海外実習：Day 0（オリエンテーション）

I am planning to do a one month of clinical rotation mainly in the department of Hepatology. I had a brief orientation today of the different places, I will go through out my one month rotation. (I probably won't be able to remember and end up getting lost…) The Dr. was on-call today and I was also able to get a sneak peak of her work. 

Today's Learning

• Different types of outpatient clinics

  • Each clinic has different set of patients, so runs differently. 

  • The role of pharmacist is quite big??? Drug interaction, dosage etc. 

    • Clinic A -> alcoholic related problems, cirrhosis etc

    • Clinic B -> cancer 

    • Clinic C -> transplant clinic

• Within a hospital there are section for research, both clinical and basic science. 

• 3 years of internal medicine -> 3 years of GI -> additional 1 year to become advanced GI 

  • luminal team and hepatology team and IBD stuff team -> didn't quite catch all of it

• Difference between Japanese and American medical students

  • American students are more used to the clinical settings (talking to the patients, giving presentation). 

  • Academic understanding level is different for each student. 

  • Ask questions when you don't know somethings. Any question is fine.  This is an academic setting. Unless the doctors are really busy, they are willing to teach you. (Unlike Japan)

  • If you ask a question, go home research about it so that it will stick with you. 

My Observation 

• The Dr.  was checking up to date.  I don't really see that in Japan. 

• In the patient list, there was a column for language (Spanish, Vietnamese, etc). 

  • If there is a patient's family and they are able to speak English, ask them for help. 

  • Dr.  said she is listening to spanish podcast to learn basic words!! She was asking basic questions such as where does it hurt, symptoms of vomiting, etc.. 

• Emergency Department have beds? Do they have walk ins? Different from ICU (3 types of ICU). 

Questions I was asked / I have 

• How do you diagnose SBP

• How to read lab values.

  • AST, ALT 

  • platelet levels to check the function of liver??

• What is considered dilation of biliary tract?

• What is ERCP?

My Goals

• Always have a stock of questions you want to ask. 

• Speak loudly and confidently.

  • Even in Japan, I am often told that I speak to softly. I noticed Dr.  leaning toward me to listen to what I was saying.