？让你对科研又有哪些认识？
2、为什么选择我们科室？你对成为一名超声医生怀有怎样的期待？
3、“多学科交叉”将为超声医学的发展带来怎样的前景？
4、If there were an opportunity of studying abroad at postgraduatestage, what would you do？
5、What is your greatest strength？
结果：拟录取。
个 人 感 想
2020年的寒假因为疫情分外漫长，在刚开始的一个多月里，我沉浸在各种网络上的负面情绪中，惶惶不可终日。后来因为不得不开始写毕业论文，才把自己从泥淖里拖拽出来，开始思考为推免准备弹药。因为我们班从大一就开始为保研焦虑，而且保研率较高，我没有过多的为保研名额纠结。反倒是因为纠结排名第三还是第四浪费了很多精力，现在想来，实在是毫无影响。成绩更像是一块敲门砖，拿到推免资格后，大家比拼的更多是综合素质。
科室要考虑清楚，毕竟这可能是一辈子从事的事业，但也要结合实际情况动态调整，如果本着“我一定要去XX科不可”的态度，可能会越走越窄，失去很多机会。
我的推免之路充满戏剧性，正如我之前的很多经历一样，有心栽花花不活，无意插柳柳成荫。计划好的路走得异常艰难，给自己更多选择和更多可能后一切顺遂的不可思议。找老师的这几个月或许很难，尤其看着身边的同学一个个定下来，但要始终相信“柳暗花明”也许就在明天，所以再坚持一下吧！
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