This doctor is already middle-aged, and he's only just started practicing medicine.

Chapter 2: Get stronger by adding skill points.

After seeing his uncle Lu Nanyong off, Lu Cheng immediately went to the 'training room' that his house had been converted into!
Upon opening the door, a pungent smell of tofu, dried tangerine peel, and pork skin assaulted his nostrils, causing Lu Cheng to instinctively frown.

[Overall Level: Resident Physician]

【基础理论：外科学（熟练9/10）、骨科学（熟练8/10）、手外科基础理论（熟练7/10）、创伤外科基础理论（熟练8/10）、急救医学（熟练5/10）……】

【外科基础技能：X线阅片术（熟练8/10）、CT阅片术（熟练8/10）、核磁阅片术（熟练9/10）、外科器械操作经验（熟练8/10）、体格检查（专精1/20）、辅助检查阅读技能（熟练9/10）】

【外科基础操作：切开术（熟练9/10），清创术（熟练8/10），缝合术（熟练8/10）、打结术（熟练8/10）、穿刺术（熟练7/10）、止血术（熟练4/10）。】

【外科基础术式：骨折切开外固定术（熟练1/10）、骨折手法复位术（熟练2/10）、骨折切开复位内固定术（熟练0/10）、关节脱位手法复位术（熟练1/10）……】

Lu Cheng looked at his panel, his smile somewhat forced.

Basic theories can be learned by reading books, image interpretation skills can be improved by reading a large amount of imaging materials, and basic surgical skills can also be practiced in the 'practice room'.

However, surgical skills cannot be learned in a 'practice room'; learning surgery is a gradual and painstaking process.

"The emergency department doesn't perform fracture surgeries, and Director Peng of the orthopedics department wouldn't allow the emergency department to handle fractures and shake the foundation of orthopedics, so let's leave it alone for now."

"In the emergency department, we will do simple debridement and suturing if possible."

As Lu Cheng spoke, he opened his notebook, which he kept in the training room.

These notebooks are Lu Cheng's accumulated basic skills practice notes from the teaching hospital, recording the corresponding abilities for different levels of operational proficiency.

[Suturing technique: superficial suture (completed), stretch bandage suture (pending breakthrough); after complete suturing of the stretch bandage, the tendon can be sutured. No one in the orthopedics department of Longxian People's Hospital can handle tendon sutures perfectly and smoothly.]

"Since Director Peng said that tendon injuries cannot be treated in orthopedics and must be transferred from the emergency department, then I will start by trying the tendon suturing procedure."

Every advancement in medical technology is the result of painstaking effort, requiring years of refinement.

Lu Cheng's basic skills were not bad in the department. In fact, his basic skills in debridement and suturing were comparable to those of the deputy chief physicians in the department. However, he was only comparable, not superior.

[Remaining skill points: 13.1 points.]

How about adding some?

[Suturing (Proficiency 10/10): Requires 10 skill points to advance to the next proficiency level.]

"We still need to push through the levels? That seems reasonable."

With 11.1 skill points remaining, Lu Cheng naturally chose to attempt the next level.

【缝合术（专精0/20），缝合术基本功提升，缝合系技能被动提升。肌腱缝合术（入门2/5），皮瓣移植缝合术（入门4/5）。】

After adding the points, Lu Cheng felt as if a surge of heat was coursing through his hand, gathering in his palm before slowly dissipating. Nothing new came to mind.

The suturing method for tendon repair is not a "secret technique." A simple online search will yield a plethora of theories. In this age of highly developed information technology, obtaining the theory is not difficult at all.

Surgical techniques cannot be achieved simply by theoretical knowledge or by simply knowing what to do.

Just like cooking, besides knowing the ingredients, the processing of the ingredients and the heat are also very important. If you make a mistake in any step, it will affect the final taste.

If surgical procedures could be performed simply by knowing how to do them, then online celebrity doctors on short video platforms would have already trained millions, or even tens of millions, of top-notch surgeons, and China's surgical capabilities would be terrifyingly strong!
The tourniquet, not a direct translation of the Japanese slang term, is a tool used by nurses to draw blood from veins; it is very elastic.

Stretching a tourniquet, as the name suggests, involves placing the tourniquet under tension, cutting it shorter, and then sewing it back together with sutures. The skill of sewing is considered to be achieved if the sutures are broken and the tourniquet is not torn.

This is a basic training material for analog tendon suturing, and it's also an introductory material. If you want to practice more advanced tendon suturing techniques, you will need to buy real animal materials such as pig tendons for practice.

Tendon suturing is an introductory procedure in hand surgery; it's not easy to get started, and it's even harder to master.

It's not an exaggeration for hand surgeons that at least 80% of surgeons cannot perform tendon sutures...

Lu Cheng watched a video online about practicing stretching and suturing a tourniquet. The tourniquet was held in a passively stretched state with nails, and then cut with scissors, causing the tourniquet to break and shrink.

Lu Cheng then meticulously reviewed the standard interrupted suture procedure for tendons and began performing simple interrupted sutures. Simple interrupted sutures are the simplest suturing technique, a medical skill that even interns can master.

However, it's not easy to sew it up properly.

Even if you want to start practicing suturing, stretching, and compressing blood vessels like Lu Cheng, you need to go through layers of practice before you can even have the ambition to covet it; otherwise, it's just a waste of resources.

For example, the most basic techniques include making anthropomorphic rubber skin, banana peel, orange peel, half-layer orange peel sewing, orange pulp sewing, deep tofu sewing, and shallow tofu sewing.

Most surgeons probably give up once they get to the halfway point of the orange peel-like texture and start suturing...

Specialists who don't require highly sophisticated suturing techniques don't bother with all the fancy stuff in suturing; as long as they can put the skin together without infection, that's enough.

Lu Cheng picked up the needle holder. The two handles of the needle holder scraped against the calluses on his right ring and middle fingers, which made Lu Cheng feel slightly uncomfortable, but he quickly got used to it.

About twenty minutes later.

Lu Cheng looked at the three tourniquets he had sewn on, put down the needle holder, took off his examination gloves, and carefully examined them...

"Even one of them broke! It seems that reaching this level doesn't guarantee a 100% success rate in suturing."

"However, with practice, I should be able to suture common tendon injuries!"

"The rate at which this skill is being improved is far too fast, many times faster than practicing suturing on my own in private."

"These skill points can be accumulated in half a month, and that's in orthopedics where there are very few opportunities for hands-on practice. What if I could get more hands-on experience in the emergency department?" Lu Chengdu couldn't even imagine how fast his improvement would be.

Or rather, Lu Chengdu dared not imagine how insignificant his own abilities were in the face of a 'cheat code'!

"It seems that many top teaching hospitals' hand surgery departments use tendon suturing as the clinical operation standard for doctoral graduates, but I don't know if that's true or not."

"But none of this matters to me. Getting some sleep and getting to work in the ER early tomorrow is the real priority!"

"I've been practicing with the progress bar for almost half a month, but it hasn't moved an inch. Reading books isn't helping either. It's probably because my progress is too slow, or maybe each step up the progress bar requires a lot of knowledge..."

"Perhaps the 0.1 progress bar won't be displayed on the panel," Lu Cheng said in a low voice.

Lu Cheng is a science student, so it's something that can be analyzed.

Beginner level: N/5; Proficient level: N/10. Professional PhD graduates typically have eleven years of medical training; including completing the initial stages, they would need around 30 points of progress.

On average, it only takes three points a year. With only half a month of whirlwind visits and occasional practice, it would be strange if you could even push it a little bit...

Learning technical skills is very difficult.

After taking a few deep breaths, I began to tidy up the workbench, masks, and sewing threads, and then cleaned them before putting them into a small sterilizer.

Back in his room, Lu Cheng tossed and turned, unable to fall asleep.

Thirty is the age to establish oneself; in many industries, this age is when one can retire.

However, in the medical field, it is still young and inexperienced.

He had always had this thought in his mind: hand surgery specialists graduate at around 29 years old, and their average level upon graduation is 'tendon suturing'.

Suturing is the most proficient medical skill of hand surgeons...

So even without a 'panel' to guide me, tendon sutures are only 'one step away', and that's assuming I don't have a teacher or mentor to help me improve my efficiency...

Ah, man, fate, and timing...

Lu Cheng looked out the window. The hot wind made the branches sway, and the dappled moonlight poured into the room, cutting the darkness into pieces and making Lu Cheng's mood uneasy.

But that doesn't stop Lu Cheng from going to work after dawn.

(End of this chapter)