◎最終日に集合写真を撮影しました

ご報告が遅くなりましたが、Finland出身の留学生Ninaさんが2週間（10月2日〜12日）、第3内科で実習しました。今回は国際医学生連盟（IFMSA：International Federation of Medical Students’ Associations）による交換留学の一環で来日されました。この交換留学は、受け入れた留学生の人数分だけ、学生を世界中のどこかへ送り出せる「持ちつ持たれつの制度」です。

そこで、国際化推進委員会の委員である熊木がコンタクトパーソンとなり、もし愛媛大学の学生が海外へ飛び込んだ時に、こんなことはしてもらいたいな、あるいはこんなのは嫌だなと思うことを考えながら週間スケジュールを用意することにしました。一番困るのは放置でしょう。

下記がそのやり取りです。英語に興味のある方はどうぞ。面倒な方は日本語だけでもどうぞ。

【2018年9月6日送信】

Dear Nina,

My name is Teru Kumagi. It is my great pleasure to contact you in person. I will be the contact person and mentor during your elective at the gastroenterology clinic between October 1-12.

We wish to prepare you a personal program so that you may acquire various things in your limited precious time while in Ehime. However, this largely depends on what you expect us and wish to accomplish in 2 weeks. So please let me know your preference. Our clinic covers both outpatient and inpatient clinic. We have a large endoscopic unit that covers routine endoscopy and therapeutic endoscopies (ESD, EIS, ERCP, EUS-BD, etc). We also have one of the most popular hepatology teams in Japan. Of note, our department covers endocrinology as well.

We look forward to seeing you very soon.

Sincerely yours,

Teru

PS: I have practiced at the University of Toronto for 4 years, so don’t worry about communicating in English.

【2018年9月6日受信】

Dear Mr. Kumagi,

Thank you for your email! I am very grateful of the effort you are making to plan a personal program for me in Ehime! It all sounds very good!

Is it possible to follow the hepatology team for one week and then in the second week maybe spend a couple of days at the outpatient clinic and a couple of days at the endoscopy unit?

Looking forward to meeting You!

Sincerely,

Nina

このやり取りで幅広く実習に加わりたい様子が伝わり、下記のスケジュールを組みました。

◎実習生・研修医およびEMSA（IFMSA-Japan愛媛支部）とともにIzakayaで歓迎会

そして、とても有意義な経験であったことが伝わる、以下のエッセーを書いてくれました。

This autumn I had the pleasure to spend two weeks at the gastroenterology department at Ehime University Hospital. I had picked Japan and as my first choice of exchange destination because I was fascinated by the fusion of ancient culture and traditions with modern metropolis along with Japan’s vast natural beauty. But besides that I also thought that Japan would be a good choice considering my educational and professional goals as Japan has a high incidence of some gastrointestinal diseases that are quite a rare back home in Finland and a different way of diagnosing and treating them. I was expecting an interesting internship, but I was really surprised of how much I actually learned during my stay.

My main field of interest in medicine are gastrointestinal diseases, but during my studies I have mainly concentrated on the surgical side of them. I was curious to see how the internal medicine side of it would appeal to me as I am much less familiar with it. I was also a little bit worried if my Japanese skills, limited pretty much to ‘sumimasen’ and ‘arigatoogosaimasu’, would be enough to understand anything going on at the department. Luckily my fears of long ward rounds in Japanese were proven wrong already on my first day. As my first experience at the department I saw a laparoscopic liver biopsy performed in local anesthesia. For me it was very exotic as in Finland laparoscopies are always performed under general anesthesia by the surgeons. The rest of my stay turned out to be not any less exciting and educational.

At the clinic I encountered many diseases that are a lot less common in Finland than Japan and got to see how they are diagnosed and treated here. For example, in Finland alcohol is the major cause of liver disease and infectious hepatitis is not nearly as common as in Japan, we have a lot less upper GI tract cancer and what comes to diagnostics we use less ultrasound and more biopsies. Also the health care system in general is quite different. During my stay I even got to see a case of Budd-Chiari syndrome, which I suppose is rare in Japan as well. I was also amazed by the Japanese doctors’ skills at endoscopy. I’ve seen a lot of endoscopies during my studies, but in Finland they make up a smaller part of the doctor’s work as they are performed by both internists and surgeons and I got to learn many new things about endoscopic diagnostics and treatment and about some Japanese guidelines. I think seeing different ways of handling things is always useful and also makes you see the more familiar way in a different light.

Before my internship I was asked about my preferences considering my stay at the clinic and was provided with a personal schedule. It made my stay very easy always having an idea where to go next and I was able to join many different routines at the clinic, such as ERCP, ultrasounds, endoscopies, RFA, TACE and outpatient clinic.

All in all, I had a really pleasant and professionally inspiring experience at the gastroenterology department and the biggest reason behind it are the incredibly friendly doctors and students, who took the effort of trying to translate what’s going on and provided a lot of interesting information. I felt very welcome at the clinic, not least because of a memorable welcoming party organized on my first week, where I got to taste various delicious Japanese dishes and enjoy a real Izakaya spirit in great company. I think this short stay has clarified my next steps on my career and provided some invaluable memories.

Ninaさんには、「フィンランドと日本の医療の違い」と称したタイトルでショートプレゼンテーションを予めお願いしてあり、分かりやすくスピーチしてくれました。

これからも第3内科では、いやいや愛媛大学では積極的に多くの留学生を受け入れ、多くの学生を送り出したいと思います。いやいや、1:1の交換条件ですから送り出す学生を探すことの方が先ですね。そのためには、多くの学生に英語の勉強をしてもらわなくてはなりません。この記事を読んでくれた学生の皆さん、そうです、あなたのことです！

（文責：熊木天児）