Report of Oversea Clerkship Program in Osaka City University
University of New South Wales
Nephrology, Plastic and Reconstructive Surgery
My exchange with OCU has been positive from beginning to end and I have enjoyed every minute of my 4 weeks. OCU welcomes students from all over the world to take part in their exchange, non-partner universities included, and it was a very straightforward application process made all the easier by the immensely helpful student co-ordinator, Ms Sakurai, who made sure I settled well into the hospital and the very comfortable accommodation just one block away.
I first spent 2 weeks in Internal Medicine (Nephrology) and was exposed to a whole range of patients with conditions ranging from glomerulonephritis to diabetes to rheumatoid disease. The system of seeing patients and note taking differed vastly from my home country back in Australia. In Japan, all notes are recorded on PC whilst in Australia it is a mix of both electronic and paper note-taking where students or interns write down the consultant's orders on the spot as we did the rounds. Over here, note-keeping is saved for after the rounds and rounding was very quickly wrapped up. Clinical activities were split over rounds, clinics, lectures and patient interaction. I enjoyed the lectures in Internal Medicine because they were held by a senior doctor to a small group of 6 (including me) students each time and I always learned something new. Another difference I noted was the doctor-patient relationship in Japan where doctors are very much held in high esteem all the time by the patients, and in return, patients here are treated with the utmost politeness and consideration. I was extremely lucky in this rotation to have with me a group of medical students that I really enjoyed the company of. They were welcoming, friendly, and always made sure I was involved in the conversation and took extremely good care of me from start to beginning such as always introducing me to the professors, helping me translate, and taking me everywhere so I did not get completely lost.
Plastic Surgery was a rotation that I absolutely would do all over again. Headed by the friendly Professor Motomura whose stories and anecdotes will keep you laughing, the whole department was a tight-knit team of wonderful doctors from the junior interns to the senior doctors. The week is split into 4 days of surgery and 1 clinic day, with classes (lectures and suturing tutorials) and patient rounds on certain days. The big difference I observed in surgery here is that in accordance with respect for the patients, the students' role in surgery is greatly minimized in comparison to Australia where students were always involved with anything from taking phone calls, to getting equipment and scrubbing in to assist. In Japan, the student's role in surgery is very much just observation. Even so, I was learning a lot each day as I was seeing more reconstructive surgery here in Japan than in Australia, and was even lucky enough to observe a pioneer surgery involving reconstruction of the orbit and eyeball. My favourite surgery was the reconstruction of the facial nerve after removal of a parotid tumor, where a sensory nerve from the leg was taken and modified through microsurgery into a substitute for the facial nerve and its five branches. In every operation, the doctors who did not scrub in would always come up to me and ask if I understood what was going on, and would take the initiative to draw complex diagrams to assist my learning.
Knowing Japanese is not necessary for this exchange, but will definitely make a big difference to how much you learn and interact with the team and patients. Even when I spoke in utterly broken Japanese and probably dropped my Teineigo (polite speech) at many points, the students and doctors were always encouraging me to keep using it and I gradually got better. My advice to future students would be to learn the Japanese words for common medical jargon beforehand (e.g blood pressure, blood test etc.) and for those doing surgery to have a list of common anatomical words in Japanese pertaining to your department. This will help you keep up a lot faster with rounds and meetings. Last but not least, remember to have fun in both your rotation and travels!
Once again, I would like to thank everyone at OCU for having made my stay so enjoyable, and making me feel welcome from beginning to end. This exchange has given me new friends, many a precious memory, and an altogether unforgettable experience.