Clinical Exchange in Japan

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Experience report

Name: Mark Zhong
School: University of Melbourne, Melbourne Medical School (Victoria, Australia)
Study Period: November 25, 2019 – December 21, 2019
Departments: Cardiovascular Surgery, Diabetes and Endocrinology

I want to begin by thanking the countless staff members, doctors, students and friends who took the time to welcome me to Nagoya University – your hospitality (and patience) certainly did not go unappreciated.

I had the pleasure of participating in a four-week elective at Nagoya University, split into 2 two-week rotations in the departments of Cardiovascular Surgery, and Diabetes and Endocrinology. The process of organising the elective was incredibly simple with the help of the program coordinator, Megumi. I had most of the documents required sent and my elective approved within a week.

Whilst the content of studies at the hospital were familiar to me, the added difficulty of navigating a foreign language and associated customs certainly proved challenging. That said there were several doctors on each rotation that had completed overseas studies or fellowships andhad an impressive understanding of English. I went in with absolutely no grasp of Japanese, however everyone made a concerted effort to translate and I even picked up a basic knowledge of the language by the end of my elective, so I definitely would not let that stop you.

My time in the Cardiovascular Surgery Department gave me access to several opportunities for learning unavailable at home. During my first day, my orientation was actually cut short as theHead of Department was needed to perform an emergency heart transplant that I got to observe! Additionally, I got to scrub in and see procedures such as minimally invasive valvuloplasties, transcatheter aortic valve implantations, aortic valve replacements and aortic dissection repairs. This was a departure from the types of operations typical back home (e.g. CABGs) and was a wonderful learning opportunity. A day in Cardiovascular Surgery typically involved a morning case meeting, one or two procedures during the day, and informal teaching opportunities scattered throughout. I was assigned a supervisor, Akita Sensei, who helped me translate and understand each procedure. I was regularly invited out for lunch with members of the Cardiovascular Surgery team and enjoyed the opportunity to discuss cases further over food, although the on-campus café and Lawsons never failed to disappoint either. Prof. Usui, the Head of Department, and many other doctors, regularly took the time to enquire about how I was doing, and I felt very integrated into the team. The rotation culminated in an end-of-year Christmas party dinner, and I had the pleasure of witnessing my supervisor break into song and dance during a Christmas skit.

The Diabetes and Endocrinology rotation was a similarly valuable experience. This rotation was more structured given that I spent the first week with other medical students at Nagoya University, following their schedule, tutorials and classes. I had the opportunity in participating in an oral glucose tolerance test (OGTT), performing thyroid ultrasounds, and clerking patients with the other medical students. Highlights of the rotation included the excursion to Toyota Memorial Hospital, the simulation lab, and themany interesting discussions over lunch with Prof. Arima and Onoue Sensei. I was particularly fascinated in the Endocrinology aspect of this rotation given my relatively infrequent exposure to this field at home.

Nagoya University Hospital itself is a large tertiary hospital with 1000+ beds. I was placed in an international residential dormitory,which was a half hour bus ride away, during my stay; most of the other students in the dorm were from several other disciplines and countries. The rooms were well equipped and surprisingly spacious. I didn’t have the opportunity to spend much time with the other dorm members given the early starts at the hospital and my travels during the weekendto Osaka and Hida Takayama. However, I enjoyed dinner with Takashi Yamamura and other students of the medical exchange students club (MDEC) on several occasions, helping me discover my passion for Miso Katsu in the process.

Although going on this medical elective wasn’t without its challenges, it certainly was one of the most worthwhile decisions I have ever made. It not only allowed me to better understand another culture and health system but was an invaluable opportunity to reflect on my own. I hope to have the opportunity to repay the kindness shown to me by everyone I encountered and look forward to my next visit!

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