Clinical Exchange in Japan

Spending a month with Nagoya University Hospital’s Dermatology Department has been one of the best decisions I have ever made. I knew I was going to become a dermatologist in the US and wanted exposure to the field in a different country—I got plenty of that, and much more!

From my first day on, the residents and attendings at Nagoya welcomed me warmly and allowed me even to assist in the OR. I had the chance to see dermatologists perform sentinel lymph node biopsies in melanoma patients, skin transplants, debridement of gas gangrene, resection of extramammary Paget’s disease—what a privilege to see these operations up close! Furthermore, I observed many procedures in the outpatient setting that I had never encountered before, such as SADBE for alopecia areata, interferon injections for post-surgical melanoma patients, Moh’s paste for gynecologic malignancies, mapping biopsies for extramammary Paget’s disease, etc. As I continued to take notes on the interesting cases I saw, I nearly filled a whole notebook by the end of the month.

The dermatologists whom I worked with were very patient and knowledgeable. They took the time to explain anything I didn’t understand and answered all my questions. I initially struggled with specific dermatological terms in Japanese, but my colleagues made sure to translate for me. I attended the clinics of Dr. Akiyama, Dr. Muro, and Dr. Kono—these were busy, fun clinics, with patients’ conditions ranging from bread-and-butter atopic dermatitis to rare congenital ichthyosis. Since East Asian patients constitute a minority of patients in the US, it was highly informative to see so many examples of both common and rare skin diseases in Japanese patients.

Additionally, I had the privilege of attending weekly Professor’s Rounds and conferences on ward patients, as well as dermatopathology teaching sessions. Furthermore, I even got to participate in clinic at a community hospital in a rural area, to gain a perspective outside the academic dermatology setting. These opportunities deeply enhanced my learning. Indeed, my personal interests were heavily taken into account by Dr. Miura, who helped coordinate my weekly schedules. Aside from individual cases, I also learned about big picture concepts like differences between the fields of dermatology in Japan versus America, plus the way Japan’s universal health coverage works.

On a personal level, it was so enjoyable to hang out with my colleagues. They held a nice welcome party for me in an izakaya, so that I got to try famous Nagoya delicacies. Upon my departure, they took me to a restaurant serving Tohoku (Northeast) foods. In-between, we ate many lunches together, chatting about all sorts of topics and exchanging knowledge. I was even invited to a takoyaki party, where I learned how to flip those cute fried octopus balls, and tasted beef intestines in motsunabe at a birthday party for one of the residents.

On the weekends, I got to explore freely! Locally in Nagoya, Osu marketplace was so full of tasty foods and intricate shops that I could spend hours browsing. Nagoya Castle was a mighty symbol of the city, and you could freely ascend the floors of the tenshukaku for a 360-degree view from high up. By riding the shinkansen for about an hour, I visited Gero Onsen for relaxation in hot springs. Tokyo was also just a shinkansen ride away—some highlights included the views from Tokyo Skytree and the seafood at Tsukiji market. Kyoto was even closer in proximity, where I walked around Kiyomizudera in a lovely kimono and played with Japanese macaques in a monkey park in Arashiyama.

My month in Japan was filled with memories that I will cherish forever. I hope to stay in touch with my colleagues and to let my experiences in Nagoya enrich my future career as a dermatologist in the US. I cannot express enough gratitude to Nagoya University for making this month possible, and I strongly encourage anyone wishing to study abroad in Japan to consider this institution.

This picture is from my last week in Nagoya, when the dermatology department gathered for a farewell party for me!