I’m a li’l ol’ Texan who was born, raised, and educated there until moving to New York for her internal medicine residency. When the opportunity arose to work in Japan, I jumped at the chance (and across the ocean) to see how medicine was practiced differently in another country and to experience an entirely new culture (besides which I did not have any firm plans after residency).
I have always loved to travel but, unfortunately before now, have never lived abroad for an extended period of time. During my vacations, I would have fleeting questions about how medicine worked in these countries compared to the US. When my program director asked if anyone was interested in this Japanese program, my hand initially shot up as if to say, “YES, pick me!”
Away I go, then, to the “Land of the Rising Sun.” What exactly does my new job entail? Well, in order to understand that part, the Japanese medical education system has to be explained first. After high school, Japanese students take placement tests in order to get into further schooling. The Japanese medical schooling combines undergraduate studies and medical school together for a total of 6 years. Because it has been felt that the new medical graduates do not experience enough hands-on clinical experience, they have to undergo a nationally mandated 2 years’ general residency training (similar to transitional year in the US). They can then undergo specialty/subspecialty training, i.e. general internal medicine, cardiology, gastroenterology, orthopedics, etc, for several more years afterwards.
In contrast, in the US, undergraduate studies are separate from medical school for a (typical) 4 years in undergrad + 4 years in medical school. Afterwards, the newly graduated doctors undergo residency training of their specialty, not subspecialty (which is reserved for fellowship training).
About 10 years ago at a Japanese residency program, a physician decided to change the residency teaching program in order to fashion it more like the US style. Many moons ago during the early formative years of developing a Japanese medical training education, it was decided to follow the German style. This style, combined with the Japanese hierarchical society, provides a medical education that is more “shadowing,” and less hands-on direct patient contact.
The medical education in the US allows 3rd and 4th year students to interview and examine patients by themselves (under supervision, of course) and encourages, nay requires, students to formulate their own impressions and plans for the patients. After medical school graduation, therefore, the new US residents generally have much more hands-on direct patient contact compared to the new Japanese residents.
The above-mentioned Japanese residency program’s goal, therefore, is to incorporate some of the US-styled teaching in order to help integrate the high level of Japanese knowledge into clinical scenarios. Some of the activities to help this goal include American-styled morning reports, stethoscope rounds (for physical findings), and OSCE’s (with standardized patients). An American faculty (which is me for at least this year) is also in residence throughout the year in order to help promote and foster the above goals.
Please join me in my journey as I explore Japan!