The First International Physician Seminar 講義内容
Alan Kawarai Lefor M.D., MPH, Ph.D., F.A.C.S.
Professor of Surgery, Jichi Medical University
【Profile】MD (SUNY Upstate 1982), MPH (UCLA 1999, Health Services)), PhD (Tohoku University 2015, Theoretical Astrophysics) I did a residency in General Surgery (SUNY Upstate) as well as a Fellowship in Surgical Oncology (NCI, NIH), and have my boards in Surgical Critical Care. Prior to coming to Japan, I was Professor of Surgery at UCLA, and heavily involved in teaching of residents (General Surgery), fellows (Surgical Oncology) and Medical Students. I have been in Japan for 10 years, and worked throughout that time as Professor of Surgery at Jichi Medical University in Tochigi. My perspectives on medical education in Japan are a result of working with students and residents in both the USA and Japan, and having been a patient in both countries.
TITLE of my session:"Optimizing bedside learning for medical students in Japan"
Session Content: The session will focus on discussing various issues in medical education in Japan, in part to describe differences in education comparing Japan and the United States but also to identify areas for possible change. The seminar participants will be the leaders of Japanese medical education and have the chance to make changes in the system of tomorrow.
Medical Students in Japan have told me that they feel like observers. This is very unfortunate and can be changed.
· Medical students in Japan must be comfortable to read English.
· Medical students in Japan need the opportunity to take advanced clinical electives.· Improved medical student teaching will result from improved resident teaching. These two cannot be separated. Residents must be trained as teachers and fully engaged in the process of student teaching.
Our patients depend on us to be complete. There is no excuse for less than a complete patient evaluation that is also cost-effective.
· “You don’t know how far you can go till you've gone too far”
· “Persistence, Persistence, Persistence”
Joel Branch, BSc, MB BS, MRCP (UK).
Director of Internal Medicine Education & Simulation Skills Training, Shonan Kamakura General Hospital.
1993-1999 – University College London School of Medicine;
1999-2006 – Residency and specialization in Diabetes and Endocrinology with General Medicine, UK;
2006-2016 - Shonan Kamakura General Hospital: permanent teaching staff (see above).
TITLE of mysession: "Importance of the Physical Examination in the Era of Modern Medicine"
Session Content: During the seminar, YOU will be integral to the discussion, because believe it or not, you DO know the answers! I will cover with you the importance of attaining good skill in the time-honored tradition of patient examination, that all physicians should be knowledgeable of, but which students and young doctors seldom appear to focus upon in detail. Lastly, I will reveal some ‘Pearls’ of physical examination to help the attendees better appreciate the importance of bedside examination in the modern era of technology that they can use in their future every day practice.
・“You cannot truly understand
your patients without taking a thorough history and physical examination.”
・ “Every patient is
interesting; to say otherwise means you have failed to appreciate the nuances of the patient’s condition.”
・“What you may consider a standard patient, will to the learned and seasoned physician reveal so much about their past life and their future. To be able to find such details, you
need to learn the art of looking and actively seeking pertinent details.”
・“To learn effective physical examination techniques, you need to have a good textbook on the subject (and hopefully a good teacher!). You need to read it,
practice the techniques, apply them to real patients, and then read the book again!”
・“Have as much clinical exposure to patients as possible. Patients ARE the best teachers, but you ALSO need to ask your senior physicians to guide you to understand the nature of the diseases you observe.”
・“Always be respectful to patients. Always consider their discomfort and distress. Remember to drape them, respect their privacy and maintain their dignity. They are gems that you should utmost cherish.”
Gautam Deshpande, MA, M.D.
Staff physician and Post Medical Advisor, US Embassy
Professor of Behavioral Medicine & Vice dean for International Affairs, St. Luke's International University Graduate School of Public Health
【Profile】 I grew up near Princeton, New Jersey and then did an undergraduate degree in Human Biology (1997) and Master’s degree in Anthropology (1999) at Stanford University. I lived in Ehime, Japan for 1 year, working as a medical English teacher, before going to medical school at The Pennsylvania State College of Medicine (2004). I completed training in General Internal Medicine at the University of California - San Diego (2007) and a Chief Residency at the University of Hawaii (2008). I then joined the UH faculty as a hospitalist. I moved to Japan, where I am the staff physician and Post Medical Advisor for the US Embassy. I am also a Professor of Behavioral Medicine in the St. Luke's International University Graduate School of Public Health and Vice Dean for International Affairs.
TITLE of my session:"Patient-Centered Medicine: The Cornerstone of Every Medical Practice"
Session Content: In 2001, the Institute of Medicine (IOM) defined patient-centered care as "providing care that is respectful of and responsive to individual patient preferences, needs,
and values and ensuring that patient values guide all clinical decisions."
In our session, we will have an interactive lecture using examples from real patient cases, covering the following topics:
・What is Patient-Centered Medicine and why should we make it the cornerstone of all of our medical practices?
・How does Patient-Centered Medicine improve healthcare and health outcomes?
・How does Patient-Centered Medicine improve our satisfaction and career satisfaction as clinicians?
・How does the idea of Patient-Centered Medicine improve our bedside clinical skills: better interviewing and history-taking, better physical exam, and better treatments for our patients?
Take-Home Messages: The center of our job as clinicians is the patient's health and happiness. By making our patients the focal point of our practice, we can improve how we talk to them, how we diagnose them, and how we treat them. We can improve not only their health, but their QUALITY OF LIFE.
Final Words: Patient-Centered Medicine is a new topic, but an old theme. It was best described by William Osler, a century ago: "The good physician treats the disease; the great physician treats the patient who has the disease."
Sandra Moody, M.D., B.S.N.
Professor-in-Residence at the Kameda Medical Center in the Department of Medicine/Graduate Medical Education, Visiting professor at Tsukuba University, Associate Professor of Clinical Medicine in the Department of Medicine/Division of Geriatrics at the University of California, San Francisco (UCSF) and the San Francisco Veteran Affairs Medical Center (SFVAMC)
【Profile】Dr. Moody received her MD from The Ohio State University College of Medicine in 1991. She completed a residency in Internal Medicine, a research fellowship in the Robert Wood Johnson Clinical Scholars Program, and a clinical and research fellowship in Geriatrics Medicine at the Yale University School of Medicine (1991-1998). Her first faculty position was at the University of North Carolina, Chapel Hill (1998-2001), and subsequently at the UCSF faculty (2001-present). She has maintained affiliation with UCSF as voluntary faculty since becoming the professor-in-residence at Kameda Medical Center in 2011. Dr. Moody has collaborated on and published research work related to the care of older adults. Her clinical work has been in the area of geriatrics, including nursing home and home care, and hospice and palliative care at UCSF; she now has clinical privileges at the U.S. Naval Hospital Yokosuka in the Internal Medicine Clinic. Dr. Moody has mentored numerous individuals in medicine at all levels. She has won honors and teaching awards for her contributions in geriatrics, palliative care, and medical education.
TITLE of my session: "History Taking and Physical Examination Through A Clinical Reasoning Context"
Session Content: This session will address the clinical reasoning process that guides through obtaining the history and performing the physical examination, leading to a potential diagnosis.
Take-Home Messages: The doctor is always thinking, reasoning. From the first interaction with the patient, we begin the clinical reasoning process. We must learn and practice this process as we would if learning to play an instrument.
Final Words: Helen Keller once said, "When we do the best that we can, we never know what miracle is wrought in our life, or in the life of another." Becoming and being a physician require that we do our best. It means hard work, life-long learning, skillful communication, and humility. We must remember that we have been given a gift – to touch the lives of our patients and bring the miracle of healing into their lives.
Kris Siriratsivawong, M.D., F.A.C.S.
Lieutenant Commander, Medical Corps, United States Navy
Department Head, General Surgery
Surgery Provider, Graduate Medical Education Committee
U.S. Naval Hospital Yokosuka Japan
1998-2002 Yale Univesity (Bachelors of Science in Molecular Biophysics and Biochemistry)
2002-2006 University of Pittsburgh School of Medicine (Doctor of Medicine)
2006-2007 Naval Medical Center San Diego (Basic Surgery Intern)
2007-2009 General Medical Officer (1st Marine Division)
2009-2013 Naval Medical Center San Diego (General Surgery Residency)
2013-2015 General Surgeon, Fleet Surgical Team, Amphibious Ready Group
2015-present General Surgeon and Department Head, U.S. Naval Hospital Yokosuka
TITLE of my session: "The One-year Fellowship Program for Japanese physicians: Clinical experience in Western-style Medicine in Japan"
Session Content: As lead surgical educator for the Japanese Fellowship program, I have been working closely with Japanese physicians who have an interest in pursuing medical training in
North America. There are multiple options for Japanese physicians to obtain clinical experience in U.S. style of medical practice. One of those options is to obtain the experience right here in
Japan, by working at one of the U.S. military hospitals. I will discuss this option for those who wish to explore this valuable experience.
Furthermore, during this session, I will go over the keys to successfully obtaining a residency position in the United States. I will touch on the challenges and pitfalls that you might encounter along the way. We will discuss the learning points from Japanese physicians that spent time in the U.S. for medical training. For those who have successfully navigated this process, I also welcome your input.
・A one-year fellowship experience at one of the U.S. Navy hospitals in Japan could be a potential stepping stone for further training in the United
・Obtaining formal medical training in the United States is a challenging endeavor, which includes learning a different set of medical terminology and changing the cultural mindset of medical education, but will open doors of opportunities.
Final Words: “Do or do not. There is no try.” – Yoda (Star Wars Episode IV)
Junji Machi, M.D., Ph.D., F.A.C.S.
Professor of Surgery; Assistant Director of Office of Global Health/Medicine, JABSOM, University of Hawaii; Founder, JrSr Corporation
1970-1977 Juntendo University
1977-1981 Okinawa Chubu (resident)
1981-1984 University of Illinois (Research Fellow)(M.S. 1982, Ph.D. 1984)
1984-1987 Kurume University
1987-1993 Medical College of Pennsylvania (Research and Resident)
1993-1995 Mercy Hospital of Pittsburgh (Resident)
1995- present University of Hawaii . Abdominal ultrasound module director, American College of Surgeons
Founder of educational corporation, Junior Senior (JrSr) in Japan.
Session Content: As a coordinator of the first
“JrSr International seminar for students and residents”, I welcome you all with my best support. The unique
strengths of this seminar include 1) international passionate clinician-educators living in Japan, 2) small group interactive sessions, 3) emphasizing basic clinical skills (history and
physical), and 4) potentially an excellent step to the US training.
The key for success of this seminar is not JrSr, not teachers but it is you. You should and can enjoy the seminar by discussion, communication and participation in the seminar and by teaching and learning each other and my making many friends. Do not hesitate to speak up, stand up, and participate. It is your seminar for improvement, globalization, prosperity and dream of yourself.
・Understanding Japanese medical education from global standpoints, particularly the value of acquiring bedside clinical skills
・Motivation to be an active learner and future teacher
・Recognition of your goals as a physician and your dreams in your life
・”Every patient is your best teacher: every clinical opportunity is a teachable and learning moment.”
・“Don’t worry about mistake or failure. Worry about the chances you miss when you don’t even try.”
・“Learn from yesterday, live for today, hope for tomorrow. The important thing is to keep moving forward.”
・“Don't quit, because you are not a failure until you quit or fail to try.”
・“The future belongs to those who believe in the beauty of their dreams.”