Christina Barthaさん

My time in Japan and at Hyogo Medical University was an incredible enriching experience, and I hope this brief account does its justice by providing insight into both my preparations and my time in Nishinomiya. Despite a Lufthansa strike, our journey went smoothly, and we arrived in Japan as scheduled on Thursday evening. The following day, with the support of Tomoka Shimada, we were able to move into the guest house, located directly next to the hospital.

I would particularly like to emphasise the exceptionally dedicated support provided by I spent the first two weeks in the anaesthesia department. I was assigned to a different supervising doctor each day, which enabled me to gain insight into anaesthesia across a wide range of surgical disciplines, including visceral, paediatric, cardiac and thoracic surgery, neurosurgery, interventional cardiology, and urology. As I had already acquired basic knowledge of anaesthesia in Germany, I was able to follow both the induction and maintenance of anaesthesia and observe differences in clinical practice between Germany and Japan. In addition, I spent two days in the ICU and two further days in the pain clinic, where I was able to observe interventional procedures and typical patient consultations. Each morning, my day began with attending the surgical planning meetings; although these were conducted in Japanese, junior doctors would often assist me by providing informal translations, so that I could follow the discussion along. A highlight of my anaesthesia rotation was the opportunity to assist with intubation under supervision. I also felt very well integrated into the team; the junior doctors made a great effort to include me in daily activities such as lunch breaks, communicating in a mixture of Japanese and English. Despite occasional language barriers, I consistently felt welcomed and involved. On my final day in the anaesthesia department, I was invited to a farewell gathering for two departing doctors. This provided a valuable opportunity to experience the team in a more informal setting, for which I am very grateful. I left the department with a strong sense of appreciation and very positive memories.

The following two weeks were spent in the neurosurgery department, which has a notably international character, with several foreign physicians and daily morning briefings conducted in English. This made it easier to gain an overview of ongoing cases and procedures. During the first week, I accompanied a group of Japanese medical students during their rotation, spending most of the day in the operating theatre. Interacting with them was particularly enriching, as it offered insight into differences in medical education. In the second week, I was able to choose which operations to observe, allowing me to explore a wide range of procedures. The hospital in Nishinomiya is particularly well known for its interventional neurosurgical approaches, such as coiling and the use of WEB devices for aneurysms. Observing these procedures was especially valuable, as I have developed a growing interest in neurosurgery as a potential career path. Additional highlights included an invitation to a team dinner and participation in the HINT conference on hybrid neurosurgical interventions. I am very grateful for these opportunities and the welcoming environment. One particularly memorable case was a direct and indirect bypass procedure in a patient with Moyamoya disease, a condition more common in Japan but rare in Germany. I was deeply impressed by the surgeon’s precision and attention to detail. Overall, I was able to observe a broad spectrum of procedures, including tumour resections (e.g. schwannomas), spinal decompressions, treatment of arachnoid cysts, and various endovascular techniques.

Throughout my stay, I consistently experienced a high level of openness and inclusion. Students often involved me in their daily routines, which provided valuable cultural insights beyond the clinical setting. In retrospect, I gained far more from this clinical placement than medical knowledge alone. It gave me the opportunity to compare two healthcare systems at a high level, reflect on different clinical approaches, and critically evaluate my own perspectives. Observing doctors and students in their daily work allowed me to better understand a different medical system and broaden both my professional and personal outlook. A particularly valuable aspect of this clerkship was the opportunity to observe structural and cultural differences between the Japanese and German healthcare systems; At the same time, I experienced a strong sense of team cohesion and mutual respect, including me in the daily life. All these observed differences encouraged me to reflect critically in my own expectations and assumptions regarding clinical practice. Experiencing alternative approaches, learning to navigate through daily life in a foreign language, getting to know so many inspiring people broadened my perspective and will influential both my future clinical work, as well as my private life from now on.

I would like to express my sincere gratitude to everyone who made this experience possible. I hope to have the opportunity to return to Japan some day in the future, both for a medical German-Japanese connection, as well as to broaden my own cultural experience once more.