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Day 4 小児整形外科では、藤原憲太先生の医師と患者の関係についていい勉強になりました。まず先生はやさしく子供の患者さんに挨拶し、穏やかな感じで話しかけるのです。子供の患者を注意深く見て、異常性を見逃すことがないようにと教わりました。先生の子供たちへの温かさに感動し、子供の患者さんには自分もこのように接しようと思いました。
Day 5 CT画像診断についてくわしく放射線科で学びました。タイでは盲腸にはCTスキャン検査が含まれていないのでCT画像で盲腸を見るのは初めてでした。膵炎の膵臓や、大腿ヘルニア、その他たくさんのCT画像を見ました。鳴海善文教授が日本のガイドラインを各疾患ごとに説明して下ったので、タイの場合と比べることができました。
Day 12 病理学ではスライドの見方を習ったり、ホルマリンを注入してスライドを作る作業をしました。先生は、自分の仕事が好きで、表舞台に立つことはなくても患者さんの疾患の回復の助けになることが自分の幸せだと語ってくださり、とても感動しました。手術中の病理報告は15分以内にしないといけないのですが、手術室に直接連絡できるシステムがあり、実際にその場面を見ることができました。
Day 16 口腔外科では、植野高章教授にがん患者のオーラルケアについて教えていただきました。オーラルケアについて気をつけて患者さんに接しようと思います。その他、下あご骨折修復、親知らずの抜歯、舌の切除などの見学をしました。
Day 17 三島救急医療センターに行きました。脳内出血による心拍停止の患者さんに対する心肺蘇生(CPR)、胸部の痛みを訴える患者さん、そして階段から落ちた患者さんへの対応と、3つのケースを見学することができました。救急患者さんの為に多くの進んだ機器がそろっており、マネジメントも含めて詳しく説明を受けました。救急センターを見学する機会があってよかったです。タイにも将来このようなセンターができればいいと思いました。
Day 18 消化器内科で午前中は上部消化管内視鏡検査を見学しました。私たちの病院とプロセスは大体同じでした。そのあと、シミュレーションセンターで、内視鏡の使い方の練習をしました。内視鏡の先が見えるので正しい方向へ動かすことができ、とても素晴らしいと思いました。午後は大腸内視鏡検査を見学しました。
ありがとうございました。
CLINICAL ELECTIVE PROGRAM
OSAKA MEDICAL COLLEGE
14th March 2016-8th April 2016
4th year medical student, Siriraj Hospital,
Mahidol University
Pornkamol Tiranaprakij
Day 1 Department of anatomy
Today,We had a chance to learn about Inner
ear Hair cell. Sensei taught us how to dissect the
newborn mice which were so little just as small as
our fingertip. This was actually our first time doing a
dissection with live animals. Therefore, this
experiment was very exciting for us. Sensei taught
us from the beginning about how to remove tissue,
crack open the bone, separate the cochlear and lastly
identify the inner hair cell. Senseis are very kind to
us. They taught us about everything and gently
explain all the instruction for us.
After we finished the dissection, we continued
with the experiment and we had an opportunity to
see the inner hair cell of newborn mice under newly-
invented fluorescent microscope which was very
advanced and convenient. The microscope was
controlled solely by computer and the picture could
be seen clearly on the computer’s screen.
Thank you so much Sensei, for teaching us a
lot for everything and also for treating us such a
wonderful Sushi lunch. Arigato Gozaimasu
Day 2 BNCT
We had such a special opportunity to have a
lecture about Boron Neutron Capture Therapy from
Professor.Miyatake. The lecture was very fantastic
and interesting. We have learnt a lot of things about
BNCT starting from the mechanism of reaction,
advantage of BNCT, management and adaptation for
treatment of Brain tumor patients and development
for future research. Professor.Miyatake explained to
us that this method can be used for treatment for
many malignant brain tumors and also kindly answer
to our question for an adaptation of BNCT for the
use of Metastatic cancerTreatment,
We have been inspired by this wonderful
lecture kindly explained to us by
Professor.Miyatake. Arigatou Gozaimasu
Suntory Brewery
In the afternoon, OMC had arranged the
program for us to go to Suntory Brewery, one of the
most famous beer factory in this area. We had a
great chance to observe the production of Beer from
the beginning until the end. Thank you OMC for
arranging this program for us
Day3 Department of Microbiology and
infectious control
We had an opportunity to join Ward round with
the infectious team. We observed management for
antibiotics and infectious control and can compare with
the system in our country. The picture next to this
paragraph is the picture of Japanese microbiology
textbook. I’m really impressed by this book because it’s
well prepared with explainable cartoons and it looks
very understandable for students.
Department of Blood transfusion
At transfusion center. Sensei explain us about
system of blood donation and transfusion guidelines
which are a little bit different from ours. I'm impressed
by one video from donation cable. It's very interesting.
Mishima Emergency critical care
Another exciting rotation, today was their yearly
training day as a preparation for upcoming disasters. As
you can see from the picture, this is all just a simulation.
I’m really impressed by well-prepared training for
unpredictable disaster we have seen today. Japan always
delicately prepares for every events and situations.
Day 4 Pediatric Orthopedic
Our rotation today was Pediatric Orthopedic Out Patient
Department with Prof Fujiwara He treated his children patients
really well. Though we could not understand Japanese, he had tried
to explain to us. He gave us a very good example of doctor-patient
relationship. We had seen he greeted his small patients gently and
talked to them kindly. He also taught us to examine our future
children patients carefully so that we would not miss any
abnormalities.
I was inspired by Professor.Fujiwara kindness and care for
his young patients. I hope that in future, I can treat my own young
patient as well as him. Arigatou gozaimasu
Day 5 Radiology
In the morning, we had a discussion about CT
image cases. It was a very fun and informative
radiodiagnosis lesson. We had a chance to see CT of
appendicitis (It was very interesting for us because
in Thailand we have different guideline which
doesn’t include CT scan. Therefore, this was our
first time seeing appendicitis as CT image.) ,
pancreatitis, femoral hernia and many more. Sensei
was very kind to us. He taught us a lot about how to
read CT image and also explain us about a role of
radiology in japan guideline for each disease so that
we can compare to our country’s guidelines.
During the lunch time Professor.Narumi treated
us a wonderful lunch and after that we stayed at
outpatient clinic where we had observed many
interesting cases. Sensei also let us do physical
examination with his patient and kindly explained to
us all about radiation interventions in this hospital.
We have learnt a lot of things today. Arigato
Gozaimasu
Day 6 Cardiology Medicine
In the morning, Professor.Ito gave us a lesson
all about basic cardiology. He explained every
mechanism of heart murmurs by giving us a picture
of graph that can explain heart sounds and murmurs.
This lesson was very interesting and understandable.
After the lesson, Professor let us examine cardiac
simulator for heart murmur which we can hear every
heart murmurs at the exactly right location as the
real body. We used our own stethoscope with this
simulator together with kind guidance from
Professor Ito.
In the afternoon, we continued our rotation
with observation of Transesophageal
echocardiogram and cardiac catheterization.
Professor explained all along the process and also
explained to us about cardiac diseases in Japan. So
that we can understand more about the difference
between Thailand and Japan
Day 7 Urology
Today Wahn and I went to different
departments. For me, I went to Urology department
where I had learnt a lot of wonderful things.
I was arranged to stay at Urology outpatient
clinic. Sensei was very kind to me. He let me do
many urology procedure such as cystoscopy, double
J insertion, and penile drug injection. Sensei
supervised me in every process. In spite of language
barrier, sensei had tried very hard to translate
patients’ information and diseases to me
In the afternoon, I had a chance to observe an
operation in newly opened OR. The operation room
is very well equipped along with high-technology
program. I’m very impressed .Thank you very much
for today rotation.
Day 8 Emergency Medicine, Takatsuki
Fire headquarter and Doctor Helicopter
Today rotation was one of the most exciting
rotation for me. In the morning, we had lecture about
Emergency system at OMC and in Japan. I had just
known about the emergency care in Japan which are
divided into steps so that patients can be well-
treated. After that we went to Takatsuki fire
headquarter where we learnt a lot more about
emergency system in Japan. They showed us the
center room which receive emergency call from all
responsible area. They gave me a chance to make a
simulation emergency call. The system can
understand many language such as Japanese, English
and Korean. We could see whole picture the
emergency system by this.
In the afternoon, we went to Osaka university
to learn about Doctor Helicopter. After I had a
lecture and saw the real doctor Heli. I was very
impressed. This emergency system is exactly the
same as in the movie “Code Blue” which I had seen
before I went to Japan.
Day 9 Department of Neurology
Today we were arranged for Neurology
Department. We were allowed to be in Neurology
ward round. We had a chance to observed many
interesting cases. We had found that there were
many rare-cased patients at OMC. Although the
ward round was in Japanese. All neurology doctors
kindly translated all information into English for us
and also explained patients’ pathology to us. From
this ward round, we can understand more about
Neurology management at OMC.
We observed many interesting diseases such
as Anti-NMDA encephalitis, Parkinson’s disease,
Stiffman’s syndrome, Multiple sclerosis etc.
Thank you very much for today rotation.
Day 10 Gastrointestinal Surgery
Today we had a great chance to observe
many interesting Gastrointestinal surgery in newly
opened operation rooms. The cases were quite
interesting and they were all done under
laparoscopy. Some of the operation used new 3D-
technology. We both had to wear 3D glasses during
the operation. After we wore the glasses, we had
found that the real-time video of the operation was
increased in dimension and quality as well. We
asked professor about the benefit of this technology.
He told us that it helps increase accuracy of the
operation, reduce length of the operation and the
field of the operation seen from the monitor will be
better and easier for surgeon to operate.
We had an opportunity to observe many
interesting cases such as Low anterior resection for