Clinical Exchange in Japan

As a medical student interested in a career in surgery, I was fortunate to be placed in the Division of Surgical Oncology within the Department of Surgery during my rotation at Nagoya University Hospital. I knew that healthcare delivery varied significantly between countries, particularly those with centralized (as in Japan) versus decentralized (as in the United States) healthcare systems, and I was excited to learn about these differences. I also knew that there were certain cancers, such as gastric cancer, that were more common in Japan than in the United States, and I hoped to learn from expert surgeons about the care of this disease.

Upon arriving at Nagoya University Hospital on my first day, I immediately felt welcome. The staff at the International Student Office and the residents, faculty, and chair of the Division of Surgical Oncology all went out of their way to make me feel like I was welcome and a part of the team. My very first day, I was given a tour of the parts of the hospital where my team worked and was told about the patients who were having surgery this week. My assigned faculty mentor helped me pick a variety of surgical cases to fill my week, as I wanted to see as many different types of cases as possible and learn from the similarities and differences in our treatments of and techniques for each disease. My first day, I was able to scrub into a distal gastrectomy surgery. The team made a huge effort to orient me to the anatomy and what they were doing in English, as well as to get to know me. They also had to walk me through simple things like scrubbing in, as their procedures were very different from at my hospital in the United States! Little differences like how surgeons scrub in and how things are arranged in the room made me reflect on why each of our healthcare systems had chosen particular methods.

In addition to observing surgeries, the surgical oncology team involved me in patient rounds, lectures and didactics for their medical students, and their weekly conference. During the weekly conference, the entire department gets together to discuss all of the inpatients as well as the upcoming surgeries that week. It was amazing to observe the collaboration between surgeons to determine the best operative approach and treatment for each patient, as well as the careful attention to anatomy to ensure patient safety during complex procedures.

Outside of the hospital, I had the chance to explore Nagoya as well as nearby cities in Japan. My rotation in Japan coincided with Golden Week, a week where many national holidays fall back-to-back, creating a sort of nationwide week of vacation. I used that week to take advantage of Nagoya’s central location between cities like Tokyo and Kyoto. Using a Japan Rail Pass, I was able to travel to each city in a matter of hours. When I returned to Nagoya, I had the chance to go around to some of the local temples and shopping centers, all of which were amazing experiences. I also received many recommendations from the residents and faculty at the hospital of restaurants to eat, things to do, and places to see. They really wanted me to have a wonderful experience!

I feel so lucky to have the support of my home institution and of Nagoya University Hospital to travel to Japan, see another healthcare system, and learn from international colleagues. I loved meeting medical students, residents, faculty, and patients, as well as seeing complex surgical cases. I can’t thank Nagoya University Hospital enough for welcoming me with open arms and teaching me so much in three short weeks