Country

New Zealand

School

University of Auckland

Elective period

3rd June 2024 – 28th June 2024

 

Internal medicine – Gastroenterology

At OMUH I was extremely fortunate to be placed in a group of very friendly fifth year students who spoke great English. The doctors at this department treated me like a special guest and were very accommodating to my learning despite the language barrier. The scheduling was very clear, and after lectures we could observe the corresponding procedures taught in that lecture which greatly improved the quality of learning.

At first, I noticed an enormous contrast between how medicine is taught in Japan and in New Zealand, because New Zealand medical schools are taught in a more unorganized manner, which creates many variables in student’s learning, whereas Japanese students will pass each stage with minimal difference in knowledge and skill amongst their peers.

Over the two weeks, I was taught various gastrointestinal pathologies, including achalasia, colon cancer, ulcerative colitis, Crohn’s disease, and their investigations and treatment options in Japan. Colon cancer screening was performed using various chromoendoscopy techniques, which aren’t widely used in New Zealand. These visualization techniques have impressive accuracy in detecting and differentiating characteristics of gastrointestinal cancers, which helps determine the most appropriate treatment option. In this department, they are also experimenting with new AI technologies to detect gastrointestinal cancers.

ESD is commonly offered as a minimally invasive treatment option for patients with early colon cancer in Japan; this is not a procedure widely used in New Zealand either due to a lack of trained gastrointestinal proceduralists. Dr. Ominami and Dr. Otani talked me through cases of duodenal and stomach ESD with patience and clarity.

At the end of my two weeks in this department, I had to present a case alongside my peers to Professor Fujiwara and answer a series of clinical questions. I had great support from Dr Ominami and other 5th-year students to complete this task, and Professor Fujiwara was very impressed with the result.

Internal medicine – Cardiology

On my first day, we went straight into the action with a mitral clipping procedure and two transcatheter aortic valve repairs, which I had the pleasure of observing right next to the primary proceduralist, Dr. Kagawa. On the evening of my first day, I was invited to a presentation given by Dr Yamaguchi hosted by Amgen in which he talked about the efficacy of PCSK9 inhibitor on ischemic heart disease. After that, he took me to an expensive sushi restaurant and treated me to some of the most delicious sushi I had ever tasted.

The schedule at this department was very flexible as I was allowed to choose which procedure I wanted to observe on the days with no lectures. I chose to watch electrophysiology procedures, such as ablation and ICD, mostly due to personal interest. I had great exchanges with Dr Yoshiyama regarding the future of pulse field ablation and discussed the nuances of complex ECG patterns. I was also taught by Dr. Tomohito on how transesophageal echocardiograms are performed.

Through discussions on ward rounds with Professor Fukuda, I was able to gain more knowledge in Cardiology and understand the different risk factors and pathologies affecting Japanese and New Zealand patients. The fact that health insurance is mandatory for all Japanese citizens was also a big surprise for me. Throughout my two weeks in this department, Dr Yamaguchi has been extremely supportive of my learning and well-being; thanks to him, I could take the most I could during my limited time in Japan. Overall, I was very impressed with the Japanese medical school system and the advanced medical procedures Japan can provide to its citizens. This elective has broadened my horizons of knowledge and perspective.

I’m also very grateful to have made such great friends with the local students: Miyu, Keitaro, Miho, Nari, Setsuko, Tatsuya, and so many more! Thank you to everyone for throwing the welcome party and accompanying me to Universal Studios Japan!