Clinical Exchange in Japan

Departments: Infection control team& Chest internal, Geriatrics
Period: July-August 2012

It is my honor and pleasure to have opportunity being a candidate for this exchange program. During the 4 weeks, I visited the Infection Control Team (ICT) along with department of Chest Internal medicine, and department of Geriatrics. After lectures and discussing not only disease, but also medical system, I really did expand my horizons. The doctors I met are all friendly and knowledgeable. Days in Nagoya is definitely memories that worth being cherished.

In the first 2 weeks attached to both the ICT and Chest internal, I realizing there are much difference between Taiwan and here in Nagoya. The ICT team members’ English is astounding fluent, including Dr. Yagi, Dr. Iguchi and Dr. Hirabayashi, thus made us no communicating problems. Additional to seeing around the laboratory instruments, I had several cultural shocks. The first thing is that instead of controlling specific antibiotic, the ICT members are mainly being suggestive and consulted mode when rather than control mode in Taiwan. Also, I attended the ICT meeting and an online video academic conference that I have never seen in Taiwan before. As for the lectures, I did acquire a lot of clinical experience and realized some Japan-unique infection issues like BLNAR which we will not face in Taiwan. Totally speaking, I found ICT is fun and interesting here.

Chest internal medicine is also interesting as well. All doctors are kind and willing to teach. In addition to various topics of lectures including infection, cancer, idiopathic fibrosis, and ventilators, I also participated in journal readings, ward runs, and routine procedures like ultrasound-guided bronchial biopsy. It makes me feel very comfortable observing the daily activities and exchange experiences in medical systems in different countries. The lab also makes deep impression on me, since it was just next to the office of. I discussed with several doctors about their research and being given with new experimental and clinical ideas which are very interesting. It is a wonderful experience involving here.

As for geriatric medicine, it is more complicated than I formerly imagined. Actually geriatrics patients are here in hospital because multiple clinical issues or have specific medical problems that need to stay in the hospital. Many things are too difficult for me to fully understand in the 2 weeks. For example, the doctors I attached, Dr. Hirose, a specialist of cardiology, showed me the abnormal DDDI electrocardiogram. Actually I can only barely to guess it was an electrocardiogram of a not-well-working pacemaker, making me a little frustrated. However, I observed many patients of dementia, delirium, diabetes, malnutrition, and Alzheimer’s disease as I expected. Besides the observation, I also had to care one patient and reported the status everyday morning. Though using English the very first day, I tried using Japanese after that. It was a challenging and memorable experience.

For old patient issues, the problem is not only medical but social. As everybody knows, Japan is already an aging society, And, I think my country will be that too in around 10 to 20 years like Japan. In fact, the elderly nursing has been going to be a social issue in Taiwan, like Japan few decades ago. Therefore I am strongly interested to know the nursing system in Japan. Dr. Suzuki gave several lectures about the topic, and arranged an afternoon to work with social workers. I think Japan has a more integrated system in elderly nursing as hospital grading, which are lots of space to be improved in Taiwan.

Overall, I found the entire program quite fascinating. I was able to learn both medical and social issues around medical behaviors in Japan. Lastly, I would like thank the international affairs office for this enjoyable schedule and the kindness of all stuff during the 4 weeks. I wish I could stay longer! Hope there still a chance going back to Nagoya again.