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Medical Grand Rounds at Peking Union Medical College Hospital
CopyFrom: PUMCH UpdateTime: 2021-03-24 Font Size: SmallBig

PUCMH owns its centennial success to great traditions and systems both academic and managerial. One of these traditions is the weekly grand round organized by the Department of Internal Medicine. The grand round is a multidisciplinary consultation for patients with critical conditions or difficulties in diagnosis and treatment. It’s also a good opportunity for junior doctors to learn and progress. In this article, Dr. Zhang Fengchun, director of Internal Medicine will be giving a detailed description medical grand rounds.

With the rapid development of modern medicine, the distinctions between subspecialties become finer and subtler. This may have promoted more precision in medicine, however, it has also led to problems that specialists usually focus more on their narrow areas or specific diseases. While the grand round, which has been held ever since PUMCH was established a hundred years ago, provides a chance for specialists to communicate and cooperate, discuss complex or rare cases, and learn from each other.

Each grand round has the following 5 steps.

Step 1: Case selection. The chief residents are responsible for selecting a case from subspecialties. The selected case should fulfill at least one of these three criteria: rare cases, difficult cases in diagnosis and treatment, or cases worthy of teaching.

Step 2: Case preparation. Responsible resident and attending physician will collect patient’s clinical data and ask related specialties to give primary suggestions before the grand round.

Step 3: Case presentation. The resident will introduce the case history first. Then the attending physician will give a brief summary and analyze differential diagnoses, then pose questions in diagnosis and treatment.

Step 4: Case discussion. This is the most attractive section of the grand rounds. Related specialists will raise questions and make comments regarding the differential diagnosis and treatment. Diverse suggestions and even controversial opinions are given. Heated discussions and debates are commonly seen.

Step 5: Summary. At the end, the director of Internal Medicine or director of the department will summarize the suggestions and state the treatment plan.

The internal medicine grand round helps solve problems in the diagnosis and treatment of patients. At the same time, it provides a platform for doctors to learn from each other, improves the cohesion within and between departments, and forms a patient-centered multidisciplinary alliance. The grand round has become a historical record of the growth of medical masters and a banner of inheriting and carrying forward PUMCH culture.


Translator: Zheng Xixi

Editor: Zhuang Junling