Kazuyuki Tanaka (5th grade)

From August 3rd to 10th, ten fifth-year students Hyogo Medical University took a lecture on bioethics at the University of Washington in Seattle, USA. I knew about this course right after I enrolled, and I knew I wanted to participate from the beginning. I am not a very enthusiastic student of medical research, and I can only study enough to pass regular exams, but I was interested in the environment and enthusiasm with which medical students overseas, especially American medical students, study medicine, so I applied for this training. I would like to write about the points that particularly interested me during this training.

First, regarding the American School of Medicine system, in Japan, if School of Medicine pass the entrance exam after graduating from high school, you can enter School of Medicine directly and attend for six years, then complete two years of initial training and three years of advanced training to become a full-fledged doctor. In contrast, in the United States, after graduating from a four-year university, you attend medical school for four years and work as a resident for three years after graduation to become a full-fledged doctor. Both programs are structured to train doctors in 11 years, but in the United States, it seems that the study of general education is emphasized, so American doctors inevitably obtain not only a medical license but also a bachelor's degree in engineering or humanities. I think the reason why American medicine remains at the top of the world is because there is diversity in the special profession of doctors, with various sub-specialties. As for tuition fees, the University of Washington, a state university, has a fairly high tuition fee of 3.5 million yen per year. However, this amount is apparently the average amount for state universities, and the average for private universities is about 6 million yen per year. Despite the high tuition fees, most students seem to be able to enroll by borrowing scholarships, and there are few families whose parents pay their tuition. The fact that there are many students who want to study medicine even if it means borrowing scholarships may be different from Japan.

We visited two hospitals, Seattle Children's Hospital and Harborview Medical Center, and this time I will write about Seattle Children's Hospital. As the name suggests, Seattle Children's Hospital is a pediatric hospital that provides treatment to children with serious illnesses living not only in Washington State but also in neighboring states such as Idaho, Oregon, Montana, and Alaska. The pediatric department alone has about 650 beds, which is surprising, but all of them are private rooms, and each room also has space for the patient's parents to stay. There are also playrooms and heated swimming pools that the children can use, which is a facility that is unimaginable for a Japanese hospital. In terms of the medical system, there are subsidies from the hospital so that children who cannot afford high medical expenses can receive the necessary treatment, and efforts are being made to provide parents who have come from far away with information necessary for their stay free of charge. Even though America is the world's largest economic power, some people may wonder where the funds come from to create and maintain such a rich environment. Seattle Children's Hospital is located in Seattle, which is home to the world's largest headquarters, including famous companies such as Amazon, Microsoft, and Starbucks. It seems that the huge donations from these companies make this system possible, and the wall at the entrance is covered with boards with the names of companies and individuals who have donated to the hospital. However, it is not only large companies that make such donations; the heated pool mentioned above was expanded with donations from employees, and volunteers are stationed in the playroom to keep children company. Since the environments in Japan and the United States are so different, I do not think that more volunteers should be mobilized in Japanese medical care, but I strongly felt that in order to consider the future of medical care, we need to learn about the medical sites of various countries and actively introduce the good points to Japan.

Finally, I would like to write about what I noticed about English conversation. I have only average English skills and no confidence, but even after 10 days, I realized that my conversations were getting smoother day by day. I especially paid attention to not showing any signs of insecurity. Just as we don't mind foreigners who come to Japan for travel or study abroad not speaking fluent Japanese, Americans shouldn't be bothered by Japanese people who are foreigners and don't speak English fluently. On the contrary, I felt that Americans are sensitive to logical structure. For example, when asked, "Which of these two treatments would you choose?", you tend to end up just stating the pros and cons of both treatments, but if you do that, you will be pressed with questions like, "Which treatment will you choose in the end?" It is often said that when talking to people from overseas, it seems that people are happier if you tell them the conclusion first. This training made me realize that people who speak foreign languages are just human beings, and that anything can be conveyed if you put your heart into it.

Finally, I would like to thank Dr. Yamanishi for giving me the opportunity to participate in this summer training at the University of Washington, the staff at Hirakata Rehabilitation Center who accompanied us, Dr. Gamo, Dr. Kondo, Dr. Nakamura, and Dr. McCormick, Dr. King, and all the other teachers who gave lectures.