Thomas Jefferson University Study Report
20th August to 24th August 2018
Looking back the week I spent in Thomas Jefferson University, it was a fulfilling time
I had dreamed of being exposed to a clinical setting in the U.S., so my dream came true. It was a short program, but I have learned a lot from it.
Before joining this program, I thought there would be a great difference in medical care between the U.S. and Japan. However, it was not necessarily true. Of course, the U.S. has a different medical system from Japan, but the attitudes toward patients are almost the same. While joining the team rounds or outpatient clinic, I realized again how important it is to make eye contact with a patient and listen carefully what he or she is complaining.
I was surprised to find that medical students in the U.S. work as if they are medical doctors. We basically observe or shadow physicians in the clinical clerkship. However, they manage patients in hospital. In outpatient clinic, they interview patients and take physical examination. In JeffHOPE, which is a student-run clinic, I saw students work hard and provide appropriate medical care. They seemed to be confident and have professionalism. We sometimes might think that we are not doctors yet, still students. I thought we must experience the clinical clerkship like them.
I liked Dr. Majdan’s lecture. He told me how important history taking is. We had an opportunity to interview a standardized patient. She complained of tiredness. We tried asking some questions, but they are not effective ones to give her diagnosis. He told us to ask questions arranged by organ system such as cardiovascular, pulmonary, endocrine and so on. It was very useful. We finally could diagnose her illness in that way. He also told us about “SPIKES”, which is a useful approach when we give bad news to patients and their families. I would like to become a hematologist or oncologist, so I would have many opportunities to inform patients that they have cancers. Things he taught me definitely will be helpful.
I was struggling to understand what they are saying in English. They are not kind enough to speak slowly for us. If we did not say anything, they did not care about us and behaved as if we were not there. We had to try to join their discussion aggressively.
“Do not hesitate and say something.” This is what I thought was the most important during this program. We should not be shy speaking English just because our English is not good enough.
Lastly, I would like to say thank you very much to everyone who supported us. This experience must have broadened my horizons, and I will work harder to become a great medical doctor.