The field of medicine is a unique discipline that is not limited by geographical boundaries. As a medical student in Canada, I was afforded the privilege of partaking in an extracurricular international exchange this past summer. With the International Federation of Medical Students Association SCORE program, I had the opportunity to travel to Ibaraki Prefecture, Japan to participate in a clinical placement with the Department of Neurosurgery at Tsukuba University. I chose Japan as an exchange country both for its educational directive and the added sentimental value. Having grown up in Okinawa, Japan before moving to Canada, the exchange was the first time I returned to the country I once called my home.
Selecting Tsukuba as my choice of exchange placement was based on the description of the project, which incorporated both a basic and clinical component; as well as the ranking of the university and its medical institutions. The institution has a reputation that precedes itself. Tsukuba University is a leader in Japan for neurosurgery, particularly in skull-based surgery, with a reputed team of surgeons and scientists. Before starting my internship placement, I read and familiarized myself with literature on the procedures I would be observing as well as some of the numerous and impressive publications by the department.
My arrival to Tsukuba and transition to the internship was managed by both Tsukuba International Medical Students’ Association (TIMSA) and the Office for the Promotion of International Medical Affairs (OPIMA). The students and staff involved organized all of my accommodation, local transport and the necessities I required for my stay in Japan. In addition, TIMSA liaised me with other international students partaking in exchanges and provided me with a tour of the city I would call home for the next 4 weeks.
Tsukuba is a bustling urban metropolis in Ibaraki Prefecture situated a short commute from Tokyo. The city center holds large shopping complexes, a variety of restaurants and venues for festivals and events. This bike-friendly city also hosts large green spaces and parks. The University, a community in its own right, is located a short bike ride away from the city center with near-by restaurants and shops. The University has a diverse and multicultural student population and is host to many international learners.
On my first day at the internship, I met my preceptor Dr. Akutsu and the team of surgeons, residents and medical students I would work with. I garnered the rhythm and pace of the department over the next few days. Mornings began with teaching, neuroradiology and case conferences followed by bedside rounds of pre-op, post-op and inpatients. The remainder of the day was spent in the OR, observing and assisting in neurosurgeries.
The breadth of surgeries I was able to participate in and learn about was beyond what I had anticipated. These spanned minimally invasive endoscopic transphenoidal pituitary adenoma resections to craniotomies for the removal of large tumors. I was able to see a wide number of procedures in the pediatric and adult patient population including angiography, coiling of aneurysms, placements of VP shunts in hydrocephalus, embolization of AVMs and intraorbital tumour sections. Moreover, I was able to assist in closures during craniotomies, enhancing my clinical experience and practical surgical skills. I was also able to participate with the Japanese medical students during their labs and learn techniques such as microsuturing and angiography. During the month, I was also able to participate in English rounds, where students present a patient to the director of the institute.
Although language posed as a barrier, the surgeons and medical students made every effort to engage me in discussions and make me feel welcome in the learning process. Residents and students translated for me during conferences and rounds, and doctors repeated and emphasized important clinical findings for my understanding. In the OR, the surgeons explained the procedure, the anatomy, the pathophysiology and clinical diagnosis. As a result of these efforts and extra teachings, my learning experience was enriched. The collegial relationship between the students, residents and doctors both in the OR and at department dinners made me feel a part of the team.
During my internship I was also able to learn about the healthcare system in Japan. The Japanese health care model is a leading system that puts the patient first and incorporates cutting-edge technology into medical care. An example of this is the Proton Therapy Centre at the institution. The doctors at Tsukuba also emphasized the importance of medical research and its practical applications and the future of neurosurgery.
Outside of the academic component of the exchange, the students at TIMSA were gracious in organizing dinners, traditional Japanese ceremonies and an excursion to Tokyo. Through my interaction with them, I was able to learn about the medical school system in Japan and bond with my international colleagues.
My exchange experience was nothing short of extraordinary. From the clinical placement to the cultural immersion, my role as both a medical student and a tourist in Japan were truly strengthened. I was able to learn under the guidance of an excellent team of teachers and will be able to incorporate the knowledge and skills I gained from this internship to my future practice as a physician in Canada. Medicine transcends borders and in every country, all medical providers work toward the same goal of enhancing patient care. To everyone involved in organizing my exchange, thank you for your hospitality and for this incredible opportunity. And to future participants of the program, I hope that you will be as fortunate as I was in your clinical placement.
Geetanjalee Sadi
MD Class of 2017
The University of Manitoba College of Medicine, Canada