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.

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