Clinical Electives Program Osaka City University
Andianto Indrawan Tjiptohardjo
It is an honor for me to complete my electives program in OCU. In this electives program I chose Neurosurgery and Neurology with each a 2-week course. Neurosurgery in Japan one of the very best in the world and while the geriatric care in Japan is very developed and advanced. These are the very reason why I chose these 2 departments in the first place.
In neurosurgery, the mentor that taught me is Ohata-sensei. Ohata-sensei himself is the Professor of the Neurosurgery department and by coincidence he is also the Associate Dean and Chairmen of then International Exchange Committee. 2 weeks in Neurosurgery, I everyday attend the morning conference that starts in 7:45 in the morning. The conference discusses about the case and evaluate the patients that has been operated or taken imaging for diagnosis. Every Wednesday there are also Journal club where one of the resident present about a journal to the people of Neurosurgery department.
The activity everyday varies in the Neurosurgery department. Mostly almost everyday I watched live operation in the operating theatre. The case varies from decompression of because of OYL to resection of Petroclival meningioma. I found out that there are many case of petroclival meningioma are referred to this hospital since this is the top referral hospital in the Osaka area even Kansai area. Petroclival meningioma is considered one of the hardest tumor in the brain to be operated due to its location which is adjacent to important structure in the mid brain.
In the second week I had the opportunity to practice my skills of basic suturing and even microscopic surgery. The suturing I practiced by closing cut wound on a pork meat and the microscopic surgery I have to make a simple suture on a gauze mat with the help of microscope. I had some lectures about MRI and learn how to interpret the image of MRI in the first week.
The one that I enjoyed the most is the hospital visits around the city. The first week I had the chance to visit Tsukazaki Hospital in Himeji city, city west to Osaka known for Himeji Castle which is 1.5 hours away by train. I met Hu-sensei the Director of the hospital and was shown around the hospital. The hospital is most famous for the Ophthalmology department around the Kansai-area. They even have 21 ophthalmologists on duty in the same day. The following week I had the chance to visit Osaka City General Hospital which is also a big hospital and center of referrals in the Osaka area. There I observed patient with gamma knife treatment. Also I observed lactocele patient is operated using bilateral endonasal transsphenoidal approach that was done by Iwai-sensei. Also I had the chance to see the pediatric department with Sakamoto-sensei.
The remaining 2 weeks I spent in Neurology and Geriatrics department. It is interesting in the hospital that these 2 departments are considered as one. I was greeted by Miki-sensei the professor of the department. For these 2 weeks, Hirakawa-sensei is the one who take care of me. She is a resident in the neurology department. These past 2 weeks mostly I got lectures and also visiting the patients in the wards since there is no operation in this department.
In the 2 weeks I also visited Kosaiin hospital in the second week. It is in the outskirts of Osaka city. It was build firstly around 1912. It is an old hospital but the geriatric service here is one of the best in the Nation. This hospital uniqueness is that this hospital offers in care treatment for dementia patient that is mobile to be in the same building and given treatment. The building is build specially so that the patient keep doing activities so that the disease didn't progress that badly. There are also other areas for the healthy elderly patients and they are put in 'houses' which they still get treatment of their diseases. The area consists of many houses for old people to stay and interact with each other. There is also building for the immobile dementia patients and also the main hospital building for patient with or without dementia. In conclusion this hospital is the ultimate treatment center for dementia patients.