Clinical Exchange in Japan

From 18.1.2024 to 12.1.2025 I had the pleasure of rotating at the hospital of Nagoya University. The first 4 weeks in the department of pediatric surgery and the next 4 weeks in the department of general oncologic surgery. For the duration of my stay, I got offered a room in the student dorms for international students. However, since I had previously met rotating students from Nagoya University in Europe, I had arranged a room with one of them. As I have heard from other rotating students staying there it is a good hub and you’re able to quickly meet other foreigners to explore Japan with.

On my first day, after going to the international office and getting an introduction to the hospital including a small tour as well as receiving an entrance card for various doors and a nametag, I was guided to the department I would be staying for the next weeks. There I was greeting by one of the attending physicians who after shortly showing me around took me quickly to the operation rooms where I was meeting most of the team and the professor in charge of it. Right away on that day I stayed to observe the coming surgeries.

On a usual day I would arrive around 8am to join the team morning conference to plan the next operation. In their department the made a habit of introducing patients in English however usually they continued more precise discussions in Japanese which wasn’t really possible to follow. Afterwards I’d go to attend the surgeries or round with them. During the surgeries themselves it was a mix of observing and scrubbing in to be the second assistant. They would usually explain roughly what they were doing and happy to answer any questions asked. After the surgeries the attendings usually took some time to shortly talk about the procedures with me to make sure I understood what was happening. After 5pm I was generally allowed to leave, however I was invited to stay as long as the surgeries lasted which on days they were done before 5mp I was released then.

All in all, the rotation was a big learning experience – mostly because I was almost always in the operations themselves and could ask any questions without having the feeling to annoy the surgeons who were always happy to help. When it comes to the medicine practiced in comparison to the one in Germany that I am used to there is not a big disparity. Some operation techniques and procedure are modified or slightly changed but if anything, I welcomed it as it opens a new perspective and one up to the reason why we practice medicine in the ways that we do.

Despite this the language barrier proved to make understanding difficult at times. Before the winter break rotating students (who tended to have a better English) where able to translate very well, however after they went for vacation the conversations with doctors and other operation staff were at times frustrating as it felt we couldn’t discuss more complex matters which can be necessary in medical treatments.

For some days I could join a student class held by the surgery department where alongside sutures and practice using a monopolar cutter we could try ourselves in laparoscopy models as well.

Aside the hospital rotations on weekends (and holidays) its relatively easy to travel to most famous places in Japan. Nagoya is located between Tokyo and Osaka, so both are possible weekend trips when using the shinkansen bullet train. Still, I’d recommend planning time before and/or after the rotation for a more stressless, and also cheaper as you don’t have to rely on shinkansen tickets and expensive weekend-hotels), sightseeing experience. When choosing places to go there are so many it’s not possible to do everything so chose what you’re interested in beforehand. My personal two favorites were going to the mountainside city of Takayama and the nearby Shirakawago as they are smaller and more traditional Japanese places compared to the mega-cities of Tokyo-Yokohama, Osaka-Kobe and Nagoya. The city of Hiroshima with its terrible history and the nearby Miyajima-island is a close second.

So finally, I can say that I can really recommend the rotation at Nagoya. The caveat is being open to ask and being interested in the rotations there are necessary for learning. The Japanese doctors were generally very helpful but not starting conversations on their own. Still as these tips at least in my experience apply for homeland rotations similarly it’s not much of a difference. Local students are happy to go and meet up and I had a good time with them on campus, the city and at events like going to a Japanese pottery class.