Report of Sidney Kimmel Medical College at Thomas Jefferson University

Clinical Training report

 

Country / Regions

United State of America

School

Sidney Kimmel Medical College at Thomas Jefferson University (USA)

Elective period

17th August to 21st August 2026

Program

International Exchange Program

 

My five-day long clinical observer program at Sidney Kimmel Medical College provided me with invaluable insights to the reality of the US healthcare system. My primary goals were to understand how clinical practice differs between the US and Japan, observe the medical education system, and challenge myself in an immersive English-speaking clinical environment.

One of the most striking aspects of my experience in Philadelphia was witnessing the huge disparity not only in the healthcare system but also in the downtown. Observing numerous homeless individuals and patients who did not have access to the healthcare highlighted the systemic challenges within the US healthcare system. When I participated in a free clinic at a homeless shelter and a free clinic at Chinatown, I saw some people with progressed diseases. While the US leads in medical innovation with surgical robots and state-of-the-art technologies, seeing the reality of divide in healthcare access made me so grateful for Japan’s universal health insurance system. These days it is widely discussed that Japan’s insurance system is collapsing and not sustainable anymore. However, thanks to this experience I started to think deeply about healthcare equality and equity.

In the educational aspects, I was highly motivated by local US medical students. They are so hard-working and very enthusiastic. One day I was asked if I would go to the bar with volunteers after the homeless clinic. I wanted to join but I said sorry I cannot go with you explaining it was over 10 pm and I needed to be at the surgery department at 6:30 am on the next day. However surprisingly they said they also needed to be at the surgery at 6 am. I was stunned how they manage their time. I had some opportunities to join rounding. I was confident in my English skills (that is why I decided to join this program), but in the real medical field they speak too fast that I could hardly catch up. This made me think I still need to keep learning English to achieve more advanced level. What was surprising was that med students also joined rounding and surgery as staff. They take vitals and check EHR systems in advance and presented to the attending doctor at the rounding, or they hold the camera at the laparoscopic surgery.

Observing surgical procedures and clinical workflows gave me an interesting contrast. The US approach values high turnover, efficiency, and standardized team coordination while Japanese approach values meticulous, detailed practices. I observed during laparoscopic cholecystectomy at the OR. I was surprised they completed it with remarkable speed. Also, the patient was not admitted after the surgery, but he was discharged on the same day.

This clerkship was a milestone in my medical education. It not only strengthened my motivation to enhance my clinical English and communication skills but also broadened my perspective on global health disparities and professional autonomy. I am eager to apply the proactive mindset and insights gained at Jefferson to my future clinical clerkships and medical career in Japan.