Clinical Training Report

Country / Regions

Austria

School

Medical University of Graz（グラーツ医科大学）

Elective period

26 August to 20 September 2024

Arriving & living in Japan

I’ve been fascinated by Japanese culture for a long time. The Japanese products we get in Europe are known for their great quality and the attention to detail. People are said to be very friendly and respectful, and the culture varies vastly to Austria which is why I was excited to experience Japan and the healthcare system firsthand this summer. Before coming to Japan, I was in contact with Ms. Sakurai, who was extremely helpful and reliable while organizing my stay. After I gathered all the required documents, it was very easy to apply for my elective at Osaka Metropolitan University and I was supported throughout the whole process. Once I arrived in Osaka, I was welcomed by Ms. Sakurai who gave me a quick tour of the University building and showed me to the dorm I could stay in during my stay. The Dorm is only a five-minute walk from the University and is equipped with everything you need during your stay.

When I first arrived in Japan, I was a bit overwhelmed by the sheer size of Japanese cities. There are only nine million people living in my whole country, so places like Tokyo or Osaka really blew my mind. However, everything is very well organized, and people are very friendly and helpful, so it was no problem to get around and I quickly got used to the crowds.

I was surprised about how hot it gets in summer, but luckily all the buildings are air conditioned. Life in Osaka was very exciting and I enjoyed it a lot. I especially loved the food, which was absolutely delicious at every place I tried. I also did a lot of sightseeing was great, but there are so many things to see that I could spend months exploring the country – a perfect reason to come back soon!

A few weeks before I came to Japan, I was contacted by Keitaro, a 5th year student who is the leader of ISAO and offered his support with potential questions I might have. During my time in Osaka, Keitaro and the other ISAO members organized some dinners for us international students, which lead to some of the best memories of my time in Japan. The people were so friendly, and we had a lot of fun!

A few weeks before I came to Japan, I was contacted by Keitaro, a 5th year student who is the leader of ISAO and offered his support with potential questions I might have. During my time in Osaka, Keitaro and the other ISAO members organized some dinners for us international students, which lead to some of the best memories of my time in Japan. The people were so friendly, and we had a lot of fun!

Internal Medicine – Gastroenterology

I was interested in the department of Gastroenterology, as I heard that Japanese doctors are very experienced in performing endoscopic procedures like OGD, ERCP and Colonoscopy. On the first day of my elective, I was welcomed by Keitaro and a great group of 5th year students. They all spoke very good English and helped me a lot with communication during my training. On the first day we were each assigned a case that was going to be treated in the following two weeks. At the end of the rotation, we presented our cases in front of the other group members. The presentation was to be held in English, so it was no problem for me to participate. The doctor responsible for my case, Dr. Ominami, offered his support throughout the process and was a very nice and reliable contact person. The patient, that was assigned to me, suffered from Stage 1 squamous cell esophageal cancer. It was discovered during a checkup after treatment for another disease. Because it was discovered this early, the tumor could be removed by ESD (Endoscopic Submucosal Dissection). It was great to witness this procedure in person a few days later. Squamous cell esophageal cancer is much less common in Europe, which also means that ESD treatment is only performed in a few specialized clinics. So, seeing this procedure and how the tumor was removed completely within half an hour, was a really impressive experience.

Throughout the two-week elective, we had some great face-to-face lectures teaching us about some of the most important diseases in Gastroenterology, such as Achalasia, esophageal and stomach cancer, colorectal carcinoma, cholelithiasis, Crohn’s Disease and ulcerating colitis. Some doctors even held the lectures in English, the other lessons were translated to me by Keitaro and the other 5th year students. I am very grateful for that, as I unfortunately don’t speak any Japanese and was still able to follow the lectures this way. After learning about the diseases, we went to see patients suffering from them. We observed a broad spectrum of diagnostic procedures as well as therapeutic measures. The doctors were always motivated to show and explain everything to me. I felt very welcomed in the department and enjoyed the time there a lot.

Plastic Surgery

After getting an insight into internal medicine in Japan, I also wanted to see a surgical department. I really enjoy plastic surgery, as it is very varied, and you sometimes have to get creative to find the best therapeutic solution. Again, I received a very warm welcome and immediately felt like I was part of the team. Professor Motomura is a very joyful and friendly person who takes great interest in international exchange and made sure that I could make the most out of my time in the department.

During the two weeks, I saw a large variety of operations such as scar corrections, debridement, skin grafts and the removal of a parotid tumor that was growing around the facial nerve and had to be carefully removed in small pieces. Most impressive for me was the operation on a one-year-old girl with polydactyly. She had a sixth toe, which had grown together with the fifth. As the sixth toe was better developed than the fifth, the fifth toe was amputated and the sixth was reconstructed using a skin graft from the ankle region.

The medical equipment and surgical techniques are pretty similar to what I know from Austria. However, I was very pleasantly surprised at how calm and relaxed the atmosphere in the operating theaters was. Even in stressful situations, the surgeons remained calm and never rose their voices. I can’t think of any situation where things got hectic or loud. Before coming to Japan, I imagined Japanese doctors to be very thorough and precise, and I was pleased to be proved right.

During the time in plastic surgery, we also had a suturing course in which a surgeon reviewed the most important techniques with us. I also received a short introduction to microsurgery and was able to practice the suturing of vessels under a microscope, using a model. During the rotation we also spent one morning in the outpatient clinic. On this day, the focus was on laser surgery, particularly for the cosmetic treatment of various birthmarks, mainly in young children.

At the end of my elective, Professor Motomura invited me to a dinner with some of the doctors and students, where we had amazing Japanese food, some great talks and a lot of fun.

Throughout my entire stay in Japan, I always felt very welcomed, and I made some great friends. I learned a lot about Japanese culture and the Japanese healthcare system. Due to the cultural differences between Japan and Austria, I have gained a new perspective on things and will definitely implement the things I have learned here back home in Austria. Thank you for an amazing experience that I will remember fondly all my life!