Office of International Affairs Graduate School of Medcine Nagoya University

My name is Marit Lien and I am a 5th year medical student at Norwegian University of Science and Technology. I came to the University of Nagoya to participate in a project at the Department of Psychiatry, and stayed from the 1th- 10th Of October 2018. My task was to perform a back translation of a clinical scale from Norwegian to English.

I had never been to Japan and knew very little about the organizing of the exchange when I arrived in Nagoya, but Miho Kobayashi at the Office of International Affairs was of great help and answered all my questions. She also helped my get in touch with a club for medical exchange students (MDEC) and I spent a lovely day with them exploring the city.

I was provided with a guest room in the hospital grounds throughout my stay, which was very convenient. I was also given a shared desk together with other students at the Department of Psychiatry and introduced to those who worked there.
The first day I was given a tour around the psychiatric outpatient clinic and the next day I got to follow one of the residents during some of his work at the inpatient clinic.

Japan is a very friendly country and I had a great time exploring such a different culture. Also, Nagoya is a great starting point for visiting more of Japan, since it is easy to reach a lot of other cities by train.

In June 2018 I spent two weeks with Nagoya University's Psychiatry Department. I found the help given from the International Office with regards to the application process before arriving, and also during the stay at NU, very helpful and essential in sorting out the right documents. I also found the help given at the International Dorm where I stayed were good!

During the two weeks at NU, together with my fellow Norwegian student Ida Steiro, we were given the task to translate the Drug Induced Extrapyramidal Symptoms Scale – DIEPSS – from English to Norwegian. We were taught the specifics of the scale by its developer Inada, Toshiya and watched educational videos that explained the different symptoms and their degrees. I found the experience of translating both interesting and educational.

The translation project was, as it turned out, the only programme that was planned for our stay, and since it did not take long to complete, and since we came to NU department of Psychiatry with hopes of gaining knowledge of Japanese psychiatric practice and to see some of the hospital, we had expectations that did not match what was planned for our stay. The exchange also did not match what had been laid out in the Norwegian application for the short-term exchange as it said we would see some ongoing clinical research and more. We were told we had arrived at an odd time as not much research was being done at that time – which made us confused as to why NTNU and Nagoya had chosen this specific time for two Norwegian students to arrive. Also, although the translation work itself was interesting, we could technically have performed that work from Norway, so I struggled to see why an exchange had been planned if this was its only goal. Ida and myself were chosen among several applicants for this exchange, and as I understand it, that was because we were the most motivated applicants – and therefore it should be noted that I did not come to Nagoya hoping for a holiday – I came motivated to learn.

Fortunately, we met a doctor specialising in psychiatry who suggested he could give us a tour of the hospital and when we asked he let us follow him for two half days during his hospital rounds. I found this experience very rewarding as through conversations and asking questions I gained knowledge of how the Japanese health system in general, and psychiatry in particular, is organised and how Japanese culture influences patients' strengths and challenges. These experiences made a large difference to me with regards to the exchange and I am very grateful for them.

I explored the specialty foods of Nagoya and made trips to Onsens and gardens around Nagoya, which was very enjoyable. Thank you for being a wonderful country and people! And thank you to everyone at NU that helped me at my time there!

In the last half of June 2018, I spent two weeks at Nagoya University together with my fellow medical student Kristina Albertsen. During the planning and preparation for our trip to Japan the International Office of Affairs at Nagoya University were incredibly helpful, as they provided us both with the necessary documents for our stay at the university, our accommodation, as well as maps on how to get around in Nagoya and even tips about sightseeing etc.

The purpose of our stay was the translation of DIEPSS, Drug-induced Extrapyramidal Symptoms Scale. Professor Toshiya Inada at Nagoya University is the developer of this scale. Before we started with the translation Inada had an extensive lecture with us where he explained the symptoms and showed us videos on how to differentiate them in terms of severity. Working on the translation was both interesting and educational. Through the work I have got a better understanding of how challenging it can be to assess symptoms using a scale like this, an instructive experience I will bring with me in my future work as a doctor.

Unfortunately, it turned out that the translation project was the only thing that was planned for us during our stay at Nagoya University. From our home institution we were given expectations that the short-term mobility program would include the chance to getting insight into ongoing research at the Department of Psychiatry including the opportunity to collaborate with Japanese students for research. Unluckily there were no research going on at the laboratory at the time we were there.

During our stay at the university we were introduced to a doctor who are specializing to become a psychiatrist. He was very helpful and obliging and told us that we could contact him if we wanted to see some of the wards in the hospital. He showed us around at the ward of Psychiatry and Paediatrics, and we even got the opportunity to follow him during his clinical work. This was both interesting and exciting, among other things we got experience in how the relationship is between doctor and patient in the Japanese culture and we also got to see some more of the facilities of the hospital.

As the work with the translation was quite limited, we had much time to experience the Japanese culture and do leisure activities. Among other things, we visited Nagoya Castle, the Japanese garden Shirotori Garden, historical museums, temples and several of the parks scattered around the city. This was exciting, and through these activities I have got an insight into the Japanese culture. I also got the opportunity to try some of the local food, including tebasaki, spicy Japanese fried chicken, at a local restaurant famous for serving this dish. It was very good and tasty! However, one of the things I appreciated the most among the different activities we did was onsen, the Japanese hot springs. The relaxing atmosphere, the variety of hot baths and the cleanliness one feel after spending some hours in an onsen is amazing – at least that is my experience.

To sum up, I am very grateful for been giving the opportunity to travel to Japan and Nagoya. Even though the stay turned out to be quite different from what I expected, I have experienced a lot and among other things I have gained some insight into the Japanese culture and health system. Getting to know other cultures different from one’s own is valuable in many ways – it adds to a more open-mind as well as knowledge, experience and a better understanding of one’s fellow humans. These are things I will bring with me – also in my future clinical work.

Professor Toshiya Inada, the man behind DIEPSS. My fellow medical student, Kristina Albertsen, to the left.

Visiting a traditional Japanese garden.