When I arrived at the Fukuoka airport, I could feel the scent of summer. Smell of blue sea and heated soil. I thought the summer had already come to Kyushu island. Before I applied for this clerkship, I considered about what I can learn from it. It reminded me of 2 years ago when I came to Kyushu University for anatomy clerkship. I talked to Japanese friends about our future during clerkship and they taught me that I don't have to be obsessed with a perfect blueprint. The important thing in life was what you're doing, not what you're achieving. So I could get wider view to see my future and the world outside. In this time, I wanted to know more about their way to live and about the culture of medical society.

I chose gastrointestinology because it was one of my favorite departments in the internal medicine. I was also curious about the system of internal medical department in Japan, specially in Kyushu university. They separate internal medicine departments into 3 parts, First, second, third internal medicine. When I heard about that, it was interesting to me because Inje University doesn't have that system. So, I wonder how they interact between those departments.

Culture of medical society

1) The medical system
Each Japanese hospital has their own medical system. Kyushu University has traditional medical system that separates internal medicine into 3 parts. I was in number 2 internal medicine and they had 2 departments. One was gastrointestinal department that I was rounding in; the other one was nephrology and stroke. In Korea, stroke disease is included in neurology, but Japanese think its one independent department. In 2 departments, they have morning conferences all together every Monday sharing their patients. It was interesting.

2) Relationship
The relationship between doctors and students was surprising me. The doctors seemed to treat the students as their co-workers. Friendly way of talking makes them communicate deeply and share the knowledge efficiently. They have one leader in each department. The leader is called a professor and doctors think he's senior to them. But the professor was kind to students, too, like the other doctors. So when I was practicing in GI department, I always felt respected.

3) GI diseases
Because Kyushu university hospital is 3rd class hospital, their patients usually had severe disease like IBD (inflammatory bowel disease), protein-loosing enteropathy or rare cancers. Although I couldn't interview the patients by myself, I could watch my friends to interview them. The first patient was HSP and second patient was Crohn's disease. My Japanese friends, Saho and Aso interviewed them, watched their examination and made the plans for treatment. I was with them during these processes, and whenever I couldn't understand Japanese, they helped me in English. Besides the knowledge of GI department, another friend, Yuka who were in nephrology taught me some new drugs for anti-coagulation, the NOAC. With their help, I could learn recent knowledge's about internal medicines.

4) Attitude to patients
Every time I watch their way to treat the patients, I'm impressed. They're amazingly polite to their patients. Whenever the doctors have to do some examination for the patients, they meet the patients before the examination and bring them to the examination room and do the examination with friendly explains. It's the same when the patients have the surgery. I thought I have to learn it.

The way to live

I could meet lots of friends in Kyushu University. Some of them impressed me with their kindness. They also taught me precious things in life. I usually hung out with 6th grade students. They had many worries for their future like me. Hanayo, Yuka, Ostubo were with me everytime. I know how hard it is to take care of foreign students. I'm really grateful for them. They also have many good points. The way to talk to people, the sweet mind to respect people around them. They explained many things about Japanese cultures and medical knowledges. It made my clerkship meaningful. Although Eri, Yui, Yuri were another department, they also helped me all the time. Traveling and talking with them, I get to know that everyone in my age have same worries for their future and it gives me some power to solve it. That's the time that I get to know we can cheer up each others.
Also, I met Misato again. She was in my anatomy group 2 years ago. That time she told me that she wanted to be an OBGY doctor. At this time, I asked her again and she said it's same until now. I was happy to see her go her own way.

Every time when I experience about foreign country, I can learn what I can't get in daily life. The places I've been to be living in my mind, in same time with me. It makes me think that what I should do, on earth. I'm really grateful to Inje University for giving me this chance to improve my insight. Thank you.  

작년 말, 실습이 끝나가던 즈음 학교 홈페이지에 신청기간이라고 올라온 소식을 듣고 교환학생을 지원해볼까 하는 고민을 했었다. 일본의 의과대학과 교류가 맺어져 있어 PBL이나 해부학 실습 등 기회는 종종 있었지만 영어에 대한 자신감이 없어 매번 망설이다 참여하지 않았었다. 일본어로 회화가 가능했기 때문에 혼자 돌게 된다면 의사사통을 일본어로 할 수 있지 않을까 하는 생각도 있었고 주변 선배들이나 동기들에게 조언을 구했었는데 임상실습을 가면 각각 따로 돌게 되고 일본 사람들도 영어가 서툴기 때문에 큰 무리는 없을 거라는 말에 용기를 얻어 지원을 하게 되었다.

규슈의과대학의 임상실습은 우리나라와 마찬가지로 본과 3, 4학년 (일본에서는 5, 6학년이라고 부른다.) 학생들을 대상으로 이루어졌다. 인제대와 다른 점이 있다면 우리는 본과 3학년 때 소위 '메이저'라고 부르는 과를 길게 돌고 4학년 때 '마이너' 중에 몇 가지를 골라서 실습을 돌지만, 규슈의대에서는 5학년 때 모든 과를 각각 1~2주씩 돌아보고 6학년 때 6개 정도의 과를 골라 한 달씩 돈다는 점이었다. 그래서인지 일본 학생들은 같이 실습을 돌 때 이전 실습의 맛보기를 바탕으로 돌아보고 싶은 과를 돌며 더 심도있게 배우려는 태도가 강했던 것 같다.

4주간 피부과를 돌며 주로 병동에서의 처치, 수술을 참관하며 스태프 선생님들이 직접 환자들에게 시간을 충분히 들여 설명하는 것을 볼 수 있어 피부과의 지식뿐 아니라 환자와의 관계 형성에 대해서도 배울 수 있었다. 피부과 교수(일본에서는 각 과당 '교수'라고 불리는 선생님은 딱 1명뿐이다.)님도 학생들에게 친절하게 설명해주시고, 증상과 연관 지어 감별 포인트도 알려 주셔서 이해하는 데 도움이 많이 되었다. 일주일에 한 번은 외래/병동/병리/연구파트로 흩어져 있는 피부과 의료진들이 모두 모여 컨퍼런스를 했는데 전문용어도 많이 섞이고 속도가 빨라 다른 때보다 알아듣기는 어려웠지만 증상, 경과와 육안사진, 병리사진을 한 번에 볼 수 있어 좋았다. 종종 일과가 끝나면 담당 선생님께서 같이 피부과를 도는 6학년 학생들과 저녁을 사 주시거나 간단한 회식 자리에 데리고 가 주셔서 일본 문화에 대한 이야기도 많이 들을 수 있었다.

출근을 하지 않는 주말, 여가시간에는 동기들과 후쿠오카, 근교에 여행을 다녀오거나 규슈의대 친구들과 함께 야구경기 관람, 시내 구경을 했다. 일반적인 해외여행에서 접하기 어려웠던 장소들도 일본 친구들의 안내를 받은 덕분에 다양한 체험을 할 수 있었던 것 같다.

지원하기 전, 영어를 잘 못해서 걱정했었는데 막상 4주간 일본에 있으면서 영어는 거의 사용하지 않고 일본어만 사용해서 영어에 대한 부담을 덜 수 있었다. 일본인들에겐 조금 서툴게 들릴 수도 있었겠지만 다들 내가 못 알아들은 부분이 있으면 쉽게 설명해주려고 노력해 주어서 실습을 무사히 잘 마칠 수 있었던 것 같다. 혹시라도 임상실습을 지원하는 데 영어가 걱정이 되어 망설이고 있다면 고민하지 말고 도전해 보라고 꼭 추천해주고 싶다.