Payda Stefan（July 2014）

Professional Exchange at Tsukuba University Hospital 2014

A million feelings were running though my head. A dream had come true. I had just received an e-mail from Japan, telling me I was accepted for a clinical exchange during 30-days at the Department of Neurosurgery at the University of Tsukuba Hospital . I was filled with joy and excitement, eager to get on the plane that would take me from my home country, all the way to the Land of the Rising Sun.

Before my arrival, the University required a bunch of documents. Curriculum Vitae, a motivation letter, letter of recommendation, passport photos, language certificates, vaccination records, a copy of valid health insurance and so on. It was a bit hectic to get everything in order prior to the departure, but the Tsukuba International Medical Students' Association (TIMSA) as well as and the Office for the Promotion of International Medical Affairs (OPIMA) at Tsukuba was very accommodating in the process, and after some intense days of frequent e-mailing back and forth, I was ready for Japan.

From Narita International Airport I went by the Narita Express (NEX) to the Tokyo Central Station, changed to the subway for Akihabara, and from there I boarded the very comfortable Tsukuba Express (TX) for a smooth forty-five minute ride to Tsukuba Station. At the station I was greeted by three very kind members of TIMSA who drove me to my apartment at the lodging house, located just a five-minute walk from the Hospital. The TIMSA students also lent me a bicycle, a small refrigerator and a micro-wave oven, without me even asking! Around noon, one of the students guided me to the OPIMA office inside the hospital where I met with the International Student Coordinator, an extraordinary helpful lady who had made a lot of preparations for my arrival. I cannot imagine the time it had taken them to make my arrival as effortless as possible. Everything from information, to equipment, card-keys, phones, showing me around the hospital and setting up meetings was skillfully organized. During my entire stay at Tsukuba, I could always depend on the kindness from the people at OPIMA and TIMSA to help me out whenever I had some trouble, big or small. I will be forever grateful for their sympathy and assistance!

Later during the first day I met with my supervisor for the first time. I was very nervous because I wanted to make a good impression, but I was greeted with genuine warmth and respect. We spoke for quite some time, and although I knew that the doctors are very hard-working and have a tight schedule, they took the time to calmly talk to me and make sure that all my questions was answered and that we were on the same page before I returned to the apartment that would come to be my home for one month.

Speaking of the apartment; I lived in a spacious and fresh-looking room with my own bathroom, shower and kitchen corner. And, the best think of all; air-condition! Even during days of 35°C or more, it was comfortable to stay inside and study during the evenings. The location was great, two-minutes' walk from the nearest convenience store, five-minutes' walk from the hospital, and a 10 minute bicycle ride to the train station and supermarket.

It soon became obvious that Tsukuba is a special city, a city designed to be a metropolitan area to serve development and scientific progress, and the hospital is no different; Large, modern, bright and full of cutting edge technology together with dedicated and passionate doctors, the University of Tsukuba Hospital constitutes an ideal learning environment for any medical student.

An ordinary day began at 07:30 AM in the meeting room with the discussion of patient cases, planning and preparation of surgeries, conference presentations and the latest medical journals. Sometimes even the students introduced a case of one patient which they had studied closely during the past week. Around 09:00 the doctors either went to the ward or entered the surgery room. The most striking feature of the operating theater was the 1.5 T movable intraoperative MRI system which enabled the doctors to use the advantage of medical imaging during the actual procedure. At Tsukuba, I saw a plethora of different surgical interventions; everything from a variety of brain tumors to cerebrovascular malformations and meningioma, all approached by different methods and strategies. This greatly enriched my medical knowledge and skills and made me evolve significantly in just this short period of time. If the surgery was finished by 16:00 I could join the evening round at the ward together with the rest of the doctors and the Japanese students. It was interesting to see the patients and how the doctors interacted in Japan. After the evening round there often was some kind of evening lecture on a topic related to neurology, neuroscience or neurosurgery, or occasionally some workshop offering more practical training in combination with theory. Around 19:00 I could head back home most of the days, but more often than not the surgeries continued for many hours and I usually stayed to watch as much as possible.

Thus, free time in Tsukuba was scarce compared to other countries. Nevertheless, I had a very good time outside the hospital as well! Once a week the doctors would go out to have dinner at one of the many local taverns, or "izakaya", and the students were more than welcome to join. During these dinners, I got the opportunity to really get to know the doctors and students of Tsukuba, and they in turn happily asked me about my country. In fact, they were so curious of the medical education and health care system in my country, they requested a special presentation on this topic during my last week. I was happy to comply and was greeted by both doctors and students eager to hear what I had to say. During the weekends I usually went to Tokyo to visit friends and different tourist attractions, but one day the TIMSA members took me mountain climbing up the 877 meter high, stunningly beautiful "purple" Mount Tsukuba and afterwards we went to have dinner and drinks at more than one place in Tsukuba city.

I could go on and on describing my marvelous experience at Tsukuba but I will try to restrain myself and summarize my trip by stating that this exchange gave me fantastic opportunities to improve as both a student, a future doctor and a human being, and I will bring back all of the knowledge from Tsukuba back to my own nation in an attempt to improve the quality of health care and increase the care of the individual patient.

Last by not least, I wish to say that I will never ever forget the warm-heartedness from all the people I met in this incredible city and to thank them for giving me the experience of a life time. If you have the opportunity to go to Tsukuba, take it!