Clinical Exchange in Japan

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Experience report

Name: Edward Yoo
School: University of Western Australia, Australia
Study Period: 16th Dec – 17th Jan 2020
Departments: Gastroenterological Surgery, Cardiac Surgery

Before my final year of medical studies, I had the pleasure of undertaking a 4-week clinical clerkship at Nagoya University Hospital in both general and cardiac surgery departments. This was my first time travelling to Japan and used the opportunity to broaden my medical experience as well as experience the country. All the staff at Nagoya University were incredibly accommodating and the doctors took the effort to explain procedures, translate patient interactions and present cases in English.

On my general surgery rotation, I was able to shadow surgeons on both the hepatobiliary team and upper gastrointestinal team. On this attachment I observed a range of procedures including hepatectomies, thoracoscopic procedures and complex open pancreaticoduodenectomies. The surgeons were highly skilled and were happy to discuss the evidence behind their surgical techniques and what measures they take to prevent or manage complications. On this attachment I also had the rare opportunity to observe a robotic gastrectomy for gastric cancer. It was amazing seeing the level of articulation provided by the Da Vinci system and looking into the stereoscopic view of the abdomen. This procedure also facilitated an interesting discussion regarding the future of robotic surgery with an expert from Tokyo and the hospital director Professor Kodera.

Both cardiology and cardiothoracics are an interest of mine, and placement with the cardiac surgery team was an amazing experience. On this rotation I participated in ward rounds, morning meetings and operations. I had the opportunity of scrubbing into a coronary artery bypass graft and total aortic arch repair. Operations occurred every day and were incredibly varied. Other operations performed included OPCAB, thoracic aorta repairs and TAVIs. The surgeons always made sure that I was briefed on the operation before they began, and no question was left unanswered. The most interesting procedures included a pulmonary endarterectomy for previous pulmonary embolisms and the implantation of a heart mate 3 left ventricular assist device.

Overall, the experience was very rewarding and provided great insights into each specialty. I was able to learn a lot from the doctors regarding surgical technique, management of complications and the future of both general and cardiac surgery. I am grateful for all the doctors and admin staff for making my time at Nagoya University Hospital so enjoyable and I would recommend anyone who is interested in Japan and Medicine to take part in the clinical clerkship program.

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