2020年度6月定例理事会・委員会会議が開催されました
直近ですと通常京都で開催されていました6月定例理事会・委員会会議がオンラインで開催されました。コロナ禍が始まった昨年度は、予定していた学術集会が急遽取りやめとなり、理事・委員会の先生方も対応に追われていたことと思います。今年は無事オンラインで開催されました。
議題は予め回覧されていました委員会の活動報告・各種情報共有・審議事項の審議でした。必要な情報は追って会員に展開されることでしょう。
2020年度6月定例理事会・委員会会議
Governor’s Message
This is the time of year to remind you of our Chapter Meeting in June. We are going to hold the meeting remotely for the first time. The all-virtual meetings have some disadvantages in some aspect but at the same time there are advantages as well – even busy doctors can participate in the meetings from their offices without travelling so far. The planning team of the Scientific Program Committee led by Dr. Sugihiro Hamaguchi has put together a great agenda. I am excited to welcome our members to the meeting.
The ACP annual meeting in the USA, Internal Medicine Meeting 2021 (IMM2021), took place the other day in the virtual style and it went successfully. Although there were some challenges for us because of time difference between USA and Japan, it was a wonderful meeting. I personally enjoyed “Thieves’ Market” by Dr. David Scrase. Cases were presented in fun and interactive session. This event will be introduced to Japan for the first time in the next Japan Chapter meeting in June. I hope all of you will enjoy!
Congratulations new fellows and masters! To follow are the pictures from the IMM2021. It’s a pity that we couldn’t do marching in the venue but it was a proud moment.
The Physicians’ Well-being Team of our Chapter conducted a questionnaire survey in March and reported that 69 (30.9%) among 223 respondents had burnt out as of the survey. The survey also found that 79 (35.4%) and 78 (35.0%) reported insomniac symptoms and anxiety, respectively, whilst 33 (14.8%) were depressed. Approximately 40% of the respondents considered changing their job responsibilities in the COVID-19 pandemic. I hope all the stress will be dispersed with weathering the coronavirus crisis.
It has been two years since I became a Governor and now it’s time to select the next Governor (Governor-Elect). I know that both of the two candidates are excellent persons and each deserves to be a governor. I hope all the members will join in the fair voting.
Stay well and enjoy your spring and summer!
Kenji Maeda
The 2nd MKSAP study session
National Hospital Organization Tokyo Medical Center
PGY 2 Tomohiro Hirai
Center Hospital of the National Center for Global Health and Medicine
PGY 1 Rika Terashima
The Resident Fellow Committee (RFC) of the American College of Physicians (ACP) Japan Chapter held their second MKSAP study session on Sunday, April 18, 2021. This session, utilizing ACP’s famous online learning tool MKSAP, is approved by ACP Headquarters. Dr. Yuji Yamada (Department of Geriatrics and Palliative Medicine, The Mount Sinai Hospital) was invited for this session with the theme of “Hematology”, and he explained five pre-selected questions from MKSAP. We had a lively study session, with participants answering each question and many more questions flying in the chat box.
The 1st question was about the “treatment of iron deficiency anemia,” and Dr. Yamada gave an in-depth explanation of common problems we encounter in our daily clinical practice.
The 2nd question was about “how to deal with poor INR control associated with warfarin usage”. Recently, DOACs are being used more frequently, and the occasions for prescribing warfarin are decreasing, but this is still a problem we encounter often. The lecture was full of useful tips for tomorrow’s practice, such as the differentiation of various anticoagulants.
The 3rd question was about the “diagnosis of polycythemia vera.” Dr. Yamada provided a clear explanation utilizing a diagnosis flowchart style, and we were able to hear Dr. Yamada’s personal experience where changes in lab data led to the diagnosis of a new hidden disease.
The 4th and 5th questions were about “HIT (heparin-induced thrombocytopenia)” and “DIHA (drug-induced hemolytic anemia)”. We discussed their differences and what to look out for in these diseases. We may know these diseases as medical knowledge but feel uneasy about actually clinically managing them. We also studied a wide range of topics, including the introduction of VITT (Vaccine-induced Immune Thrombocytopenia), a new finding that has become a hot topic with the new coronavirus vaccine.
This MKSAP study session was also a time to increase motivation for daily study. Dr. Yamada carefully explained important points in actual clinical management, including common pitfalls. He taught us in a way that is easy for non-specialists to understand, while mixing in his expertise and advanced viewpoint.
RFC will continue to hold events, including this study session, to improve our daily practice. In addition, we will provide a platform for those who want to go abroad. The ACP Japan Chapter Annual Meeting is scheduled to be held, for the first time online, on June 26 and 27, 2021. The next MKSAP workshop is scheduled to be held in August or September after the Annual Meeting. We look forward to seeing you at our ACP Annual Meeting and at one of our many study sessions.
第2回MKSAP 厳選5題 -Training with Specialist-
国立病院機構 東京医療センター
初期研修医2年 平井智大
米国内科学会(ACP)日本支部の若手医師部会(Resident Fellow Committee：RFC)は、2021年4月18日(日)にACP本部公認のMKSAP勉強会を開催いたしました。
第2回となる今回は「血液内科」領域をテーマに山田 悠史先生（マウントサイナイ医科大学 老年医学・緩和医療科）をお招きし、MKSAPより厳選した5題を解説いただきました。当日は、１問ごとに参加者が回答、チャットボックスには質問が飛び交う、活発な勉強会となりました。
第1問は「鉄欠乏性貧血の治療」について、日常臨床でよく出会うプロブレムを病態から掘り下げて解説いただきました。Common diseaseということもあり、多くの時間を割いたこの問題では、鉄動態に重要なヘプシジンに関連した新薬が生まれつつあるという最新の知識に触れ、病態に立ち戻ることの大切さを考えさせられました。
第2問は「ワーファリンでINRコントロール不良時の対応」についてでした。最近はDOACが頻用されてきており、ワーファリンの処方機会は減少しつつありますが、まだまだ出会うプロブレムです。抗凝固薬の使い分けなど、明日からの診療に役立つTipsが盛りだくさんでした。
第3問は「多血症の診断」でした。診断のフローチャートを見るような見事な解説と、検査の変化の裏に隠れている新たな疾患に気づかれた経験を伺うことができたのは、Liveの勉強会ならではであったと思います。
第4、5問は「HIT（ヘパリン起因性血小板減少症）」「DIHA（薬剤性溶血性貧血）」に関する問題でした。知識としては知っていても、実際のマネジメントには不安を覚える疾患について、鑑別や考えるべきことをまとめて話していただきました。また、新型コロナウイルスワクチンで話題となった新しい知見「VITT（Vaccine-induced Immune Thrombotic Thrombocytopenia）」の紹介を含めて幅広く解説していただきました。
今回のMKSAP勉強会も、専門家の視点を交えながらも、非専門家にもわかりやすく、よくある落とし穴を含めた実際のマネジメントで重要になる点を丁寧に解説していただき、日頃の学習へのモチベーションがアップする時間となりました。
RFCでは、今回の勉強会も含め日常の診療をステップアップさせるイベントを開催していきます。加えて海外を目指す方々のプラットフォームを提供していきます。2021年6月26、27日には初めての試みとなるACP日本支部年次総会のオンライン開催が予定されております。次回のMKSAP勉強会は、総会終了後8、9月の開催を予定しております。関心のある方は総会企画とあわせて、ぜひご参加ください。
ACP日本支部 公式Twitter開始
The 1st MKSAP study session
US Naval Hospital Okinawa, PGY4
Shota Obata
Gunma University
Rika Terashima
The Resident Fellow Committee (RFC) of the American College of Physicians (ACP) Japan Chapter held a MKSAP study session on February 17, 2021. This new project was made a regular series because of its high popularity, as seen in the results of last RFC seminar’s survey. An expert in the field of internal medicine was invited, and each of the five pre-selected problems were explained in detail by RFC members. The purpose of this series is to learn the latest clinical knowledge from frontline experts through MKSAP’s high quality problems and enhance our knowledge of each internal medicine field in a short amount of time. We plan on holding this seminar series every few months.
For this session, we invited Dr. Jun Kataoka (Department of General Emergency Medicine and Intensive Care Unit, Nerimahikarigaoka Hospital) to talk about “Respiratory and Intensive Care”.
For the first and second question, he explained in detail using slides: the indications for intubation in acute respiratory failure, and the treatment of ARDS. Personally, even if I could choose the best treatment option, I have always found it difficult to explain why that particular treatment is effective. Dr. Kataoka’s concise and clear explanations with regard to respiratory physiology and ground-breaking research, helped deepen my understanding.
The third question was about different types of pleural effusion. We tend to treat pleural effusion without much thought because it is a condition that we routinely encounter in the medical setting. However, by reviewing the condition’s definition and categorization, I managed to improve my understanding. I found the clinical experience-based explanation on indications and pitfalls of pleural effusion drainage to be especially memorable.
The fourth question was about treatment methods for severe acute exacerbations of asthma. I felt the differentiation of these drugs in clinical practice is directly relevant to how we treat these patients daily. As a related topic, he also touched on the latest treatment for chronic management of asthma, which further expanded my knowledge.
The last question was about the treatment of COPD with repeated acute exacerbations. What I found most interesting was the relationship between the patient’s eosinophil count and the efficacy of ICS for patients with COPD. We were able to see the thought process behind choosing which patients to put on ICS, as well as how to take into account eosinophil count and asthma comorbidity. It was a very meaningful and helpful topic to learn about.
RFC will continue to hold events, including this study session, to improve our daily medical practice. In addition, we will continue to provide a platform for those who want to practice abroad. As mentioned in the previous newsletter, the ACP Japan Chapter Annual Meeting will be held, for the first time online, in June 2021. If you are interested, please join us.
第1回MKSAP 厳選5題 -Training with Expert-
沖縄海軍病院 PGY4
尾畑 翔太
米国内科学会(ACP)日本支部の若手医師部会(Resident Fellow Committee: RFC)は、新企画として2021年2月17日(水)にMKSAP勉強会を開催いたしました。これは、前回のRFCセミナーのアンケートでMKSAPの勉強会が好評であったことから、定例化したものです。当日は、内科領域の専門家を招聘し、１つ１つの問題を丁寧に解説いただきました。取り上げたのはRFCメンバーがピックアップした５問で、１問ごとに、参加者各自が考え、回答を投票し、解説を受けるというサイクルを回すことで、理解を深めることができました。MKSAPの良質な問題と専門家の最新の知見に触れることで、短時間で各分野の知識を磨くことを目的としており、今後も数ヶ月に1回の頻度で開催していく予定です。
今回は「呼吸器・集中治療」領域を題材として、片岡惇先生(練馬光が丘病院・総合救急診療科・集中治療部門)をお招きしました。
1問目・2問目は急性呼吸不全における挿管の適応やARDSの治療方法についてスライドを使用しながら詳しく解説をいただきました。個人的には、これまで治療法の選択肢を選ぶことができてもなぜその治療法が有効なのかは説明できず、難しいと感じておりました。しかし、呼吸生理学や画期的な研究の紹介を交えた簡潔かつ明瞭な解説で、一歩さらに深く理解できました。
3問目は胸水の性状に関する問題でした。日常でよく出会う疾患であるがゆえに普段何気なく診療しがちな領域ですが、一度振り返って定義を見直すとさらに見識を深めることができると実感しました。また、ドレナージの適応および落とし穴についての、実臨床に基づいた解説が印象的でした。
4問目は喘息の重症急性増悪に対する治療法について解説をいただきました。臨床現場での薬剤の使い分けは明日の診療に直結すると感じました。また、関連する話題として喘息の慢性期管理に関する最新の治療にも触れていただき、さらに知識を広げることにつながりました。
最後の問題は急性増悪を繰り返すCOPDの治療についての問題で、一番興味深く感じた点はCOPDに対するICSの有効性と注意点および好酸球数の関連性でした。ICSをどの患者に導入するか、好酸球数や喘息の合併などを考慮しながら決めていく実際の診療過程を垣間見ることができ、非常に有意義でした。
RFCでは、今回の勉強会も含め日常の診療をステップアップさせるイベントを開催していきます。加えて海外を目指す方々のプラットフォームを提供していきます。前回のLetterでもご紹介いたしましたが、2021年6月には初めての試みとなるACP日本支部年次総会のオンライン開催が予定されております。関心のある方はぜひご参加ください。
Women’s Committee
American College of Physicians Japan Chapter Interim Report 2020
Women’s Committee
Chair: Noriko Yamamoto MD, FACP
Report: What we have done:
The Women’s Committee has 10 members including 4 male members. We started out with 6 female members from 2017 July. I am pleased to increase the male members. That’s because the female members don’t know how the male physicians feel about something female physicians work and struggle. And when the male members talk about their confusion to attend some problem with female physicians on our mailing list, female members notice their confusion and find their own problems and other obstacles .I think it’s important that such a mutual understanding keep going for long time, moreover the male and female physicians will get to sympathize each other.
Session Plan:
This June we couldn’t hold the annual session of Japan Chapter, we have a plan to hold the session at next annual meeting. We collaborate with the Physician’s Well-Being Team and have a plan to hold the work shop about physician ‘s Burn-out.
Facebook Page
We have the Facebook page. We post the news and articles of ACP and other information, news about gender inequity.
Woman in Medicine Month (September)
We recommended a FACP from women’s members on September, Dr. Naoko Iwasaki MD.
Plan: What we are going to:
We will hold the session about communications at the workplace next meeting. We are making the details of this session concretely. We collaborate with the Physicians Well-Being Team; we might have the workshop about physician’s Burn-out and coaching next year except annual meeting. I want to increase more female FACPs in Japan Chapter. I wish many female physicians will have activities in ACP Japan Chapter vividly, I will recruit some members for Women’s Committee next term.
Scientific Program Committee
American College of Physicians Japan Chapter Interim Report 2020
Scientific Program Committee
SPC Chair Sugihiro Hamaguchi
１．Report: What we have done
It is terribly regrettable to report that two major annual events, The ACP Japan Chapter Annual Meeting 2020 and The Joint session with Japanese society of Internal Medicine, were cancelled because of the enormous impact of corona virus disease 2019 pandemic not merely on our preparation procedures for the events but also all participants’ health and lifestyles changes.
The annual meeting 2020 was planned to be held on June 6 and 7, 2020 at Kyoto university and The Joint session with Japanese society of Internal Medicine was on April 11, 2020.
２．Plan: What we are going to do
- We are now planning the ACP Japan Chapter Annual Meeting 2021. This will be a complete online meeting and is planned to be held on June 26th and 27th 2021.
There will be one website with several channels (rooms) for participants to enter and each channel has its own characteristics. Using some interesting and useful software, a feasible and enjoyable meeting is being planned.
- The annual meeting of Primary Care Research connect (PCR connect) is going to be held on December 19th and 20th, 2020. (https://pcrconnect.org/) PCR connect is an integrated research network among ACP Japan Chapter, Japan Primary Care Association, and Society for Clinical Epidemiology for the enforcement of primary care related research outputs from Japan. It is planned to be held on December 12 and 13, 2020.
Student Committee
American College of Physicians Japan Chapter: Interim Report 2020
Student Committee
Chair: Hideta Teshirogi
Vice-Chair: Takeshi Matsushita
Our mission is to facilitate interest and interaction amongst ACP student members, provide an educational experience, and contribute to the further success of ACP Japan Chapter (ACPJC) and its international collaborations.
1.REPORT: What we have done
Recruited 11 new student committee members
We recruited 11 new committee members from 9 medical schools
including a medical school in China. Our new diverse and international members have widened our horizons and brought unique perspectives to our projects.
Survey: Japanese medical students’ view on their future international career
We conducted an online survey to bring to light Japanese medical students’ current thoughts on pursuing an international career in the future. The aim of our survey was to use the results to provide better educational opportunities and much-needed information to medical students. We had 549 participants from 58 universities, covering 70% of Japanese medical schools.
Public relations (Facebook page / Twitter Account)
In an effort to present our work to the public, we have created an ACPJC student committee Twitter account in addition to the Facebook page we already have. We have posted self-introductions of each committee member and meeting reports so that viewers feel closer to our organization. Our Facebook page has reached over 148 follows and 9639 views.
- ・ACPJC Student Committee Facebook
page: https://www.facebook.com/ACPSCJapan - ・ACPJC Student Committee Twitter: https://twitter.com/acpsc_japan
2. PLAN: What we are going to do
Using the data we collected from the survey, we plan to hold seminars that respond to the participants’ needs and wishes. The topics include practicing international standardized medical history taking and learning how to pursue an international career as a Japanese physician. Simultaneously, we will prepare for the ACPJC Annual Meeting’s student session for next year and continue our SNS activities on Facebook and Twitter.