Clinical Exchange in Japan

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Tulane-Nagoya Medical Student Exchange Program: A Personal Reflection

Mr. PEI, Theodore Tze-Sheng from USA
period: 2014/4/7-5/2

My pediatric month-long rotation at Nagoya University Hospital was without a doubt one of the most memorable and rewarding experiences of my entire life. From an academic perspective, I was initially apprehensive due to the anticipated language barrier, and I expected my learning opportunities would be limited at best. This however was far from the truth. Not only were the attending physicians proficient in English, many of them, as I would learn, spent years in post-graduate training in the United States at such esteemed institution as the NIH and CDC. Furthermore, far more crucial than the ability to communicate was the motivation to teach and share. My attending physicians - every last one of them - were so utterly enthusiastic to teach me their craft and their culture, I felt embarrassed at times to have expected anything less. While I cannot recall the names of all my attendings, these individuals in the departments of hematology/oncology, neonatology, neurology, and the incredible department of cardiology at Chukyo Hospital will forever have my deepest gratitude and respect. But besides the individuals, as tertiary care centers, Nagoya and Chukyo provided the opportunity to observe and learn about otherwise rare congenital and oncologic diseases at centers of specialized excellence. For example, the hematology/oncology ward alone had several dozen patients at any given time suffering from rare leukemias with incidences of 1:10000 or less.

Furthermore, what I found equally if not more fascinating and rewarding was learning about and experiencing the mechanics of the Japanese socialized healthcare system. Efficiency, order, and thorough documentation, as I would quickly realize, are not just themes in Japan, they are intrinsic virtues built into every facet of the proud nation’s culture and society. When applied to healthcare delivery, the result is a system that is second to none. In stark contrast to the fragmented, blunderous, and broken American healthcare system, Japanese citizen enjoy a healthcare machine that is streamlined, government supported, and effective. My attendings, unhindered by for-profit insurance companies and unnecessary administrative paperwork, were able to focus nearly 100% of their attention on patient care and teaching students like myself. This epiphany made perhaps the most significant impact on my experience as a future physician. Moreover, aside from the medical educational experience, it goes without saying that what truly exceeded every nuance of what I thought Japan would be like, what I could not have ever anticipated, was the initial shock and ultimately love affair I would have with Japanese food and culture.

Japan is the polar opposite of America in so many ways that it simply defies description. And yet, there is absolutely beauty and bewilderment to be found in every corner of this island nation. Japanese people are exceptionally, and to any unprepared American, incomprehensibly indebted to helping their fellow human in any way they can, bar none. I was chased down a full length train platform by a woman on the train to return a banana that I dropped, and this was just one of many examples. Regarding the food, I simply cannot understand how food can at once be incredibly healthy, well-portioned, affordable, diverse, and palate pleasingly delicious beyond any reasonable description. Japanese art, architecture, and wilderness as I experienced in Kyoto was beyond sublime, and made me in awe at the respect Japanese citizens have for their history and leaders of eons past. Then of course there’s Tokyo where pulsating masses of people, electrified lights and marquees, and all night raging parties will give any major metropolis a run for their money any night of the week. In the end, I will simply say this opportunity is not to be undervalued, squandered, or feared in any way whatsoever. It will change you and spin you around until you are dizzy and drunk and cannot take any more, and then it will leave you asking for more. This is an experience of a lifetime, nothing more and certainly nothing less. And they love cats there, enough said.

Special thanks to Dr. Kondo and Dr. Kojima for their kindness, teachings, and commitment to the exchange program. I certainly hope visit you both again some day.

Theodore Pei, MD, MPH
Tulane SOM, Class of 2014

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