この度はトーマスジェファーソン大学、米国野口医学研究所のスタッフの方々のおかげで大変有意義な研修を送ることができました。臨床医学、医学教育に大変興味があり、留学前にアメリカでこれらがどのように実践されているか学んでくることを目標の一つにしていましたので、病院実習、JeffHope、寮生活どれをとっても貴重な経験となりました。病院実習では、学生が実習の一環として臨床に出ていることやresidentがattendingに気軽に相談できることに感銘を受けました。この屋根瓦式が日本の医学教育に足りないものであり自分が実践するべきものであると感じています。シャドウィングだけでなく初診を取らせていただき、様々な手技にも挑戦する機会を与えてくださいました。実技教育も充実しており、座学の知識の運用が効率的に学べました。特に印象的だったのが、午後のclinical skills trainingとPelvic sessionです。clinical skills training では白熱したディスカッションを交えて診断に迫ることができ学ぶことが多かったです。Pelvic sessionではなぜその手技を行う必要があるのかを確認しながら、模型を用いてトレーニングを行いました。そして最も日本の医学教育との違いを感じたのがJeffHopeです。国の社会的な側面を肌で感じ、さらには学生のみで運営することによる責任感がそこにはありました。単に医学を習得するのではなく、医療に近いことが実践されていました。日本で実現するには設備が足りない部分もありますが教育的にも社会的にもやる価値のあるものであると感じました。そして、最高のルームメイトに恵まれたことはこのプログラムを有意義なものにした大きな要因の一つです。将来のこと、理想の医師像、プライベートなことまで多くのことを語りました。住む場所は離れていても一生の仲間を手にしたと思います。

このプログラムを通して、自分の日頃の医学、英語の勉強法と現実とのギャップを感じることができました。このギャップを修正し、またの留学の機会に備えたいと思います。日本の医療システムにはまだ多くの改善点が残されていると思います。増え続ける医療費、高次医療機関とそれ以外の役割分担、病院での待ち時間の長さなどがそれにあたると思います。医学教育においても知識の修得ばかりで実践的ではない、教育の質の担保など多くの改善点があります。未熟ではありますが、本プログラムで得たものを生かしこれらに取り組んで参りたいと思います。

 

謝辞

本プログラムに参加するにあたり、事前に調整をしてくださった野口医学研究所スタッフの方々、トーマスジェファーソン大学のOffice of International Affairsの方々に感謝いたします。また本実習に際し、慣れない英語で質問を致しても熱心なご指導をしていただいたトーマスジェファーソン大学の先生方に感謝致します。懇親会では浅野嘉久先生、津田武先生に貴重な話をしていただきアメリカで医師として戦う意味について深く考える機会を与えていただきました。本プログラムに関わったすべての方へ心からの感謝の意と御礼を申し上げたく謝辞にかえさせていただきます。

 

 

 

 

 

 

 

 

 

 

April 9, 2018

 

To all the staff of Thomas Jefferson University

 

I am very grateful to you and to Noguchi Medical Research Institute. Thanks to your excellent help, I could make my program meaningful and many kinds of programs such as observing clinical skills, JeffHope and dormitory life got valuable for me. I’m generally very interested in clinical medicine and medical education. That’s because I made it one of my aims to learn the effective way to contact with patients and educate medical students. All programs grabbed my heart and let me learn a lot about clinical and educational skills. In observing clinical skills, I found, even though they were just medical students, they worked as what is called training doctors in Japan and attending doctors were so warm that the workplace had a very good atmosphere so that all workers could consult with attendings freely. I think this is what we have to acquire and spread throughout Japan in order to improve Japanese medical system. Not only shadowing, I was given a lot of opportunities to examine some first visitors and of course I could get a lot of insightful advice. In clinical skills training, through very productive discussions, we could get many useful advice. In addition to it, the pelvic session was the most practical one ever.

The most impressing program was JeffHope. I felt the difference in the social aspects between America and Japan and the fact that it is run only by medical students gave them responsibility. While in Japan we are taught only about medicine from medical books, in JeffHope they learned not only medicine but also social background from practical experiences. This program is very educational and I think it will become the basis of doctor for them.

I also want to mention that I had a wonderful roommate. We discussed our future, the ideal image of doctor and we got to know each other very well during our dinners together. I’m sure he is a permanent friend who can motivate each other.

This program made me aware about the differences between America and Japan and also let me find excellent ways to study English and medicine. I’m sure that this experience will help me dealing with Japanese medical programs and innovating Japanese medical educational systems.

Finally I would like to express my gratitude to all people who helped me during this program.

 

Warmest regards

 

National Defense Medical College 6^th year

Norihisa Tada

 

 

 

 

 

 

 

 

 

 

 

Acknowledgements

 

I would first like to express my sincere gratitude to Thomas Jefferson University and Noguchi Medical Research Institute for their continuous support to the program. Thanks to your excellent help, I could make my program meaningful, as well as many other programs such as observing clinical skills, JeffHope and dormitory life. I am especially grateful to Janice Bogen, Natanya Williams and Matthew Dugan, in the department of the Office of International Affairs for their warm reception.

 

My sincere thanks also goes to Dr. Wayne Bond Lau, who gave us a wonderful clinical skills training. In his lecture I could brush up the way to make good use of medical knowledge and get a lot of advice which can be put to good use immediately.

 

I’m also grateful to Dr. Stefani Russo, who taught us pelvic procedure in detail. Her afternoon session was so profitable and practical that I can put her teachings into practice immediately.

 

Besides my wonderful advisors, I would like to thank the rest of doctors who gave me great advice: Dr. Brianna Shinn, Dr. Nicholas Governatori, Lindsey Higdon, Ronald Hall and Katrina Foo for their insightful comments.

 

I am also grateful to Ms. Angell Shi and Ms. Stephanie Wey, the medical students who guided us even though they were busy preparing their examinations.

 

Finally I would like to thank all people who gave me a great support and encouragement.

 

Yours sincerely,

 

National Defense Medical College 6^th year

Norihisa Tada