Clinical Exchange in Japan

Great thanks to everyone I met at Nagoya University Hospital for making my exchange so impressive and fruitful.

At the Emergency and Critical Care Medicine, I spent most of the time in ICU. The most impressive thing was how they operated great teamwork to care every patient. At the morning conference, each patient was discussed in detail. Everyone was encouraged to express his or her opinion, including doctors from different departments and the nurses. It was amazing to know that every patient has two main care doctors here, and I thought it could provide more effective medical care. I have learned much knowledge about critical care medicine such as the setting of mechanical ventilator and some biomarkers to predict fungal infection. Also, I viewed some medical procedures such as PCPS insertion. Doctors in EMICU were so nice to answer my questions in both Japanese and English because I was not good at Japanese. Having lectures about shock and ARDS with medical students here was also interesting.

At the Geriatrics Department, I had the chance to visit nursing home and group home. It was my first time to know how group home executed. To make the staff and the dementia patients live together might slow down the disease progression of these patients. I also visited home care and found some difference between Japan and Taiwan. In Taiwan, nurses visited home care patients every one or two weeks. But in Japan, nurses visited one patient every one or two days, which might lower the risk of infection or other emergency of home care patients.

I also spent much time at the Geriatric ward, and found some interesting cultural difference. Doctors in Japan took the patients’ life quality as the priority. So they would hold many family meetings for finding the most comfortable approaches for patients. For example, since the NG tube insertion was quite uncomfortable, doctors would encourage the patient to receive gastrostomy if his or her life expectancy was more than one year. I also had some simulation exercise of echocardiography and bronchoscopy. And I found out Nagoya university provided many kinds of simulation exercise including robotic-assisted surgery for students. The simulation experience might help students to decide which department they would like to apply.

Although I just stayed at each department for two weeks, I had a great time not only learning medical knowledge but also talking about some social or ethical issues with doctors and students. Hope we can meet again in the future.