２．札幌徳洲会病院 Dr. Shadia Constantine,
「How the maternity leave system works in the US and how to keep work-life balance?」
さらにcompetitiveなAwardとして、John Tooker Evergreen Awardがあります。この賞は支部を活性化させるための革新的な活動を評価するもので、今年は25支部から28件の応募がありました。この賞にnominateするだけで高い評価をうけるのですが、大変ハードルが高く、今年応募したのは全支部の3分の1未満です。そうした各支部の自信作がひしめき合う中，日本支部は他の4支部と共にこのEvergreen Award Winnerに選ばれました。海外支部では唯一のものです。
その受賞理由を選考委員会ChairのDr. Michael Tanの文面を引用しお知らせします。
Your submission, “In the Clinic: Japanese Translation Project,” captures the spirit of innovation that the John Tooker Evergreen Awards Program seeks to recognize. The Chapter subcommittee felt this was an outstanding initiative that demonstrates a powerful way that ACP international chapters can be active at the local level. Subcommittee members commended this program
for not only being innovative, but provides member
encouragement, engagement, and recruitment/retention all in one.
This program is a great model for other international chapters.
私はEarly Career Physiciansのポスター発表の枠に応募しました。“Impact of the hospitalist system in Japan on quality of care and healthcare economics”という当院で行なった臨床研究について発表を行いました。ホスピタリストは幅広い内科の問題に対応できる、入院対応のスペシャリストとして米国で発展してきました。米国ではその有用性が多数報告されてきました。本邦においても患者を総合的に診療できる医師の必要性が強調され、専門医制度にも変革が生まれていますが、ホスピタリストの有用性を検証した研究はありませんでした。当院では2017年度に米国でホスピタリストのトレーニングを積んだ指導医の元で総合内科が診療を開始しました。本研究は当院に入院した誤嚥性肺炎の患者を対象とし、ホスピタリスト群(当科)とコントロール群(その他専門科)による治療が医療経済(入院期間、医療費)、医療の質(抗菌薬投与期間、経口抗菌薬への変更率、採血や胸部レントゲン撮影回数)、死亡率・再入院率へどのような影響を及ぼすかを調べた後ろ向きコホート研究です。プロペンシティスコアマッチングを用いて解析を行いました。結果として、死亡率や再入院率を上げることなく、医療経済および質をホスピタリスト群が有意に改善させました。
ポスター発表以外の時間はできる限りセッションに参加しました。同じ時間帯にいくつも魅力的なセッションが行われていました。携帯のアプリで発表の会場、時間、資料の確認を行うことができ、非常に効率が良いと感じました。参加したセッションはいずれも質が非常に高く大変勉強になりました。積極的な参加を求められるセッションもあり、ピッツバーグの先生が発表したヘルスリテラシーを上げるための取り組みに関するセッションでは、他の参加者と議論を行う場面がありました。ACP日本支部のEarly Career Physicians Committeeで「国際学会で地蔵にならないための英語セミナー」と言うセッションを開催していましたが、もっと国際学会で積極的に参加し、発言する姿勢や能力を磨きたいと感じました。
The 3rd American College of Physicians India Chapter Congress was held from August 31th to September 2nd in Lucknow, the capital of Uttar Pradesh, the most populous state in India. The theme of the congress was “Practicing wellness to prevent illness”. On behalf of the International Exchange Program Committee (IECP) at the ACP Japan Chapter, Dr. Tsutsumi and I participated this meeting.
Leaving home early in the morning of August 30, we arrived in Lucknow in the middle of the night. It became the next day when we got to a hotel after a short drive from the airport. It was a muggy night. We could see a couple of cows roaming on the street from a car window. The hotel was located alongside a main street, and had extensive grounds surrounded by tall fences. There were several security guards in front the gate, who asked a few questions to a driver and checked inside the trunk before our car got to the building. Despite after a long travel and coziness of the room, I couldn’t fall asleep easily. I mused over the days I spent in India 26 years ago.
The reason why Dr. Tsutsumi and I came to India originated from a short conversation with Dr. Muruganathan, the Governor of the ACP India Chapter, at the ACP Japan Chapter meeting held in Kyoto, back on June this year. At that time, and until now, the members of the IECP have been discussing what new programs and seminars it could offer. Through the discussion, the idea of an exchange externship program with international chapters of the ACP (chapters outside the United States) came across, and it seemed really nice to us. Having heard that the Governor of the India Chapter was being invited to the meeting, I talked to him to convey the idea at the reception revenue.
“Sounds great. No problem, I think. Let’s do it.” He replied quickly with a big simile on his face.
To be honest, I didn’t expect that things went well so easily. The next day I emailed him a thank-you note. The day after next he replied me to invite me to the India Chapter annual meeting to be held three months later. Actually, I have ever been to India 26 years ago. It was when I was a medical college student. Back in 1992 summer, I backpacked across India for a month on my own. The experience I had during the travel was so impressive, or more correctly put, it was so shocking that it has been a part of my life since then. So, when I read the mail, I definitely thought it was an opportunity I could not miss. After exchanging several emails regarding the schedule and a content of the lecture they want us to deliver in the meeting, Dr. Tsutsumi and I were finally and formally invited to participate in it. I was assigned a talk on the following topic: Is microalbuminuria an indication for RAAS blockade therapy in patients with normal blood pressure? My summer of 2018 was spent preparing for it.
The congress was really great. All sessions were held in English. The topics covered were ranging widely, from clinical research conducted by medical students to up-to-date, clinically relevant theme presented by professors from both inside and outside India. There were also a webinar presented by three physicians from Mayo Clinic, the theme of which was the role of the hospitalist in this day and age. I was amazed by their eagerness to learn the problems that we face and discuss how to deal with them by sharing information with half a dozen invited physicians from abroad. They were from the United States, the United Kingdom, the United Arab Emirates, Bangladesh, Bulgaria, and Japan. In fact, the panel discussion entitled “Challenges and solutions of medical practice” held for this purpose was I thought one of the highlights of this congress. Dr. Tsutsumi participated as one of panelists and commented clearly and sharply about the issues Japan faces. He also did a perfect presentation in his lecture about Japanese medicine in overaging society.
Furthermore, we really appreciated their hospitality. There was a buffet-style reception dinner on the second day of our stay. It was a warm and cozy atmosphere. All participants were talking each other in a relaxed mood. We had a fun time talking with other participants and enjoying a little spicy Indian food. During our stay in India, every single participant and organizer was always nice and kind to us. India warmly welcomed me back.
The experience we had with distinguished colleagues in the India Chapter will be valuable assets to the IEPC. Besides being able to deepen the friendship with them, we could understand the health care environment in India and could also inspect the situation of a big city in India from security perspective, for the planned exchange externship program between the two chapters. Based on them, the IEPC now starts to prepare for its success.
I would like to end my report by showing appreciation to all the people who were involved in my attendance to the congress, to the members of the IECP, to my colleagues in Japan, and to my family. Namaste!
米国フロリダ州のUniversity of Florida, Department of Medicineの内科系専門科で，3週間のエクスターン研修ができます。現地でのプログラムを監修頂くのは日本でも長い指導歴をお持ちのDr. Jerald Stein（スタイン先生）です。米国の一流の内科系臨床研修プログラムを見学できる貴重な機会であり、将来米国での臨床研修を考えている若手医師、米国式臨床研修システムを日々の指導に取り入れたいと考えている指導医クラス、そして米国の臨床研修システムを肌で感じてみたい全ての方に最適です。当委員会メンバーが研修前から研修者をサポートします。