Clinical Exchange in Japan

My time on the General Medicine and Geriatric services has been one of my most meaningful clinical and life experiences to date. In particular, my most enjoyable and informative experiences were working with Dr. Okazaki in the rural clinic at Nakatsugawa, with residents and faculty in the outpatient clinic at Nagoya University, with Dr. Kitamura and Dr. Shimojima at the Kachigawa Family Clinic, and with the medical students and Dr. Kim on the Geriatrics service. In particular during my time in the rural clinic, I was able to experience clinic exposures in a rural setting of Japan and also participate in house calls. We saw a large number of patients, and I came away with a better understanding of the disease conditions and health concerns of our rural citizens. Dr. Okazaki was also extremely helpful in actively translating conversations for me. I also very much enjoyed the house call visits during my urban clinic experience, and also the very large variety of patients seen in the Family Clinic.

The inpatient ward experience was also helpful in learning about the more complex disease conditions experienced by citizens of this population. We discussed and managed the care of patients with dermamyositis, polyarteritis nodosa, mixed connective tissue disease, and idiopathic thrombocytopenia, just to name a few of the complex pathophysiological states that were on the ward service. This was helpful to garner a better understanding of the sicker and more severe disease states of patients within this population. One area to improve, that is especially so on the ward experience, would be to continue to pair students with residents and physicians who can likely help translate the Japanese language to English in a helpful way, as a significant amount of the conversations occur in Japanese. Overcoming the language barrier is likely to be one of the most significant ways to ensure a optimized student experience and engagement within the rotation for non-native language speakers.

Finally, the quality of individuals I encountered were of the highest degree I’ve experienced anywhere ever before while visiting a foreign country. Everyone I worked with was extremely giving, kind, and caring toward ensuring I had the most positive experience possible. Dr. Okazaki, Dr. Takahashi, Dr. Teshigawara, and Dr. Kim are four outstanding individuals who especially went out of their way to contribute most significantly to my lasting positive impressions. I felt extremely welcomed with warm and open arms by the medical students, residents, and faculty on the General Medicine and Geriatric teams of Nagoya University. Overall, this was a superb clinical and life experience, and I would highly recommend it to future colleagues and students at my institution and home country.