International Exchange Program Committee

American College of Physicians Japan Chapter: Interim Report 2020

International Exchange Program Committee

Chair： Takahiko Tsutsumi
Vice-Chair Yuji Yamada, Mitsuya Katayama

Our mission is to facilitate and promote international exchange opportunities in medical education for members of the ACP Japan Chapter.

Report: What We have done

Online workshop

Because of the worldwide COVID-19 infection, most activities which have been

promoted by IEPC have been limited or postponed indefinitely. To overcome this situation, we have focused on online workshop which cannot be affected by this devastating infection. On October 25th, 2020, IEPC held the online workshop “The first step for U.S. residency/fellowship^ using ZOOM. Total of 78 participants applied to our workshop.

The workshop was consisted of two parts. The first part was lectures performed by 4 physicians, Dr. Jindai, Dr. Nogi, Dr. Yamada, three of whom are IEPC members, and one guest speaker, Dr. Natsumi Tanabe, the current chief resident of University of Hawaii Internal Medicine Residency Program (UHIMRP). Their lectures were focused on the basic information, tips, and updates of residency/fellowship program.

The second part was Question/Answer session. All the questions which were collected from the participants beforehand were answered by the four physicians mentioned above and me, Dr. Tsutsumi. During this session, the function “chat system” were also used simultaneously. Participants can ask questions or comment anything using this chat system which was helpful to make this session interactive. Post-

workshop questionnaire from the participants showed a very positive response.

Plan: Where we are going to

We plan to hold subsequent online seminar which I believe will fit well in the current situation. We are also under negotiation with Dr. Jerald Stein, whose contribution to ACP Japan is well known. We are planning to perform online English oral presentation seminar which will be a great education for young physicians.

March 7, 2021

Health and Public Policy Committee

American College of Physicians Japan Chapter Interim Report 2020

Health and Public Policy Committee

Chair: Hiroshi Ono
Vice-chair: Masato Ito

REPORT: What we have done

Even now, it is still in the corona-era, and face-to-face meetings have not been held since last December. Furthermore, there is a history that ACPJC 2020 was not held this year　unfortunately, and no project has been completed since the committee was reorganized last July. We are currently continuing discussions on the mailing list for the topic mentioned in the PLAN below.

PLAN: What we are going to do

Evaluation and consideration of the integrity of online medical care/telemedicine

In Japan, which has a super-aging society, online medical care/telemedicine has been in the limelight since 1997 in order to solve the uneven distribution of doctors in metropolitan areas and the impaired accessibility to HCFs in rural areas. Since then, in 2018, concerning social issues such as rapidly expanding aging society across Japan, IT progression in this field was accelerated aiming to reduce outpatient visits as a patient factor, and to popularize telemedicine as part of reforming the working style of doctors (unfortunately, which was not noticeably spread at that time).

As the new coronavirus infection (COVID-19), which began in the winter of 2019, is spreading again, the government has been taking the initiative in accelerating to spread of telemedicine using phones and/or computer networks as solution tools for the concerning situation (e.g. getting become difficult for patients to consult doctors directly). Then, this type of medical care is once again in the limelight, and a scheme for its proper operation having been formed now. In response to these global and social movements, we all HPPC members are continuing discussions on the mailing list focusing on this topic.

Generally, telemedicine is conducted between doctors and patients, and it is possible to examine, monitor using some extra-equipment, and explain the diagnostic results of patients not in urgency, but in principle, the first examination must be face-to-face, and prescription can be made after the examination. However, the technology in this field is progressed largely from the IT professional’s view, not from the clinician’s view. Therefore, from the clinician’s standpoint, we are currently discussing the limitation of telemedicine, the practice of EBM, CW/HVC, and the method of establishing professionalism within “Human to Human (H2H)” communications, and we would like to make recommendations from this committee in the future.

March 7, 2021March 7, 2021

Generalism-Continuing Medical Education Committee

American College of Physicians Japan Chapter Interim Report 2020

Chair: Teruhisa Azuma

1. REPORT (What We have done)

We defined general mind and “genespelist” as follows respectively in 2019.

- 1. General mind: An attitude of physicians to continue to learn and practice the knowledge and skills of all fields toward the patients’ health issues apart from their specialities.
  2. Genespelist: A specialist who can practice medical care with general mind mentioned above.

In 2020, we conducted the following activities based on the concept mentioned before.

- 1. We eternalized our thoughts concerning “genespelist”, respectively
  2. We summarized the concept and practices as a graphic record named as “the skill up for generalist through collaboration with specialist”, for generalists to collaborate with specialists.

2. PLAN (What We are going to do)

- We will organize the corresponding workshop entitled as “The Genespelist Course for Specialist” in the ACP-JC 2021, which was being held in 2020.
- We will hold the case conference and/or workshop using products mentioned above.
- We will brush up the questionnaire on practicing with the general mind and conduct another survey targeting senior residents and young specialists (within PGY10) of each department.
- We are planning activities illuminating the value of genespelists by combining work style reform in Japan and practicing medical care with general mind.

February 24, 2021

Governor’s Message

今は程度の差こそあれ、コロナ禍で神経を使いながらの診療をされている方が大半と思いますが、皆様お疲れ様です。
今この原稿を書いている時点ではまだ緊急事態宣言は解除されていませんが、今後ワクチン接種が幅広く進み、事態が緩和されることを願っています。

しかし、いまだ各種学会はオンラインが主流で、ACP本部の年次総会IM2021（4月29日～5月1日）も、日本支部の総会（6月26日～27日）も例外ではありません。最近オンライン形式の学会も悪いことばかりでなく一長一短があることが段々分かってきました。短所としては特に海外の学会では時差があり、場合によっては深夜～早朝にかかると睡眠時間が取れなくなること（通常の学会なら夜の就寝時間はきちんととれるがオンラインでは日中は通常の仕事があり休めない）が挙げられます。国内の場合でも診療と重なれば学会参加より診療の方を優先せざるを得ないという事もあり得ます。画面上の面談は出来ても実際のface to faceの出会いとは違って参加者同士の交流が深まらないという点も欠点でしょうか。一方、今まで日ごろ忙しくて、あるいは距離があり過ぎて学会になかなか参加できなかったという方には手軽に参加出来てしかも旅費も宿泊費もかからないという利点があります。是非この利点を生かして頂ければと思います。SPCの濱口杉大先生が中心となりオンラインの特性を生かした支部総会を企画して下さっていますので、是非ご参加ください。

本部の昨年の年次総会（IM2020）が中止になり、今年のIM2021もオンラインになることから、今年本部では昨年度から今年度の2年にわたる新FACPや新MACPの先生方のためのオンラインでのconvocation ceremonyを企画しています。実際にレガリアを着用しての行進ではなく残念ですが、それなりに意義あるものになると思います。新FACPの方のためのceremonyは4月29日東部時間（夏時間）午後6時から（日本時間では4月30日金曜日午前7時に相当）、新MACPまたは名誉フェローの方のceremonyはその一時間後（日本時間4月30日午前8時）、支部の表彰などのceremonyはさらにその一時間後（日本時間4月30日午前9時）に予定されています。平日の朝ですので、視聴できないという方も多いかと思われますが、あとからでも視聴できるようになる予定です。

この場をお借りして先日2月6日～7日に行われた第一回ACPアジア大会（Asian ACPCON 2021）にご参加いただいた皆様に御礼申し上げます。初めての試みでしたが今回の主催のインド支部のご努力で成功裏に終わりました。第2回目はバングラデシュ支部、第3回目は日本支部が主催して継続して毎年行われる予定です。引き続き皆様のご協力をお願い致します。

最後に今年は次期支部長を選ぶ選挙の年にあたります。詳しくは時期が来ればLNC委員長の永山正雄先生からお知らせがあると思いますのでよろしくお願い致します。今年選ばれた方は「次期支部長指名者」Governor-Elect designeeと呼ばれ、来年2022年春（本部総会終了後）からは「次期支部長」Governor-Electとして一年間研修の上、2023年春（本部総会終了後）から私とバトンタッチして、支部長Governorの業務に就いていただくというスケジュールになります。公明正大な選挙になりますよう、期待しています。

2021年2月　　　　　　　　　　　　　　　　　　　　前田賢司

December 2, 2020

The 6th RFC seminar – GIM x Infectious Diseases –

Toshiro Goto, MD
Nerima Hikarigaoka Hospital, Tokyo, Japan

The Resident Fellow Committee (RFC) of the American College of Physicians (ACP) Japan Chapter held the 6th RFC Seminar on Saturday, November 21, 2020. This seminar is held twice a year and aims to improve young physicians’ clinical skills through lectures by experts in various internal medicine fields, and the “Bullet Diagnosis Dojo” which uses ACP’s lifelong learning material, the MKSAP. The theme of this year’s workshop was “GIM x Infectious Diseases”. We invited Dr. Harumi Yano (Professor of Infectious Diseases, International University of Health and Welfare, School of Medicine) and Dr. Mikiro Kato (Department of Infectious Diseases, University of Tsukuba, School of Medicine) to join us for a very productive workshop. Although this was our first time to holding the seminar online due to COVID-19, we received over 100 participants across the country, including eager medical students, young doctors, and veteran doctors. The seminar was a great success, with many engaging questions and discussions taking place in the chat room.

The event began with a message-driven case review session featuring guest lecturer Dr. Kato, on a Nigerian patient presenting with diarrhea. The intriguing case reminded us the necessity of returning to the basic principle of infectious disease treatment whenever we encounter complex cases, which is to perform culture and determine drug susceptibility. In the second session by Dr. Yano on antimicrobial agents, Dr. Yano reiterated the importance of linking pathology, microorganisms, and antimicrobial agents to each other. We learned to take a thorough history, understand the entire clinical course, make a wide range of distinctions, and select the appropriate antimicrobial agents for a given microorganism. At the “Bullet Diagnosis Dojo,” we presented a series of four case questions based on the famous ACP’s official question book MKSAP. Participants received educational comments and tips on each question, which deepened their understanding on infectious disease medicine.

RFC will continue to organize events where young doctors and medical students can learn medical knowledge and techniques useful for tomorrow’s clinical practice that will help them achieve a higher level of excellence. We will also continue to strive to be a platform for those who wish to gain clinical experience abroad. If you are interested, please consider joining us.

December 2, 2020

ACP日本支部 Resident-Fellow Committee主催　「第6回RFCセミナー」

練馬光が丘病院初期研修医１年目
後藤寿郎

米国内科学会(ACP)日本支部の若手医師部会(Resident Fellow Committee：RFC)は、2020年11月21日(土)に第6回RFCセミナーを開催いたしました。本セミナーは、内科系各分野の専門家を講師としてお招きし、講演やACPの生涯学習教材MKSAP等を用いた「弾丸診断道場」を通じて、若手医師の臨床能力の向上を図ることを目的に、年２回程度開催しているものです。

今回のテーマは「GIM×感染症」で、矢野晴美先生(国際医療福祉大学医学部感染症学教授)と加藤幹朗先生(筑波大学医学群感染症科)をお招きしました。今回は新型コロナウイルスの影響を受けて初のweb開催となったことで、学生から若手医師、ベテラン医師まで、全国から100名以上の方々に熱心にご参加いただき、チャットでも多数の質問やコメントが飛び交う大盛況となりました。

第一部はナイジェリア人の下痢を題材とした、メッセージ性のある症例検討会で、加藤先生にコメンテーターを務めていただきました。「非常に悩ましい症例に出会った時こそ、培養し薬剤感受性判定をする」という感染症診療の基本原則に立ち返ることが大切であるということを再認識しました。

第二部では、矢野先生から抗菌薬についてレクチャーいただきました。講義内では「病態」「微生物」「抗菌薬」の３つを結びつけて考えることが、改めて強調されていました。十分に病歴を聴取して臨床経過全体を把握し、広く鑑別を挙げ、想定される微生物と適切な抗菌薬を選択することを学びました。医学生は症例をベースとしながら薬理機序や微生物といった基礎医学と臨床医学のつながりを意識し、初期研修医は疾患ベースに、後期研修医以降は臨床微生物学の強化を意識した勉強をしよう、と具体的なアドバイスもいただきました。

第三部は、毎回好評の「弾丸感染症道場」です。米国内科学会公式問題集(MKSAP)を用いて、取り上げた４題一つひとつに関して先生方から教育的なコメントをいただき、知らないと解決できない臨床課題について、参加者の理解もきっと深まったことと思います。

RFCでは、今後も若手医師や医学生がワンランク上の診療を目指せるような、明日からの診療に役立つ知識やテクニックを学べるイベントを行っていきます。それと同時に、海外を目指す方々のプラットフォームであり続けられるよう努めます。2021年6月には、初めての試みとなるA C P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。

November 29, 2020

Governor’s Message

Winter is approaching and the days are getting shorter. It is time to review this year and think about the next one.

It is regrettable that we had to give up the annual chapter meeting (Kyoto) in June due to the Covid-19 pandemic. It was a pity too that the IM meeting 2020 (LA) in April was cancelled and the fall meeting of Board of Governors (Savannah, GA) in October was changed to a virtual meeting.

I am thankful for our chapter members who have dedicated themselves to their patients and the society in the difficult time of pandemic. I am also thankful for our advisory council and committees who have been busy with the work of our chapter.

I’d like to take the opportunity to congratulate Keijiro Saku, MD, MACP, on his election to Mastership in the College. Dr. Saku, the President of Fukuoka University, was a person of distinguished service in the beginning period of our chapter.

Also congratulations to the new fellows for 2020: Tadashi Matsumura (March), Kazuaki Jindai, Takashi Matono (July), Tomohito Gohda, Mitsushige Nishimura, Eiichiro Sando, Kazutomo Sawai, Ryoma Tanaka, Ryusuke Yoshimi, Yuki Kataoka (September), Naoko Iwasaki, Yoshitsugu Obi, Kazuhiro Takahashi, and Yoshitaka Tomoda (November). Congratulations to all! Dr. Naoko Iwasaki was elected directly upon nomination by the Governor with a help from Women’s Committee (chair: Noriko Yamamoto) in response to a new College initiative to appropriately recognize outstanding women members.

In closing – I am amazed at what we can do with technology, such as meetings through Zoom and other platforms. There are so many events with this technology in 2021. In February, the first Asian chapters’ conference in virtual style, the Asian ACPCON 2021, will be hosted by India chapter. The IM meeting 2021 during April 29^th to May 1^st will go virtual too, and we are also planning to hold a hybrid or virtual chapter meeting in June. So please stay tuned!

Please feel free to contact us if you have questions or suggestions. I wish you a peaceful holiday season.

Yours,

Kenji Maeda

July 7, 2020

New Member of Student Committee

Committee: Student Committee

Job Title: –

Name: Yuka Iijima

Degree: MBBS

Institution: Fudan University

Division/Department: Faculty of Medicine

Hobby: Ballroom Dance, Flower Arrangement, Reading Books

Message: I would like to be an international physician who can make a difference to public health.

July 7, 2020

New Member of Student Committee

Committee: Student Committee

Job Title: –

Name: Naoki Harada

Degree: –

Institution: Juntendo University

Division/Department: Faculty of Medicine

Hobby: Traveling

Message: I have had a strong interest in medicine, especially the heart is the part of the body I find most fascinating.

July 7, 2020July 7, 2020

New Member of Public Relations Committee

Committee: Public Relations Committee

Job Title: Assistant Professor

Name: Yasuyuki Arai

Degree: MD, PhD

Institution: Kyoto University

Division/Department: Department of Hematology

Hobby: Travelling

Message: Hope to be a good connector between ACP Japan and ACP global.

American College of Physicians Japan Chapter: Interim Report 2020

International Exchange Program Committee

Chair： Takahiko Tsutsumi Vice-Chair Yuji Yamada, Mitsuya Katayama

Report: What We have done

Online workshop

Plan: Where we are going to

American College of Physicians Japan Chapter Interim Report 2020

Health and Public Policy Committee

Chair: Hiroshi Ono Vice-chair: Masato Ito

REPORT: What we have done

PLAN: What we are going to do

Evaluation and consideration of the integrity of online medical care/telemedicine

American College of Physicians Japan Chapter Interim Report 2020

Chair: Teruhisa Azuma

We defined general mind and “genespelist” as follows respectively in 2019.

In 2020, we conducted the following activities based on the concept mentioned before.

We will organize the corresponding workshop entitled as “The Genespelist Course for Specialist” in the ACP-JC 2021, which was being held in 2020.

We will hold the case conference and/or workshop using products mentioned above.

We will brush up the questionnaire on practicing with the general mind and conduct another survey targeting senior residents and young specialists (within PGY10) of each department.

We are planning activities illuminating the value of genespelists by combining work style reform in Japan and practicing medical care with general mind.

Chair： Takahiko Tsutsumi
Vice-Chair Yuji Yamada, Mitsuya Katayama

Chair: Hiroshi Ono
Vice-chair: Masato Ito