Clinical Training report

Exchange Student Elective Repot

I have always been attracted to Japan, because of the culture and their way of life. Hence, getting a chance to travel to Japan for a clinical elective was a dream come true for me. Hailing from a Medical College in India, I did not know what to expect when I came to Japan for the first time, for a clinical Elective in Hepato-biliary-Pancreatic Surgery at Osaka City University.

We landed on Thursday, 4 days before our elective starts so that we could get over the jet lag and get acclimatized to the weather and the time difference between our 2 countries. Our Journey from the airport was quite easy, thanks to the specific instructions provided by Ms. Aki Sakurai, our contact person from the Educational Affairs Department. She met us at the hospital and got us registered and took us to our apartment, which was just a stone's throw away from the hospital. Thanking her in just words on this small article is quite an understatement on how much she has helped us. If it wasn't for her, we wouldn't have been able to travel to Japan, let alone attend the clinical elective!

On Monday (First day of my elective), I was asked to stand in front of the locker room at 8:45 AM where I was greeted by the cheerful faces of Kanako and Mizuki! They took me the Out Patient wards of the 2nd Surgery Department, where I met Professor Shibata, who was the head of the department. He was kind but stern, and briefed us about the department and asked us to introduce ourselves. This is where I met, Yuki, Momoyo and Takashi too.

After the chief resident of cardiovascular surgery showed us the way to scrub into the OT, we were asked to choose from 4 surgical departments. Oesophagus, Thoracic, Cardiovascular and Hepato-biliary-pancreatic surgeries were the options to choose from.

I chose hepato-biliary-pancreatic surgery along with Momoyo. We watched a Pancreticoduodenectomy performed by Assoc. Prof. Tanaka, who is extremely kind, funny and polite and the residents in the OT. It was quite exciting to watch. Even though there were some language barriers, everybody showed so much effort to translate conferences and operative techniques in English.

On Tuesdays and Fridays, there were clinical conferences with all the cases presented in the department overseen by Prof. Shibata, which was in Japanese. Professor Shibata was kind enough to translate the major findings and the investigation reports to English. Even if that wasn't the case, there was someone sitting next to me trying to translate it to English for me!

I too was assigned a case for presentation, which was a case of IPMN. This was an entirely new disease for me, as I had never seen a case of IPMN in India and read it quite briefly! So, this made me go through Maingot's quite thoroughly. I had to present this case in front of the entire department, but this was made a piece of cake thanks to the help of Dr. Hamano and Dr. Aota. I was even offered the chance to scrub in for the Pancreacticoduodenectomy for the patient. During the surgery is when I met Prof. Kubo, the head of the HBP Surgical team for the first time. He is a man of such high-caliber that he has discovered a type of occupational Cholangiocarcinoma! He was really nice and kind enough to explain the major surgical steps of the surgery! He was leaving the next day for a conference in Hong Kong, and sadly this was my first and last meeting with him, as I was finishing off my elective by the time he was back. I hope to come back and learn from him soon!


On my last day, I accompanied Assoc. Prof. Tanaka to the Out Patient Clinic, where he saw many patients. He was kind, courteous and carefully explained the entire case to all his patients. I believe I have to learn a lot from him! After this we had a case-review session with Prof. Shibata where all of us had to present our cases, pre-op, op, post-op review in detail. Thus, this clinical elective ended with all of us drinking Tea with Prof. Shibata in his office and of course, a tiny photo session! In the evening, Assoc. Prof. Tanaka took me the OCU Skills lab and taught me Ultrasonography and Laparoscopic Suturing! I will never forget whatever he has taught me!

Not only did I enjoy the clinical experiences, my evenings were made really enjoyable thanks to my hospitable hosts and the new friends I met in the apartment provided by the university. I enjoyed bonding with Mizuki over beers and Chu-hi, just chilling, talking and eating pizzas with Takashi and his friend Mori, The baseball batting centre and dinner with Yuki and Momoyo, teaching how to eat Indian food to Kanako and Yuki. At the apartment we even had a small mini-international food festival with food from Korea, India and Vietnam! I even met exchange students from Sweden and France, resulting in a truly international exchange and experience.

One of the evenings we were taken for a lavish welcome party at a traditional Japanese restaurant, courtesy of Prof. Koyama, the head of international affairs at OCU, by Chizuru, Hikari and Erina.

Towards the end of my clinical elective, I and Momoyo were taken to a Kushikatsu restaurant by our residents of Hepatobiliary-pancreatic surgery where we bonded of katsu, beers, sake and much more. I hope all of them will remain my friends and teachers for a long time!

There were a lot of similarities and many parallels could be drawn in the patient care, surgical approaches and patient-doctor interaction between the Japanese and the Indian system. But, the entire clinical set-up a student experiences is quite a stark contrast from what the Indian set-up is, but it was quite easy to acclimatize to. Japan is one of the countries that I respect and appreciate the most, regarding the people, the structure, the ambitiousness, punctuality and the openness the doctors have with the patients is something that I need to learn and practice.

I am extremely happy and thankful for the opportunity provided by Osaka City University for a clinical elective. I recommend OCU to anyone interested in pursuing a clinical elective abroad. I hope and wish that I can come back to Japan for my specialization and of course to meet all my friends, colleagues and professors at OCU. I have absolutely no regrets and will cherish these wonderful memories for life!