Reem Abughannamさん

My four-week elective at Hyogo Medical University (HMU) has been one of the most meaningful and transformative experiences of my medical education. I would first like to express my sincere gratitude to HMU, the physicians, medical students, staff, and the Robert Wood Johnson Medical School Office of Global Health for making this opportunity possible. I arrived in Japan hoping to learn about a different healthcare system, but I left with far more than clinical knowledge. I return home with lifelong friendships, invaluable mentors, a deeper appreciation for cross-cultural medicine, and a renewed sense of purpose as I continue my journey toward becoming a physician.

One of the most remarkable aspects of my experience was the extraordinary hospitality that I encountered from the moment I arrived. Although I spoke very little Japanese, every physician, student, nurse, and staff member went out of their way to make me feel welcome. Despite the obvious language barrier, they consistently included me in rounds, teaching sessions, procedures, and discussions. Whenever communication became difficult, someone was always willing to translate, explain concepts more slowly, or simply ensure that I felt involved. Their patience and kindness transformed what could have been an intimidating experience into one where I truly felt like a member of the team. Their generosity demonstrated that compassion in medicine extends beyond patient care, it also includes the willingness to educate, mentor, and welcome learners from different cultures.

My time in the Combined Intensive Care Unit (CICU) was particularly impactful. The CICU exposed me to critically ill patients with complex and often rapidly changing medical conditions, including septic shock, disseminated intravascular coagulation, severe infections, advanced neurologic disease, and cardiac emergencies. Watching physicians systematically evaluate critically ill patients reinforced the importance of maintaining a broad differential diagnosis while continuously reassessing a patient’s clinical course. I was especially fascinated by following a patient with septic shock and suspected DIC whose hospitalization became increasingly complex with pneumonia, pleural effusions requiring thoracentesis, urinary tract infection, and multiple organ dysfunction. Observing the diagnostic reasoning behind her management allowed me to connect many of the concepts I had recently learned during medical school with real decision-making.

The CICU also taught me lessons that extended beyond medicine itself. I witnessed both remarkable recoveries and heartbreaking losses within only a few weeks. Seeing one patient improve enough to leave the intensive care unit while others unfortunately succumbed to their illnesses highlighted both the resilience and fragility of human life. These experiences reminded me that medicine is not solely about curing disease, but also about supporting patients and families through some of the most difficult moments they will ever experience. I also had the opportunity to observe differences in end-of-life care and resuscitation practices compared to those in the United States, which broadened my understanding of how culture and healthcare systems influence medical decision-making.

Equally influential were the physicians who served as my mentors throughout my rotation. Despite their demanding schedules, they consistently dedicated time to teaching me. They explained their reasoning, answered countless questions, and even prepared educational presentations specifically for my benefit. Their humility was as impressive as their expertise. No matter how accomplished they were, every physician remained approachable and genuinely invested in my education. Their commitment to teaching demonstrated the profound impact of thoughtful mentorship on medical students and inspired me to become the kind of physician who prioritizes educating future learners.

My final week on the pediatric service provided an entirely different perspective on patient care. I had the opportunity to observe pediatric surgery, pediatric neurology, and pediatric infectious disease while learning from physicians who demonstrated exceptional medical expertise and compassion. One of the most memorable experiences was observing surgery for a child with suspected Hirschsprung disease. Having previously encountered this condition only in infants, I found it fascinating to learn that older children can also present with the disease. Watching the surgical team perform a pull-through procedure allowed me to appreciate both the technical skill required in pediatric surgery and the collaborative nature of operating room teams.

Beyond the operating room, I greatly appreciated the educational sessions provided by the pediatric faculty. A pediatric neurologist spent considerable time teaching me about seizure disorders and epilepsy classification, while a neonatologist presented an engaging lecture on pediatric infectious diseases. These sessions complemented the clinical experiences I had throughout the month and significantly expanded my understanding of pediatric medicine. More importantly, they reflected the tremendous generosity of the faculty, who willingly devoted additional time to ensuring that I had a meaningful educational experience as an international visiting student.

Outside of the hospital, living in Japan was equally educational. Initially, the language barrier was one of the greatest challenges I had ever experienced. Everyday activities such as grocery shopping, ordering meals, or navigating public transportation suddenly became difficult tasks that I had always taken for granted. Experiencing these challenges gave me a much deeper appreciation for what many immigrant families experience when adapting to a new country. It reminded me of my own parents’ experiences immigrating to the United States and strengthened my empathy for future patients who may struggle with language barriers within the healthcare system. This experience will undoubtedly influence how I care for patients from diverse cultural and linguistic backgrounds throughout my career.

As the weeks progressed, I also gained a deeper appreciation for Japanese culture. The respect, humility, professionalism, and consideration that characterize everyday interactions were evident throughout both the hospital and the community. Whether observing the teamwork between physicians and nurses, interacting with medical students, or simply navigating daily life, I was consistently impressed by the kindness and thoughtfulness of everyone I encountered. I formed meaningful friendships with many of the medical students, and our conversations about medical education, career goals, and cultural differences became some of the most memorable moments of my stay. These relationships reminded me that although healthcare systems may differ across countries, medical students everywhere share the same passion for learning and caring for patients.

This experience has fundamentally changed my perspective on medicine. Before arriving in Japan, I primarily viewed global health as an opportunity to observe different healthcare systems. I now understand that it is equally about building relationships, learning from diverse perspectives, and recognizing that there are many effective approaches to delivering excellent patient care. I learned that medicine is truly a universal language built upon compassion, curiosity, teamwork, and lifelong learning. Although language barriers occasionally limited communication, they never prevented meaningful teaching, mentorship, or human connection. As I return to Robert Wood Johnson Medical School, I now carry a renewed appreciation for cultural humility, patient-centered care, and international collaboration. The lessons I learned at HMU will continue to influence the physician I hope to become. I will always look back on my time in Japan with immense gratitude and consider it one of the greatest privileges of my medical training.