Clinical Exchange in Japan

Japan was the perfect destination for my elective and it was a privilege to rotate through the surgical departments at Nagoya University Hospital. My university has been a sister school with Nagoya University for over two decades and has hosted Japanese students ever since. I had the opportunity to meet a few of them and learn about Japan, which led to the decision to apply for the clinical clerkship, not only for my personal, medical benefits but also to expand cultural horizons. I began the application process a year before my arrival with the International Affairs Office staff, where Dr. Hitoki Hasegawa and Miho Kobayashi assisted me greatly in sorting everything out.

Pediatrics/NICU/Hematology and Oncology

From the beginning I was welcomed with open arms by professors and doctors. As a member of the Pediatrics, and later NICU and Hematology team, each morning I would come to the given department for rounds and lectures on key pediatric topics. After that, I was assigned to a physician who would discuss the patients’ history, diagnosis and treatment. Much of the rest of the day was spent on patient care. Twice weekly conferences were held, assessing all pediatric patients in the hospital. Due to my presence, the conferences were conducted in English, for which I was extremely grateful. Prof. Takahashi’s evening oncology-hematology rounds were interesting, as they gave an opportunity to learn about successful leukemia and solid tumor treatment details directly from a widely recognized researcher.

Pediatric Surgery

Prof. Uchida introduced me to his team who took great care of me. I observed and scrubbed in operations throughout the clerkship and was exposed to cases that I may not be able to find in Europe, for instance biliary atresia. I was truly impressed by the professor’s and doctors’ willingness to educate me and explain every step of operations despite how busy they were. What surprised me more was how hardworking the small team was, compared to other faculties. I stayed with the surgeons as long as I could to learn as much as possible, often leaving the hospital around midnight. Despite long hours spent in the operating room, the atmosphere was relaxed and fun. At the end of most of the days a late evening conference was held, either in English or kindly translated for me by Dr. Tanaka. During my farewell party, Dr. Shirota gave me a lovely Japanese souvenir: beautiful chopsticks with sakura drawings, symbolizing the ongoing spectacular cherry blossoming.

Gastroenterological surgery II

This rotation was my personal favorite. Prof. Kodera welcomed me to his department and explained when and where certain GI teams operate, giving the opportunity to attend procedures which interested me the most. Showing interest in upper GI operations, I followed that particular team three days a week in the OR and during the rest of the week I joined students for scheduled lectures and classes. The lectures were held in Japanese, thus I spent that time in the simulation lab, to which prof. Kodera had given me access. There, I practiced computer simulated operation techniques and polished laparoscopic skills, which I consider as the most valuable skill gained during the entire clerkship. I was surprised by the number of advanced simulators and learning equipment available for students, basically at any time throughout the day. Later during the clerkship, Prof. Kodera and Dr. Tanaka invited me to a few dinners to explore exquisite Japanese cuisine which was without a doubt a fantastic and delicious experience.

Orthopedics and Rheumatology

As I was escorted to the department, I was welcomed and introduced to doctors of various teams. I was then presented with the timetable of planned operations which I would attend. In the morning I would accompany a pediatric orthopedist, Dr. Matsushita, at his outpatient clinic twice a week and assist in operations during the rest of the week. I was exposed to a few periacetabular osteotomies for developmental hip dysplasia. At the clinic every case was thoroughly explained to me and during consultations I would perform physical examinations. I was truly impressed by Dr. Matsushita’s effort and willingness to answer all my questions despite his busy schedule. On the alternating days, I joined other orthopedic teams, the Tumor Surgeons, Hip Surgeons and Sports Medicine Surgeons and attended to their journal clubs in the morning and assisted in operations. I had a chance to see a few femoral fracture surgeries and osteosarcoma resection with reconstruction. Once a week I would attend Prof. Ishiguro’s evening rounds and be asked a few questions on orthopedic diseases present in Poland. This clerkship has served as a great experience for me, given my keen interest in Orthopedic surgery.

Nagoya and beyond

Apart from my time in Nagoya, I was also able to travel all over Honsiu and Hokkaido by the Shinkansen train and plane. Kyoto was without a doubt the most beautiful city I have ever visited; unique and lovely preserved with gems at every corner. I was fortunate to be hosted and guided by Dr. Hinoki’s family around modern, busy Tokyo and see parts of the capital known mainly to locals. The prime destination for art devotees is Naoshima – a remote island home to several Tadao Ando’s museums and breathtaking Chichu Museum. Traveling in Japan is easy, convenient and fast and Nagoya’s central location allows easy weekend getaways to far, northern Sapporo or nearby Nara.

Nagoya University Hospital is an academic care center offering the opportunity to see rare pathology that would be hard to encounter during a medical career in Europe. I would strongly encourage medical students to pursue a clinical clerkship in this institution – one of Japan’s best. This stay provided me with invaluable experience of healthcare in a foreign country while expanding my medical knowledge and skills. The friendliness and openness of all departments, complexity of cases, and great teaching environment made my experience truly enjoyable. It was an honor to work with and learn from the excellent physicians of Nagoya University.