International Clerkship Report

The experience of international clerkship in 5th grade in Tokyo left me a wonderful impression of the neat, polite, and kindness medical environment in Japan. As a result, I chose to apply for a clerkship in Japan again this year without the slightest hesitation, and thankfully was accepted by OCU.

OCU kindly arranged a student to be my contactor. She had an instruction of the environment of hospital for me, and led me to the dorm on the first day. The dorm is very close to hospital, and also quite clean and new. It is equipped with all the furniture I need, including free Wi-Fi and even washing machine. I feel very comfortable living in this beautiful dorm.

For the first 2 weeks, I chose Radiology department to start with since it requires less communications. The course is mainly composed of lectures and images reading. The image reading class especially impressed me a lot, I spent a morning with teacher looking at the images taken just a while ago. He first told me chief complaint of the patient, and then I need to point out where the abnormal part is. It's actually a big challenge to me, but after this I learned how to read neck and pelvic CT, which was usually ignored by me before due to its relatively poor image quality. I think it is a precious and useful skill in the future when I need to read the CT images all by myself.

The lectures include angiography, myelography, abdominal CT, nuclear medicine and radiation oncology. Thanks to the translation by classmates, I can understand most of the contents. Teachers taught us basic knowledge by PowerPoint slides in the morning and then showed us the machines in the afternoon. There are the newest radiation oncology machines in OCU, it is very interesting to see how these expensive and cool machines work in person.

After the learning in Radiology department, I chose Endocrinology department for the next. In Japan, endocrinology belongs to "Second Internal Medicine" which also includes nephrology and rheumatology, this is very different from Taiwan's system. Each student gets 2 patients from senior doctors, we have to be very clear about their disease recovery progression and the test results of blood or image everyday because there is a teacher who checks what we learn every afternoon. I got two patients with nephrotic syndrome and pheochromocytoma, both are very rare disease so I learned a lot. The communication with my patients was primary made by my contactor, I really have to give a special thanks to her for all the help and kindness.

Unlike in Taiwan, professors in Japan have ultimate rights; thus the professor chart round every week is a very important event. Professor Inaba will see all the inpatients of second internal medicine department during chart round, usually followed by over twenty doctors behind him. At beside he asks if patient feels any discomfort and listen to resident's report so that he can make adjustment to the treatment plan. This scene was only seen in Japan drama before, so this a very fresh and interesting experience to me.

During my stay in Japan this month, I think there are some advantages of Japanese medical environment. The newest medicine, for example: ultra long-acting insulin Tresiba, the brand new form of oral anti-diabetic drugs SGLT2-inhibitor, and some tests like BAP the osteoblast marker. These medicines and tests are still not in the market of Taiwan yet maybe because of the smaller market size or lower efficacy of government. Combine the profound history of medicine and meticulous nationality, Japan is still considered to be the leading country in Asia, Taiwan still have so much to learn and to make improvements. Thanks OCU for giving me this international clerkship opportunity, I appreciate a lot and will make good use of what I learned in this month in the future.