Simona Yordanovaさん

My name is Simona Yordanova, a fifth-year medical student at Medical University Sofia, Bulgaria. When asked why I chose Japan for my exchange program, my answer would go back to 2019. While researching universities, I would endlessly scroll their websites. One day I stumbled upon an announcement: Sofia Medical University was seeking two students for an exchange program in Japan. The idea not captivated me, it heavily influenced my choice of where I would pursue my higher education. However, the global pandemic delayed such opportunities. Little did I know that five years later the program would be reopened. Along 50 other applicants, my colleague Tugay and I were selected. Words cannot describe my excitement when I read our names as the two students chosen for the exchange program.

Preparation and Arrival

Months of preparation followed, guided by the assistance of Ms. Tomoka Shimada, who patiently answered all our questions. There was some anxiety; however, everything vanished upon arrival. Ms. Shimada welcomed us warmly and escorted us to a cozy guesthouse equipped with everything we needed. There, we met our housemates, Linda and Mia from Germany, who soon became dear friends. The university generously allowed us a few days to accommodate during which we explored Osaka and its surroundings, setting the tone for the adventures that would fill our weekends.

First Rotation: Cardiology

Our clinical rotations began with a two-week rotation in Cardiology, primarily in the Coronary Care Unit (CCU) and Interventional Radiology Center. We observed a number of procedures: 1) Catheter Ablation: Precision-guided by 3D electrical mapping for anatomical-based treatment of arrhythmias; 2) Angiography & Interventions: Coronary/peripheral angiography and stent placements; 3) Swan-Ganz Catheterization: Measuring right heart chamber pressures; 4) Device Implantations: ICDs, leadless pacemakers, and TAVI. The doctors demonstrated remarkable expertise in the minimally invasive procedures; 5) Innovative Therapies: Drug-coated balloon dilation and interventional myocardial biopsies.; 6) Diagnostics: Treadmill tests and scintigraphy; and many more…

Beyond observation, we trained in echocardiography and engaged in CCU case discussions along the doctors. There we would follow through the process of treatment and decision making for patients of various cardiac disease. What stood out to me was the endless patience and dedication of the doctors as they answered all our questions. The educational process was as effective as one could imagine as while one doctor would perform a procedure, another explained each step, bridging theory and practice together. This rotation set an exceptional standard for our subsequent rotations. Furthermore, I was deeply impressed by the extremely collaborative atmosphere where all healthcare professionals worked with mutual respect, creating a feeling of a stress-free environment in what would otherwise be one of the most stressful units in a hospital.

Gastroenterology: Innovations in Digestive Health

The next two weeks I shadowed the specialists in the gastroenterology department. My experience there solidified my already existing impression of Japan as a leader in early cancer detection and endoscopic innovations. I was particularly impressed by their integration of robotics and AI-assisted imaging systems, which enhanced precision in biopsy taking and treatment procedures. I also saw advanced endoscopic submucosal dissection (ESD) techniques for treating early-stage tumors without invasive surgery. I had the privilege to observe Professors Shinzaki and Fukui during their outpatient care, gaining invaluable into their clinical expertise and patient interactions. One of the highlights of my experience in the department was the Hepatobiliary team’s expertise of the usage of endoscopic ultrasound for diagnosing and managing pancreatic cancer and of ERCP, which facilitated both diagnostic and therapeutic intervention such as stent placements for biliary obstruction. Once again, the rotation left me with tons of new knowledge and impressions as the members of the gastroenterology unit’s teams’ kindly and carefully took me through the specifics of their craft and further fired up my interest for this specialty.

Traveling Around Japan: A Cultural and Scenic Journey

Beyond our experience in the hospital, every weekend Tugay and I would undergo an adventure to yet another part of Japan. Starting in Osaka, we enjoyed the city’s vibrancy as we visited the neon-lit Dotonbori, the beautiful Osaka castle and the peaceful yet curious Katsuoji temple. This amazing city known for its friendly people and amazing cuisine quickly become our new home for the next month. Naturally, it was also the landscape to the unforgettable moments spent with our Japanese friends and colleagues. In Kyoto we wandered through the endless torii gates of iconic Fushimi Inari Shrine, we marveled at the splendor of Kiyomizu-dera Temple and found serenity and peace in Jojakko-Ji. Uji had us feeling green as we consumed an impressive amount of matcha and visited Byodo-In temple and its beautiful surroundings. A day trip to Nara brought close to the cute bowing deer and led us to the impressive Todai-ji Temple and its towering Buddha statue left me in awe. Kobe welcomed us with its unique architecture and bustling environment. An unexpected highlight of our travels however was the retreat to Lake Biwa, Japan’s largest freshwater lake. Seasons changed as we took a peaceful walk in the sun along its shimmering waters followed by a quick climb to the winter landscape of the surrounding mountains by a cable car. There we enjoyed one of the most impressive views I have ever come across – a panoramic view of the lake and Shiga prefecture. As my internship ended, a bullet train took me to Japan’s heart- Tokyo, a city which carries an unparalleled energy. Days started flying away in Shinjuku, Shibuya, Akihabara and Ueno. And as I could not have been any luckier – the cherries blossomed…

Closing reflection: a journey beyond words

If this report managed to convey even a tiny fraction of what this journey meant to me- then it has fulfilled its purpose as words cannot capture the month that passed in Japan. For like in the country where ancient temples stand next to neon-lit skyscrapers, intertwining tradition and innovation this experience brought together professional growth and cultural immersion and it deeply inspired me. As I carry the memories of Japan’s nature, culture and people in my heart I will do my best to incorporate their devotion, professionalism and collaborative spirit into my future practice.

ありがとうございます, for the knowledge, for the experience and for the inspiration.