2018年7月17日発行のAnnals of Internal Medicine誌に、ACP日本支部から投稿した記事が掲載されました。インパクトファクターの高いジャーナルですので、なかなか得難い名誉なことです。今回は元記事をFacebookに紹介してくださいましたPRCの委員の先生の他に、コメントを寄せてくださいました萩野昇先生にもAuthorとしてご参加いただきました。一方でLetterのAuthorは人数が限られていますので、公開後に議論にご参加いただいた先生のみで議論内容を確認して投稿いたしました。
Dr. Uchiyama and I joined Doctor’s dilemma on behalf of our hospital. Doctor’s dilemma is one of the most popular part of Japan chapter, which is held every year in Kyoto. Luckily, We could win the championship. This article will be a simple report of my experience. It would be my pleasure if you get a rough image of what ACP Dr’s dilemma is and get interested in it.
Doctor’s dilemma is so called medical knowledge competition. Residents from many hospitals join it in pairs. More and more teams are taking part in it every year. The winner will be given the chance to participate in Doctor’s dilemma held in USA.
Doctor’s dilemma is divided into two parts, Preliminary and Final. In the Preliminary, we used smartphones to answer the questions. The questions were not so difficult, which made us a little bit nervous as losing even one question would be deadly. Ten team passed the Preliminary, which included us.
The Final started after short break. We answered 25 question from 5 areas, GIM, ID, Collagen, Nephro and Hemo. The questions were very practical and connected directly to what we do every day. We finished 25 questions at the second place.
The final question was to diagnose the case. I felt a little bit awkward because I have never seen the disease. However, the case was so typical that we were able to give the right answer. The final question was special because we could bet points as we wanted. We bet all the points and got our score double. We succeeded in making comeback to win.
It was a good match. Many factors contributed to our win. One of the reasons I would like to emphasize is that we belong to Tokyo bay medical center. We bought MKSAP with help and we use it as a self assessment literally. Attending stuffs are also very educative and nice. They Kindly cheered for us on the day. I strongly recommend you come to our hospital.
Finally, I would like to thank everyone who helped holding the ACP Japan chapter. I expect Dr’s dilemma to be even more competitive next year.
I am honored to report that Dr. Takano and I won first prize in the American College of Physicians (ACP) Doctor’s Dilemma competition in Japan.
At first, my goal in joining the competition was simply to assess my skills as an internist. Since distinguished young doctors from all over Japan would be in the contest, I wanted to compare my abilities to theirs. However, with the support of my partner, Dr. Takano, I ended up winning the championship.
Several factors contributed to our victory. First, we prepared for the competition by working up many MKSAP questions to enhance our medical knowledge. Second, our teamwork might have been superior to that of other teams because Dr. Takano and I have been colleagues since we were junior residents. Above all, I believe that our success resulted from our day-to-day sincere attitude and strong passion for helping every patient we see in our hospital. Our success was cultivated in the excellent environment that the attending doctors in our hospital promote. The victory led me to conclude that our hospital is the ideal place to practice medicine and improve my skills as a physician.
I am quite excited about the chance to participate in the ACP Doctor’s Dilemma Final that will be held in Philadelphia in 2019. Since Japanese teams typically struggle in the tournament, our biggest goal is to win the first game. I have no doubt that we can do it. I look forward to it and will continue to brush up on my medical knowledge until then.
Finally, I would like to express my heartfelt gratitude to the attending doctors who gave us the chance to join the competition, the friends who congratulated us, and my family who support me unconditionally.
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.
On the first day of ACP Japan Chapter annual meeting 2018 in Kyoto, the International Exchange Program Committee (IEPC) held a panel discussion-style luncheon seminar entitled “Why not pursue a global career path?” Although it was a nice and sunny Saturday noon, ideal weather for outing with friends or families, the venue was packed and filled with the energies of the audience. Most of them were seemingly clinical residents or medical students, but some senior clinicians were also attended. After introducing themselves and their career path briefly, five speakers told their story on why they recommend a global career path.
First speaker was Dr. Yamada, who is currently serving for his clinical residency in New York. He explains the difference in educational system for clinical residents between Japan and the United States. Dr. Yamada also mentioned how exciting it is to work with people with various backgrounds in the world’s most vibrant city, also known as a melting pot of races.
The second speaker was Dr. Mamiko Ohara from Kameda Medical Hospital. As reflecting back the days she was struggling to survive as a researcher from Japan among many talented scientists at a top-ranked research institution in the United States, she introduced the “Planned happened theory” by John D. Krumbolts. According to the theory, there are five things to keep in mind to make your dream come true; those are curiosity, persistency, flexibility, optimism, and risk taking. Dr. Ohara closed her remarks by quoting the following phrase, “You can accomplish more than eighty percent of what you cannot achieve with your earnest effort.” Next speaker was Dr. Mitsuyo Kinjo from Okinawa chubu Hospital. As a mother of three children, she told her experience on pregnancy, childbirth, and raising children while working as a clinical fellow at a hospital in New York. In addition, she stated that earning a master degree of public health during her stay in New York was a significant event not just because it was awesome to study at an academic graduate school abroad with people from many countries, but because the network she created at the school has been affecting her career since then. Dr. Yuko Takeda, from Juntendo University, took over the talk. Dr. Takeda, who spent about a half of her career abroad, focused her story on adult learning. She emphasized that studying abroad is not a privilege limited to young people because adult people can learn effectively about problems they face and they have experience that would be precious resource for them. Dr. Takeda also suggested that studying abroad with a child/children would definitely add more value than staying alone, in that you can encounter unique experience in parenting in foreign countries. The last speaker was Dr. Tsutsumi from Takatsuki Hospital. He provided detailed information on how to succeed in matching clinical residency programs in the United States based on his experience as a mentor for four Japanese young physicians, all of them are currently working as a clinical resident or a fellow in the United States. “All too often, they rush to apply to the programs as soon as they are eligible to apply and ended up failing. They have no clear strategy to success. I’ve been seeing so many cases like that.” He ended his speech by stating that getting into the United States residency program is still possible, and that potential applicants need to have a well-crafted strategy as well as passion.
In the discussion, one attendee asked panelists about their way to improve English speaking ability. Some panelists introduced their tips, and they all agreed that there is no end to learning English and that we do not need to pay too much attention to speak “correct” English. There was also a discussion on the scope of “global career path”. Dr. Takeda indicated, “Some people from foreign countries who are now living in Japan are in desperate need of medical care. Providing medical care to them or doing what we can do for them is another way to pursue a global career path.
At the end of the session, Dr. Kiyoshi Kurokawa, the founding Governor of ACP Japan Chapter, gave us a message that it is vitally important for all of us to see and feel the world outside Japan whenever we can, in order to lead a fulfilling career path in this ever changing world.
We hope that this seminar has provided each participant some insight into a globally oriented career path and would help them pursue it.
Acknowledgement: We really appreciate Dr. Yuko Takeda for her participation as a panelist and also for her thoughtful talk. We are also grateful to Dr. Kiyoshi Kurokawa and Dr. Shotai Kobayashi, the former Governor, for their attendance and their fabulous comments.
国際交流プログラム委員会 (IEPC)より、“グローバルキャリアのすヽめ−Why not pursue a global career path?”と題したパネルディスカッション形式のランチョンセミナーの報告を頂きましたので、PRC委員会からも広報いたします。（PRC 前田正彦）
The International Exchange Program Committee
International Exchange Program Committee (IEPC)では、“グローバルキャリアのすヽめ−Why not pursue a global career path?”と題したパネルディスカッション形式のランチョンセミナーを開催しました。パネリストとしてご登壇頂いた5名の先生方には、お一人ずつ簡単な自己紹介とご自身のキャリアパスをご提示頂いた後、それぞれの視点で「なぜグローバルなキャリアを勧めるのか」について語って頂きました。