Tugay Selimさん

I am pleased to present this report on my participation in the Exchange Student Clinical Program at Hyogo Medical University, between March 3 and March 28, 2025. The experience was extraordinary, far surpassing my expectations in every possible aspect. I gained invaluable clinical knowledge and hands-on experience, deepened my understanding of advanced medical technologies, and developed a profound appreciation for the Japanese healthcare system and culture. The medical staff and students at Hyogo Medical University were incredibly supportive, professional, and generous. Their hospitality and willingness to teach created an ideal environment for growth. The program not only strengthened my medical foundation but also opened my eyes to new perspectives in patient care, diagnostics, and interprofessional collaboration.

Department of Cardiovascular Medicine (March 3–14, 2025)

My first two weeks were spent in the Department of Cardiovascular Medicine, where I observed and learned about a wide range of advanced cardiovascular procedures. I had the chance to witness Catheter Ablation for the treatment of arrhythmias, where the precision and coordination of the medical team were truly remarkable. I also observed Treadmill Stress Tests and Cardiopulmonary Exercise Testing (CPET), which offered insight into functional cardiovascular assessments.
Another highlight was witnessing a Transcatheter Aortic Valve Implantation (TAVI), a cutting-edge, minimally invasive procedure. I was also present during Coronary Angiography and Interventional Procedures, as well as Cardiac Catheterizations, which allowed me to understand hemodynamics and coronary anatomy more deeply. Observing these complex interventions helped me better understand how diagnostic tools and treatments are applied in real-time, often in critical scenarios.
Time spent in the Cardiac Care Unit (CCU) was another defining experience. I was able to observe the management of acute and chronic cardiac conditions and engage in discussions with residents and senior physicians about case studies. The patients had a variety of pathologies—ranging from myocardial infarctions and arrhythmias to congestive heart failure—and each case provided a new learning opportunity.
During the second week, we had a particularly engaging session focused on cardiac ultrasound (echocardiography). We were taught the basics of probe handling, image acquisition, and interpretation of echocardiographic findings. Practicing these skills under the supervision of skilled cardiologists significantly boosted my confidence and deepened my understanding of cardiovascular diagnostics.
For such a short time, the amount of clinical and practical knowledge imparted to us was extraordinary. The physicians were passionate educators who took the time to explain procedures, clarify doubts, and encourage our participation. Their patient-centered approach, technical mastery, and enthusiasm for teaching left a lasting impression on me.

Department of Respiratory Medicine (March 17–28, 2025)

The second half of the exchange was spent in the Department of Respiratory Medicine, where I encountered an entirely different but equally fascinating set of clinical challenges. One of the most educational aspects of this rotation was seeing a wide variety of patients, especially those with lung cancer. Cases of mesothelioma, which are quite rare in Bulgaria, were particularly interesting to follow due to their unique presentation and diagnostic complexity.
I also observed the clinical management of interstitial lung disease, pulmonary aspergillosis, and asthma, including patients undergoing treatment with newly approved biologic and immunotherapy drugs. It was fascinating to see how monoclonal antibodies are being used to personalize therapy in patients with severe asthma who were previously unresponsive to conventional treatments. The careful patient selection process and monitoring protocols provided valuable insights into the modern era of precision medicine.
One of the most impressive features of this department was their use of lung ultrasound and bronchoscopy. The bronchoscopy procedures were performed with incredible precision and efficiency, and it was fascinating to observe how real-time imaging was used to assess and obtain biopsies from various parts of the lung. I also had the unique opportunity to perform a bronchoscopy on a training model, which was both exciting and educational. Practicing the handling of the bronchoscope and navigating the airways gave me a much clearer understanding of the technique and increased my appreciation for its diagnostic and therapeutic value.
The doctors in this department were equally dedicated to teaching, providing thoughtful explanations and involving me in clinical discussions. I appreciated their openness and the way they encouraged curiosity and active engagement, which made me feel like a genuine part of the team.

Cultural Immersion and Collegial Support

Beyond the clinical experience, this program allowed for meaningful cultural exchange and personal growth. The local medical students were extremely welcoming and eager to help us understand their daily routines, customs, and traditions. Thanks to their kindness, I was able to experience various aspects of Japanese life—enjoying traditional food, learning basic language phrases, participating in local events, and understanding the cultural nuances of communication and social interaction. Their support also extended into the hospital environment. They helped us navigate the healthcare system and explained cultural elements that influence how care is delivered in Japan. Their companionship created a sense of belonging and made the experience even more memorable.

Reflection and Takeaways

Participating in this program has had a transformative impact on me both as a medical student and as a person. I have returned with improved clinical knowledge, more refined practical skills, and a deeper appreciation for the role of empathy and teamwork in medicine. I now feel more confident performing diagnostic techniques, understanding disease pathophysiology, and interacting with patients from diverse cultural backgrounds. Furthermore, seeing how cutting-edge medical technology is integrated into daily clinical practice in Japan has inspired me to pursue continuous learning and innovation in my future career. The Japanese approach to medicine—characterized by precision, respect, and discipline—is something I deeply admire and hope to incorporate into my professional ethos.

Acknowledgments and Conclusion

I am sincerely grateful to everyone at Hyogo Medical University and Medical University of Sofia who contributed to making this experience so special. My heartfelt thanks go to the professors and clinicians who generously shared their knowledge and time, the administrative staff who organized the program so smoothly, and the Japanese students who offered unwavering support and friendship throughout. This exchange program has not only enriched my medical education but also inspired me to become a more globally minded and compassionate physician. I wholeheartedly recommend this program to fellow students seeking an unforgettable clinical and cultural experience. I leave with a renewed sense of purpose, greater clarity about my future in medicine, and memories that I will treasure for a lifetime.