Clinical Exchange in Japan

My home medical school has had a longstanding academic partnership with Nagoya University, and from my first year, I met students from Nagoya who encouraged me to come as soon as I had the chance. Many of my own classmates who went before me came back saying that it was the best rotation they'd had in medical school. So I came into my month in Nagoya with high hopes, and I was not disappointed: the experience was as professionally rewarding as it was personally enjoyable, and I am so glad to have been able to take part.

I completed rotations in psychiatry and general internal medicine, each for two weeks. Because my Japanese is limited, I was concerned at first that I would have a difficult time on services that are so dependent on historytaking and oral communication, but I shouldn't have worried--someone (often, to my embarrassment, an attending on the service) would always translate for me and make sure I understood the discussion and clinical thinking. I also had lots of time to hang out with medical students on the team, both in structured didactic sessions and more informally on the wards.

During my psychiatry rotation, I worked both in the university clinic and in the hospital. In contrast to my home clerkship, which focused primarily on inpatient treatment of acute psychoses, in Nagoya I experienced the full breadth of a general academic psychiatry service, where patients with subtle cases ofmood or eating disorders would present for treatment for the first time. I also had the (completely optional) chance to spend an evening shift of general medicine call at the university hospital ED with a couple of the residents, which was one of the highlights of the rotation for me.

My general medicine rotation was similarly broad. Every day I was in a different practice setting: in the hospital, in outpatient and Kampo clinics, on home visits, and in suburban and rural clinics in Kachigawa and Nakatsugawa. The faculty took me to lunch, encouraged me to talk about my impressions with them, and showed me unfailing kindness. I especially enjoyed the days I spent on home visits and in practices outside of Nagoya--it was bracing to step away from the city for a while, and these short experiences showed me some of the starkest differences in health care between Japan and the US.

The clerkship also left me time to just be a visitor to Japan, and some of my fondest memories of the exchange are of time spent with friends and colleagues outside of work: walking out of the hospital into Tsuruma Park and finding cherry blossoms in full bloom, awkwardly trying out festival games, bonding over music and books, going to kabuki performances, seeing my hosts' amused reactions as I tried natto and shirako for the first time.

I am grateful to the Office of International Affairs for offering this opportunity, and especially to the faculty, residents, students, and staff of the university, who made me feel so welcome.