Drʼs Dilemma に参加して

先のACP日本支部総会におけるDoctor’s Dilemmaで見事優勝した東京ベイ・浦安市川医療センターチームの内山秀平先生からの寄稿(日本語ver)です。是非、ご一読ください。(PRC 小尾佳嗣)

この度、京都にて開催されました米国内科学会(ACP)日本支部総会におきまして、Dr.’s dilemmaで優勝をおさめ、2019年に行われるPhiladelphiaでの本選に出場する機会を頂くことができました。日本全国の名だたる病院の若手医師が集まる中、優勝という最高の形で終えられたことは私にとって大きな驚きであり、また同時に喜びになりました。これからPhiladelphiaにおける本選に向けてさらに知識を高め、本番ではできる限りの力を尽くし、悔いのないように取り組みたいと考えております。

出場者にとってのこのイベントの最大の魅力は、日常のトレーニングの成果を試す機会が得られることであると感じています。日々の診療は一つの施設内で行われるため、自身の医療知識やスキルを相対的に評価する場面はなかなかありません。今回のDr.’s dilemmaは、非常に限られた領域ではありますが内科医師としての力を他施設の若手医師の皆様と比較する非常に良いチャンスとなりました。この文を読んでいる初期研修医・後期専修医の皆様、自身の力試しと考えて、ぜひ奮って来年以降の本イベントへの参加をご検討ください。

今回優勝することができた理由は、第一に、当院ではMKSAPによる自己学習を推奨しているため、それに取り組み日々の医学知識の研鑽を重ねたことが考えられます。第二に、チームワークが良かった点もあるかもしれません。高野先生と私は後期専修医としての同期ですが、それ以前に初期研修医として同じ施設で勤務していました。気心がよく知れていたのでお互い遠慮せずに回答できるため、クイズでは相互に知識を補完しあいながら協力し、その結果、後半はほとんど全問正解することができました。しかし何より、私たちの最大の力の源は当院の指導医の先生方が作り出す日々の素晴らしい教育環境と、全国各地から集まった切磋琢磨できる素晴らしい同期の皆であると感じています。優勝はもちろん嬉しいことではありますが、当院での日々の努力が正しい方向に働き、医師としての力が育っていると実感できたことが何よりも嬉しく感じられました。

私たち二人だけの力では、優勝には到底たどり着かなかったでしょう。今回の優勝は東京ベイ・浦安市川医療センターの総合内科全員で勝ち取ったものであると考えています。この機会に、日々お世話になっている皆様にあらためて感謝を申し上げます。

そして、このような貴重な機会をいただくことができましたACP 日本支部の諸先生方に感謝を申し上げ、優勝報告といたします。

 

東京ベイ・浦安市川医療センター

内山秀平

Greetings from Dr. Ende (Immediate Past-President of ACP)

Impressions of Japan ACP Chapter Meeting 2018

Jack Ende, MD, MACP, Immediate Past-President, ACP

 

I was honored early in June to present a plenary talk on Professionalism and the College Update for the ACP Japan Chapter Annual Meeting 2018.  The meeting was a great success.  The topics presented ranged broadly across the practice of internal medicine, medical education, professional development, and, even, physical diagnosis.  What left the greatest impression on me, however, was the theme of the meeting:  “Mind and Arts as Essentials for Internists:  Beyond Evidence and Technology.”

As Meeting Chair, Yugo Shibagaki, MD, FACP, so eloquently wrote in the program guide, “Patients’ needs are not only for medical treatment or cure, they’re also for relief and comfort, sincere attitude and sympathy, and for compassion of doctors and medical staff to listen to their mental as well as physical suffering.”  Dr. Shibagaki continued, “Medical schools tend to teach only skills and knowledge, but not professional or affective attitude or mindfulness.”

What is mindfulness and how does mindfulness relate to practicing internal medicine?

Mindfulness can be defined as the psychological process of bringing one’s attention to experiences occurring in the present moment.  It is a heightened sense of awareness of what is really happening.  In our field, internal medicine, mindfulness is appreciating that a patient is sad or angry or confused – and doing something about these emotions, even if it is merely providing an empathetic comment.  It is appreciating that a patient’s clinical situation is determined by their environment, their relationships, and their lived experiences – and then factoring those social determinants into the treatment plan.  It is also the doctor recognizing within him or herself that, at least at that moment, the stress may be too intense, or the workload too great – and then taking steps to improve those unfavorable conditions.

I also appreciated the message of the program was intended to move us forward, not backward.  This was clear from the subtitle:  “Beyond Evidence and Technology,” calling attention to the word “beyond.”  Mindfulness does not take us back, it moves us forward to a different level – I would say a higher level – of clinical expertise as internists.

The 2018 ACP Japan Chapter meeting was enormously successful, which is not at all surprising given the outstanding commitment and energy of the Chapter’s leadership, members and staff.  The program demonstrated just how enriching medical practice can be, particularly when that practice goes beyond evidence and technology.  I am grateful to have been part of the meeting.

Greetings from Dr. Muruganathan (Governor of ACP India Chapter)

 

Date: June 9th, 2018

Dear Brothers and Sisters, Greetings!

Thank you for inviting me to attend the ACP Japan Chapter Annual Meeting 2018. I thank Governor ACP Japan Chapter Dr. Fumiaki Ueno and family for the nice welcome and hospitality. You have chosen the right theme “Mind & Arts as Essentials for Internists: Beyond Evidence & Technology”. The practicing medicine is both science and art. Science of uncertainty and art of probability.

The arrangements, the venue, the registration procedures were really good. The workshop on Statin was very innovative and involved everyone. The participants in the workshop were made to ask clinical questions and also were made to use the internet to search the latest guidelines and articles relevant to the topic. There were debates whether they can trust the answer

they found.

The participant clearly understood the 5 steps of evidence based medicine. With the above background applying and sharing the decisions with the patient was also highlighted. I understood in Japan they use only small dose of Statin to reduce cholesterol. On the whole the workshop was simple and

complete to cover all the points regarding Statin usage.

I could attend only one workshop. There were other useful interesting topics in other halls like How to evaluate jugular venous pulse at bedside – you can do it, from now on, Minds and arts for end of life discussions through case discussions of cancer patients at terminal stage, A workshop to write “letter to the editor” and etc.

We had a good lunch with the dignitaries who include Dr. Jack Ende Past President ACP, Governor Dr. Fumiaki Ueno, Dr. Kenji Maeda Governor Elect and others. Regarding the session on hypertension there was an initial discussion about how to develop guidelines. During my talk on “Recommended Treatment Protocol for Improving Management of Hypertension Globally” I recommended the following 2 protocols.

HYPERTENSION PROTOCOL – SINGLE PILL COMBINATION AS FIRST-LINE TREATMENT

HYPERTENSION PROTOCOL – CALCIUM CHANNEL BLOCKER AS FIRST-LINE TREATMENT

There were lot of questions on hypertension regarding the definition, the target especially for elderly population etc. I always used to promote home blood pressure monitoring in my country. I am very happy to know most of the patients in Japan are using the home blood pressure monitoring. Ambulatory Blood Pressure Monitoring (ABPM) is ideal but it is not practical. Sooner there may be some devices like wrist watch which can record ABPM very easily. There were lot of discussion about automated office BP monitors. There were lot of lively questions on various aspects of treatment from the audience and

the hall was full.

I was fortunate to be a referee for the “Kurokawa Prize” for poster presentation. Lot of innovative original research papers were presented by the junior doctors. The talk given by ACP past President Dr. Jack Ende on Professionalism was mind boggling. Overall I learnt lot of new points both in academics and organizing. The award function and reception were well organized. I could meet lot of new fellows during the reception and made friendship with them. This also helped me to initiate exchange programme and other joint activities between Japan and India ACP chapter.

The people in Japan are very nice, cordial, honest and helpful. The transport like bullet train, subway train and busses were amazing. I and my family thoroughly enjoyed every movement of our stay in Japan both at Tokyo and Kyoto. We are looking forward to the next best opportunity to visit Japan again. Congratulations to Dr. Fumiaki Ueno, Dr. Yugo Shibagaki, MD, FACP Chair, ACP Japan Chapter Annual Meeting 2018, Governor Elect Dr. Kenji Maeda and members of the organising committee for the wonderful conference.

Thank you once again.

 

A. Muruganathan, MD, FACP
Governor, ACP India Chapter

Kurokawa Prize in Student

Toshiro Goto, senior medical student

Tokai University

I performed my presentation titled“Cavitary Lung Lesions in a Patient with Positive IGRA and PR3-ANCA are not Always due to TB or GPA: a Case Report of Right-Sided Infective Endocarditis”. It was an honor to receive first place in theKurokawa prize competition, the best abstract award (medical student section) at the annual conference of the ACP Japan Chapter 2018.
I am interested in clinical reasoning, so I often attend case conferences and journal club sat the General Internal Medicine department to read and discuss cases from theNew England Journal of Medicine. A doctor suggested that I write an abstract. However, I was a fourth-year student at that time and had not started my clinical clerkship yet, so I started asking about cases for the abstract. Since I have a passion for studying infectious diseases and rheumatology diseases, I still remember how excited I was when I took this case.

In this case, it was saddening to learn that is under standing of laboratory data led to them is diagnosis of the patient which resulted in anatrogenic exacerbation of the patient’s condition. We must consider bacteremia and infective endocarditis from the history and vital signs, and send a blood culture for examination. If the culture is positive, then we need to perform an echocardiogram. There is no doubt that his quality of life would have been improved with those few non-invasive procedures. A famous Japanese doctor who I respect says that the essence of the physician is the differential diagnosis. You can’t take note of the patient’s history, conduct a physical examination, perform a laboratory examination, and conduct the treatment without a differential diagnosis. So in this case, if infective endocarditis was included in the differential diagnosis in the early stages, we could have avoided such a situation by conducting a blood culture and an ultrasonography. It is said that a lot of unneeded laboratory examinations are performed in Japan. Some people even say “clicking the order button is not the prescription for a doctor’s anxiety to misdiagnosis”, but the lesson I learned from this case is that laboratory examinations sometimes startle us, not knowing the character of the laboratory examination.

In closing, I would like to take this opportunity to express my appreciation to you all. It would be impossible to have this award without your help. I will go forward on my newly set goal, which is to do a presentation at theACP Internal Medicine Meeting 2019 in Philadelphia, PA, USA. Thank you for your time.

Kurokawa Prize in Early Career Physician

Section: Recipient’s Remarks

Kiyoshi Shikino, MD

Department of General Medicine, Chiba University Hospital

I am honored to have received the Kurokawa Prize at the ACP Chapter Annual Meeting, 2018. The “Best Abstract Award” was named as the “Kurokawa Prize” beginning in 2018, I am especially honored to be the first person to be awarded this prize.

Research particulars

What triggered this research was that I felt that there were few physicians who could perform the fundus examination confidently. Even when I observed others, few doctors were using the ophthalmoscope with confidence in actual medical practice, except for my mentor, Professor Masatomi Ikusaka. Makoto Kikugawa (Department of Medical Education, Kyushu University), one of the co-researchers, reported that approximately 90% of junior residents, senior residents, and fellows in internal medicine performed the fundus examination less than once in a few months. He also reported that the reason for the problem was mostly that they were not proficient at the fundus examination.

When I taught residents the fundus examination, I discovered why observing the fundus was difficult for them. Funduscopy is inherently difficult to teach because there is no way to verify that the learners have obtained a proper view of the fundus. The teacher cannot give students feedback on whether what they are seeing or the teacher is seeing.Furthermore, it is extremely difficult for the teachers to point out why learners cannot observe the fundus. It was such a dilemma.

Turning point

The turning point of our research was a visit to the Department of Internal Medicine, Stanford University Medical School in March 2017 where I met Dr. Errol Ozdalga and learned the educational method using the iExaminer system for fundus examination. I talked with him about implementing this educational method in Japan as well as to conduct research on its educational effect. He approved of it pleasantly.

Introduction to Clinical Clerkship at Chiba University School of Medicine

First, because of actual instruction in using this iExaminer system, student satisfaction was high, and I heard students saying that they wanted to use it actively even in future clinical training. Next, in order to confirm whether the skill really improved, I asked for the cooperation of the fundus examination simulator at the Chiba Clinical Skills Center. To evaluate the educational effects, we assessed fundus examination skills in a pre-test and a post-test. Discussions between co-researcherswere intense, raising questions such as what to make the subject matter, how many cases we must prepare, and so on. Since we were particularly interested in evaluating skills in “observing fundus,” I was keen to prevent the evaluation of skills in “interpreting fundus.” In addition,to minimize the influence of teachers’ educational skills, we developed an instructional design, led the faculty development, and randomly assigned the teachers.

Future expectations

In this study, the diagnostic accuracy of a fundus examination improved by using the iExaminer system and the time taken to identify funduscopic findingswas shortened. The iExaminer system can be implemented immediately because it can be used for free if you have the adapter and an iPhone. By spreading this teaching method, I hope that more internists can examine the fund us with confidence.

Poster_ACP Japan 2018_Shikino

 

ACP日本支部2018年次総会 黒川賞(若手医師部門)を受賞して

千葉大学医学部附属病院 総合診療科の鋪野 紀好先生から、ACP日本支部2018年次総会 黒川賞(若手医師部門)受賞の報告を頂きましたので、PRC委員会から広報いたします。(PRC 宮内隆政)

・・・・・・・・・・・・・・・・・・・・・・・・・

ACP日本支部2018年次総会 黒川賞(若手医師部門)を受賞して

千葉大学医学部附属病院 総合診療科

鋪野 紀好

この度は、ACP日本支部2018年次総会で黒川賞を頂き、大変光栄です。2018年度から”Best Abstract”は「黒川賞」に変更となり、最初に黒川賞を受賞できたことを大変名誉に思います。

研究の経緯

今回研究を行うきっかけとなったのは、眼底鏡診察を、自信を持って実施できる内科医は少ないと感じたことである。自分の周りも見回しても、我が師匠である生坂先生を除いて、眼底鏡を実際の診療で積極的に活用している医師はほとんどいなかった。共同研究者である菊川誠先生(九州大学大学院医学研究院 医学教育学講座)が発表されているが、初期研修医、内科専攻医、内科指導医のいずれも、約90%は眼底鏡を利用していないまたは2、3ヵ月に1回の使用頻度とされる。その理由としては、眼底鏡診察が苦手というのがほとんどの理由であった。

自分が眼底診察を教えてみると、なぜ観察が難しいのかに気付いた。それは、学習者と指導者が同じ画面を共有できないことにある。学習者からすれば、今確認しているものが、本当に正しいのかについてフィードバックを受けられず、確証が得られない。また指導医も、なぜ確認できていないのかを指摘するのは至極難しい。そんなジレンマを感じていた。

研究の転機

研究の転機となったのは2017年3月のスタンフォード大学医学部内科への視察であった。そこで、エロル・オズダルガ医師と出会い、眼底鏡の教育にiExaminer systemを用いた教育手法について学んだ。彼とは、この教育手法を日本に持ち帰り実践したいこと、また教育効果についてリサーチしたいことを語りあい、快く承認してくれた。

千葉大学医学部クリニカル・クラークシップへの導入

まず、このiExaminer systemを用いて実際の教育を行ったところ、学生からの満足度は高く、今後の臨床実習でも積極的に使っていきたいという声が相次いだ。次に、本当にスキルが向上するかを確認するために、本学のシミュレーションセンターである、クリニカル・スキルズ・センターへ眼底鏡シミュレータの協力を仰いだ。教育の前後で評価することで、教育効果を明確にするためだ。題材は何にするか、問題数はいくつにするかなど、共同研究者とのやり取りは白熱した。特に今回の研究は「観察力」の評価だったので、そこに「解釈力」の評価が混入しないように腐心した。また、教員による教育効果は二重盲検化がデザイン的に困難であったため、最小限にするための工夫を行った。

今後の期待

今回の研究では、iExaminer systemを用いることで、眼底鏡診察の診断精度が向上し、かつ観察時間が短縮されることが示された。iExaminer systemは約8000円のアダプターと、今日だれもが携帯しているiPhoneさえあれば、フリーで利用できるため明日からでも実施可能である。この教育手法が広まることで、自信を持って眼底を診察できる医師が1人でも増えることを祈ってやまない。

Poster_ACP Japan 2018_Shikino

写真:黒川賞演題候補としてのプレゼンテーション

写真:スクリーンに自分の名前が映し出された時には心が震えた瞬間であった

写真:右からBA Muruganathan先生、Jack Ende先生、筆者、黒川 清先生

写真:応援に駆けつけてくださった千葉大学医学部附属病院 総合診療科 メンバーと

Chapter Business Report 2017-2018: SPC

Scientific Program Committee

Chair; Yugo Shibagaki,  MD, FACP

 

Agenda 1  Organization 2017-18

 

Chair:  Yugo Shibagaki

Vice-chair:  Teruhisa Azuma, Sugihiro Hamaguchi

Members:

Masako Utsunomiya, Shungo Yamamoto, Yasuhiro Akai, Tsuguru Hatta

Hideaki Shimizu, Mikio Hayashi, Shunpei Yoshino, Sho Fukuoka, Atsuko Uehara

and Noriaki Kurita

 

Agenda 2   Chapter Business Report: June 2017 – Present (June 2018)

– ACP Japan Chapter Annual Meeting 2017 (http://www.acpjapan.org/acp2017/)

Last year, we held the ACP Japan Chapter Annual Meeting 2017 at the Kyoto University Clock Tower Centennial Hall and the Kyoto University International Innovation Center on June 10th and 11th, 2017. Since we expanded the venues (rooms) for the session, we could accommodate as many as 32 sessions (didactic sessions, workshops), 8 luncheon seminars, special sessions (Plenary session, Governor’s address, Dr’s Dilemma and ACP update), a poster session with almost 100 abstracts with best poster presentation on the following day, so we kept the number of the sessions which increased significantly every year since 2013. The Doctor’s Dilemma (Medical quiz session) attracted many contestants from hospitals all over Japan which ended with a much success and the some of the winners were selected as the members representing ACP Japan Chapter and just participated and did their best in the Doctor’s Dilemma held in Internal Medicine 2018 held in May, 2018 in New Orleans. The poster discussion was a very lively session with many participants with full of discussions. Three presenters with each representative of students, residents and young physicians were awarded and had a chance to give a presentation in the main hall the next day, applied to the Internal Medicine Meeting 2018 and seemed to get motivated by this wonderful experience. We had the immediate past president, Dr. Nitin Damle, who provided the educational talk at the plenary session and ACP update.

Agenda 3     Chapter Business Plan:

– Organizing the Annual Meeting 2018 of the ACP Japan Chapter (http://www.acp2018.org/)

On June 2nd and 3rd, 2018, we will organize the Annual Meeting 2018 of the ACP JC in Kyoto. Beginning last year, Kyoto University International Innovation Center was added to the venue of the Meeting as well as Kyoto University Clock Tower Centennial Hall to accommodate more attractive sessions and lectures. In fact, this year we accommodate 45 sessions with special sessions

The theme of the Meeting this year is “Mind & Arts as Essentials for Internists: Beyond Evidence and Technology”. We will address this very important issue in the plenary session, following the keynote lecture from the immediate past president of ACP, Dr. Jack Ende, with experienced physicians who practice medicine with mindfulness as guest speakers, discussing how we can raise the mindful care as well as technical part of medicine in the era of super-aging society with the frail elderly. In addition, we will offer sessions like Dr’s Dilemma (an inter-institutional Quiz tournament by teams of residents), the poster-discussion session, as well as the special talk by Dr. Jack Ende. This time, we also invite Dr. Muruganathan from India chapter of ACP to enhance the partnership with Asian chapters.

 

– Organizing the Annual Meeting 2019 of the ACP Japan Chapter

We are planning to hold ACP JC 2019 on June 1st and 2nd in Kyoto with the same venue as this year.

In the Clinic Japnese translation project. How to incorporate In the Clinic in daily practice: 5 minutes bedside teaching

Dr. Kitano : St. Marianna University Yokohama City Seibu Hospital, Emergency and Critical Care Medicine

5-minutes teaching held on 3rd Jun 2018 at Kyoto

In the Clinic Japanese Translation Project has been in progress which is one of the leading project of PRC (public relations committee). There have been more applicants than the actual slots for the translation teams. The first translated article of In the Clinic, which is HCV, has been posted on the ACP main chapter’s webpage this April. Through this project, our goal is to have the members of ACP Japan Chapter to be able to utilize the excellent ACP resources including In the Clinic.
At this year’s annual meeting, we have presented a practical workshop with the collaboration of ‘In the Clinic Translation Project’ and ‘Bedside 5-minute Teaching’ We prepared the 12 general rules = Bedside 5-munite Teaching, which are based on 6 articles of In the Clinic.
In this practical workshop, participants have output the Bedside 5-munites Teaching and at the end of the seminar, they appeared to find themselves be able to use the rules as part of their active knowledge in the clinical setting. We hope this workshop served as an eye-opener to get one out of a lifelong sense of insufficiency where one feel he/she is not acquiring active knowledge even with a lot of literature reading.

症例の型を説明する講師

ACP日本支部総会・講演会2018の最終案内

あと2週間弱と迫ってまいりましたACP日本支部総会・講演会の最終案内です。

****************

2018年6月2日(土)・3日(日)に、京都大学百周年時計台記念館・国際科学イノベーション棟にてACP日本支部年次総会を行います。
Home Pageは http://acp2018.org/index.html となります。

今年も数々の魅力的なセッションをご用意いたしております。http://acp2018.org/program.html

今回は大きな会場を多く用意したため、多くのセッションで空席があります!!

事前Web参加登録は閉め切っておりますが、当日受付は参加登録・セッション申込共に可能です。
その場合、京都大学国際科学イノベーション棟1階 「ACPJC2018総合受付」(6月2日(土)、3日(日)9時~)までお越しください。
http://acp2018.org/venue.html

また、是非、ご友人、同僚、後輩の方々にも本会をご紹介頂ければ幸いです。

何卒よろしくお願い申し上げます。

柴垣有吾拝
ACP日本支部年次総会・講演会

ACP日本支部年次総会セッション2-C2-1「FACPへの道 - なぜ,そしてどのようにそれを目指すのか – 」に関する事前アンケートのお願い

Health and Public Policy Committee委員長の小山雄太先生より、ACP日本支部年次総会セッション2-C2-1「FACPへの道 - なぜ,そしてどのようにそれを目指すのか – 」に関する事前アンケートのお願いです。(PRC 小尾 佳嗣)

=====以下、文面引用===================================

皆さんこんにちは.小山雄太@山形県酒田市・日本海総合病院と申します.

今年6月のACP日本支部年次総会において,Health and Public Policy CommitteeとCredential/Membership Committeeとの共同企画セッションを開催することになりましたので,セッションの紹介と皆さんへお願いがありメールを投稿いたしました.

セッションは
6月3日 9:15〜10:35 2階 C-2会場
「FACPへの道 - なぜ,そしてどのようにそれを目指すのか – 」
です.

本セッションの紹介は後半に記しますが,
・ 将来FACPを取得しようと思っているかいないのか,またその理由
・ (FACPの方には)なぜFACPになろうと思ったのか
・ FACPを取得して日常業務に変化があったか
・ 資格を取得したうえでの将来の展望は?

などについて会員の皆さんのご意見を頂戴して,このセッションの参考にできればと思い事前アンケートをお願いすることにいたしました.

当日,本セッションにお越しになるかどうかに関わらず,また皆さんの日本支部での資格がMemberかFellowかその他の資格かに関わらず,acp-exchangeの皆さんからFACPに対するイメージやFACP取得の理由(もしくは取得しようとしない理由)などについて無記名のアンケート形式でご意見を賜れれば幸いです.

アンケートはフォームメーラーを用いて行います.
お答えいただける方は,下記URLへ飛んでいただき,必要事項を記入してください.
https://pro.form-mailer.jp/fms/44898cfa144656

選択での回答は少なく自由記載が多いのですが,それでも全部で10分はかからないと思いますので,どうかお気軽にご意見をお寄せください.

・ セッションの準備のため,締め切りは5月26日 18時まで といたします.
・ お寄せいただいたご意見は集約して,セッション当日に(必要に応じ個人の特定ができない形にして)一部をご紹介して参加された皆さんでの討論の参考にさせていただきます.
・ アンケートの集計結果は,年次総会終了後にご紹介できるように何らかの形式で(まだ詳細を決めていませんが)準備したいと考えています.

以下,本セッションの紹介です.

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2017年7月1日現在,日本支部においてACP本部が認定するMasterは6名,Fellowは320名,Honorary Fellowは1名ですが,このセッションは

・ MACP,FACPの方々がどうしてFACPを目指したのか
・ FACPを目指す道のりがいかなるものであったのか
・ FACPを取得することによって診療・教育・研究など日常業務におけるpracticeがどのように変化したのか(あるいはしなかったのか)
・ FACPとしての将来の展望をどのように描いているのか

などを知ることで,MACPやFACPを目指す皆さんに向けたメッセージとともにその取得意義を考えてみようという趣旨で行います.セッションでは,上野文昭・現日本支部長と前田賢司・次期日本支部長のお二方からもコメントを頂戴するほか,FACP取得をもっとイメージしやすくするために,資格取得のためのpathwayについてもお示しする予定です.

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FACP取得にご興味をお持ちの方など,多数の皆さんのお越しをスタッフ一同お待ちしております.

どうぞ宜しくお願いいたします.


小山 雄太
日本海総合病院 腎臓膠原病内科
Yuhta Oyama, MD, FJSIM, FACP
〒998-8501 山形県酒田市あきほ町30
Phone: 0234-26-2001
Fax: 0234-26-5114
e-mail: yuhta217@sweet.ocn.ne.jp