Clinical Exchange in Japan

Dermatology (2 weeks)

Based on my experience, a rotation in Dermatology at Nagoya University Hospital is perfect for international medical students who have an interest in this specialty. This is because the Japanese medical system is structured in such a way, that patients are referred or present to the hospital with a wide range of pathology, from the common to the very rare so you are exposed to an extensive range of dermatological conditions, even in a short period of time.

During my rotation, I spent time in the treatment clinic, specialist clinics, on the ward and in surgery.

The daily treatment clinic provides ample opportunity to see various dermatological pathology and treatments and is impressively efficient as nurses and doctors work very well as a team. The specialist clinics ran simultaneously with the treatment clinic and usually involved patients with complex or rare conditions. Surgical cases, both elective day cases and those requiring general anaesthesia, were very interesting to observe as I hadn't had much prior exposure to dermatological surgery and a good mix of cases are usually carried out during the week from the removal of cancerous lesions to the removal of simple nevi.

I also found the weekly ward round to be a very interesting experience due to Professor Akiyama’s fast paced style and how busy it is with virtually the entire team of doctors and medical students involved - easily more than 20 people!

Of course all consultations are carried out in Japanese but virtually all the doctors within the department speak excellent English and are keen to explain and discuss each case and translate where they can. The great thing about dermatology in comparison to other specialties, however, is that you can directly see the lesion so the issue of the language barrier of slight lessened.

I would like to express my sincerest gratitude and appreciation to the whole of the dermatology department for being so welcoming, friendly, inclusive and accommodating. I would like to especially thank Dr. Yuki Toyama (resident doctor), Dr. Ito and Dr. Murase for their day-to-day supervision and generous hospitality. I had a thoroughly enjoyable and educational experience and will forever be grateful for having had the opportunity to undertake this clinical clerkship.

General Medicine/Family & Community Medicine (2 weeks)

My relatively short rotation within the department of General Medicine was a very enriching and educational experience.

Given that Nagoya University Hospital is a tertiary referral centre, I had the opportunity to observe a range of diseases, most of which were fascinatingly complex and quite rare. Some of the cases that I saw included that of Castleman’s disease and TAFRO syndrome, cryptogenic organizing pneumonia, Takaysu’s arteritis and RS3PE syndrome – all conditions I had never seen before beyond a textbook. Observing the diagnosis and management of these cases was very intriguing and I feel that my exposure to such conditions definitely broadened my medical knowledge.

The opportunity to observe consultations in the outpatient clinics as well as ward-based care was great as it allowed me to observe the different ways medicine is practiced in Japan. The opportunity to spend a day at a family clinic in Kachigawa and a rural clinic in Nakatsugawa further supplemented this by allowing me to observe the practice of primary care in different settings with contrasting demographics.

Furthermore, the opportunity to attend a theatrical performance organized by Dr. Okazaki involving individuals with dementia was a very valuable and insightful experience that re-emphasized the importance of patient empowerment.

I also thoroughly enjoyed participating in the communications skills training sessions provided for the 5th year medical students. I particularly liked how students are allowed to lead most of the session with support from one of the doctors.

Beyond medicine, I am grateful for the opportunities I had to discuss wider topics such as aspects of Japanese culture and current affairs with the team and other members of the department who as a whole were very friendly, polite, hospitable and accommodating.

I am very grateful for having had the chance to undertake this placement and would like to thank Prof. Sato and the whole Department of General Medicine for the opportunity.

Further thanks:

I would like to especially thank the lovely Ms. Tomomi Inagaki for organizing everything so seamlessly as well as rest of the staff of the International Office for being so friendly and helpful.