Report of Oversea Clerkship Program in Osaka City University

I had never thought of ever visiting Japan, but when I saw I had an option to go train there for a month I thought it would be a great opportunity to experience the different lifestyle in Japan as well as their culture, food and most importantly, their roles as clinical pharmacists in the hospital.

When I arrived Dr Ishimura was already at the airport along with Ms Sakamoto. I am very thankful for their efforts to come to the airport and welcome us. Dr Ishimura had taken us to the dorms, we wouldn't have been able to get there on our own and I am grateful for his kindness.

On the first day of the training we were shown around the pharmacy. What caught my eye was the automated dispensing machine for injections, the compounding machine and the transport of medications. With the automated dispensing, each patients order is automatically dispensed and then checked by the pharmacists. The compounding machine packed each dose making it accurate for dispensing and the machine for transporting medications to each ward reduces the time of medication delivery to all 18 wards.

We were given options to which ward we want to work in and I chose haematology and oncology, respiratory disorders and gynaecology and obstetrics. I chose these three wards as we have not gone into detail about them yet and we are supposed to take these subjects next semester and I thought it would be a great opportunity to learn about them in advance. In all three departments I learned a lot. All pharmacists take the patients medication history, ask the patients if they have had any allergies to any medication in the past and if they are experiencing any adverse effects with the current therapy and to any medication that they had been taking before. The pharmacists also check if the right dose has been prescribed according to individual patients needs by checking their lab reports and monitoring their renal and liver function and then adjusting the dose of medication accordingly.

Some of the diseases and treatment I learned about in the wards include follicular lymphoma, multiple myeloma, acute lymphoid leukaemia, acute myeloid leukaemia, different types of lung cancer, tuberculosis, ovarian and cervical cancer. I am thankful for the time and patience the pharmacists, doctors and nurses had to teach me. I was able to communicate with doctors and nurses and I was given the chance to suggest to the doctor a change in dose of a patient's medication. I was also able to interact with the patients and take their medication history. In the haematology ward, one of the doctors explained about myelodoplastic syndrome and a nurse took me around the ward and showed the day to day work carried out by nurses, how they monitor patients undergoing radiotherapy and how blood transfusions are done.

Some of the diseases and treatment I learned about in the wards include follicular lymphoma, multiple myeloma, acute lymphoid leukaemia, acute myeloid leukaemia, different types of lung cancer, tuberculosis, ovarian and cervical cancer. I am thankful for the time and patience the pharmacists, doctors and nurses had to teach me. I was able to communicate with doctors and nurses and I was given the chance to suggest to the doctor a change in dose of a patient's medication. I was also able to interact with the patients and take their medication history. In the haematology ward, one of the doctors explained about myelodoplastic syndrome and a nurse took me around the ward and showed the day to day work carried out by nurses, how they monitor patients undergoing radiotherapy and how blood transfusions are done.

We also had a chance to visit the primary health care department, the ICU and the ECU learning by observation and have a brief introduction about the Disaster Medical Assistance Team (DMAT).

The chief pharmacist Mr Nagayama and Ms Kawakami had arranged to take us to a botanical garden in Kyoto as well as to a pharmaceutical distributor which was exciting as we got to see all the medicinal plants we learned about in pharmacognosy and the pharmaceutical industry was interesting too as I have only been to one in Malawi where everything is done manually, whereas in Japan nearly everything is automated.

I am thankful for the hospitality by the pharmacy department. They were very welcoming and willing to teach us as well as learn from us too. All staff working in OCUH are very respectful towards each other and I respect that. A welcome party was held during the first week and all the pharmacists attended it. It was really nice to get to know everyone outside of the hospital. One of the haematology doctors also held a dinner with a few nurses and the pharmacist in that ward which was delightful and I appreciate their kindness for making an effort to get to know me more and I am grateful that I got to spend time with them and know more about them too. A farewell party was also held on the last day. I was saddened to have to say bye to everyone and I hope that I can meet them again. I had a great experience training in OCUH, I learned a lot and I feel fortunate to have had the opportunity to train there. I would love to come back to OCUH in the future and I think Japan is great place, but the best of it is its people.