Governor’s Message

This is the time of year to remind you of our Chapter Meeting in June. We are going to hold the meeting remotely for the first time. The all-virtual meetings have some disadvantages in some aspect but at the same time there are advantages as well – even busy doctors can participate in the meetings from their offices without travelling so far. The planning team of the Scientific Program Committee led by Dr. Sugihiro Hamaguchi has put together a great agenda. I am excited to welcome our members to the meeting.

The ACP annual meeting in the USA, Internal Medicine Meeting 2021 (IMM2021), took place the other day in the virtual style and it went successfully. Although there were some challenges for us because of time difference between USA and Japan, it was a wonderful meeting. I personally enjoyed “Thieves’ Market” by Dr. David Scrase. Cases were presented in fun and interactive session. This event will be introduced to Japan for the first time in the next Japan Chapter meeting in June. I hope all of you will enjoy!

Congratulations new fellows and masters! To follow are the pictures from the IMM2021. It’s a pity that we couldn’t do marching in the venue but it was a proud moment.

The Physicians’ Well-being Team of our Chapter conducted a questionnaire survey in March and reported that 69 (30.9%) among 223 respondents had burnt out as of the survey. The survey also found that 79 (35.4%) and 78 (35.0%) reported insomniac symptoms and anxiety, respectively, whilst 33 (14.8%) were depressed. Approximately 40% of the respondents considered changing their job responsibilities in the COVID-19 pandemic. I hope all the stress will be dispersed with weathering the coronavirus crisis.

It has been two years since I became a Governor and now it’s time to select the next Governor (Governor-Elect). I know that both of the two candidates are excellent persons and each deserves to be a governor. I hope all the members will join in the fair voting.

Stay well and enjoy your spring and summer!

Kenji Maeda

April 26, 2021April 28, 2021

The 2nd MKSAP study session

National Hospital Organization Tokyo Medical Center
PGY 2 Tomohiro Hirai

Center Hospital of the National Center for Global Health and Medicine
PGY 1 Rika Terashima

The Resident Fellow Committee (RFC) of the American College of Physicians (ACP) Japan Chapter held their second MKSAP study session on Sunday, April 18, 2021. This session, utilizing ACP’s famous online learning tool MKSAP, is approved by ACP Headquarters. Dr. Yuji Yamada (Department of Geriatrics and Palliative Medicine, The Mount Sinai Hospital) was invited for this session with the theme of “Hematology”, and he explained five pre-selected questions from MKSAP. We had a lively study session, with participants answering each question and many more questions flying in the chat box.

The 1st question was about the “treatment of iron deficiency anemia,” and Dr. Yamada gave an in-depth explanation of common problems we encounter in our daily clinical practice.

The 2nd question was about “how to deal with poor INR control associated with warfarin usage”. Recently, DOACs are being used more frequently, and the occasions for prescribing warfarin are decreasing, but this is still a problem we encounter often. The lecture was full of useful tips for tomorrow’s practice, such as the differentiation of various anticoagulants.

The 3rd question was about the “diagnosis of polycythemia vera.” Dr. Yamada provided a clear explanation utilizing a diagnosis flowchart style, and we were able to hear Dr. Yamada’s personal experience where changes in lab data led to the diagnosis of a new hidden disease.

The 4th and 5th questions were about “HIT (heparin-induced thrombocytopenia)” and “DIHA (drug-induced hemolytic anemia)”. We discussed their differences and what to look out for in these diseases. We may know these diseases as medical knowledge but feel uneasy about actually clinically managing them. We also studied a wide range of topics, including the introduction of VITT (Vaccine-induced Immune Thrombocytopenia), a new finding that has become a hot topic with the new coronavirus vaccine.

This MKSAP study session was also a time to increase motivation for daily study. Dr. Yamada carefully explained important points in actual clinical management, including common pitfalls. He taught us in a way that is easy for non-specialists to understand, while mixing in his expertise and advanced viewpoint.

RFC will continue to hold events, including this study session, to improve our daily practice. In addition, we will provide a platform for those who want to go abroad. The ACP Japan Chapter Annual Meeting is scheduled to be held, for the first time online, on June 26 and 27, 2021. The next MKSAP workshop is scheduled to be held in August or September after the Annual Meeting. We look forward to seeing you at our ACP Annual Meeting and at one of our many study sessions.

March 23, 2021

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.

March 7, 2021March 7, 2021

Women’s Committee

American College of Physicians Japan Chapter Interim Report 2020

Women’s Committee

Chair: Noriko Yamamoto MD, FACP

Report: What we have done:

The Women’s Committee has 10 members including 4 male members. We started out with 6 female members from 2017 July. I am pleased to increase the male members. That’s because the female members don’t know how the male physicians feel about something female physicians work and struggle. And when the male members talk about their confusion to attend some problem with female physicians on our mailing list, female members notice their confusion and find their own problems and other obstacles .I think it’s important that such a mutual understanding keep going for long time, moreover the male and female physicians will get to sympathize each other.

Session Plan:

This June we couldn’t hold the annual session of Japan Chapter, we have a plan to hold the session at next annual meeting. We collaborate with the Physician’s Well-Being Team and have a plan to hold the work shop about physician ‘s Burn-out.

Facebook Page

We have the Facebook page. We post the news and articles of ACP and other information, news about gender inequity.

Woman in Medicine Month (September)

We recommended a FACP from women’s members on September, Dr. Naoko Iwasaki MD.

Plan: What we are going to:

We will hold the session about communications at the workplace next meeting. We are making the details of this session concretely. We collaborate with the Physicians Well-Being Team; we might have the workshop about physician’s Burn-out and coaching next year except annual meeting. I want to increase more female FACPs in Japan Chapter. I wish many female physicians will have activities in ACP Japan Chapter vividly, I will recruit some members for Women’s Committee next term.

March 7, 2021

Scientific Program Committee

American College of Physicians Japan Chapter Interim Report 2020

Scientific Program Committee

SPC Chair Sugihiro Hamaguchi

１．Report: What we have done

It is terribly regrettable to report that two major annual events, The ACP Japan Chapter Annual Meeting 2020 and The Joint session with Japanese society of Internal Medicine, were cancelled because of the enormous impact of corona virus disease 2019 pandemic not merely on our preparation procedures for the events but also all participants’ health and lifestyles changes.

The annual meeting 2020 was planned to be held on June 6 and 7, 2020 at Kyoto university and The Joint session with Japanese society of Internal Medicine was on April 11, 2020.

２．Plan: What we are going to do

We are now planning the ACP Japan Chapter Annual Meeting 2021. This will be a complete online meeting and is planned to be held on June 26th and 27th 2021.

There will be one website with several channels (rooms) for participants to enter and each channel has its own characteristics. Using some interesting and useful software, a feasible and enjoyable meeting is being planned.

The annual meeting of Primary Care Research connect (PCR connect) is going to be held on December 19th and 20th, 2020. (https://pcrconnect.org/) PCR connect is an integrated research network among ACP Japan Chapter, Japan Primary Care Association, and Society for Clinical Epidemiology for the enforcement of primary care related research outputs from Japan. It is planned to be held on December 12 and 13, 2020.

March 7, 2021

Student Committee

American College of Physicians Japan Chapter: Interim Report 2020

Student Committee

Chair: Hideta Teshirogi
Vice-Chair: Takeshi Matsushita

Our mission is to facilitate interest and interaction amongst ACP student members, provide an educational experience, and contribute to the further success of ACP Japan Chapter (ACPJC) and its international collaborations.

1.REPORT: What we have done

Recruited 11 new student committee members

We recruited 11 new committee members from 9 medical schools

including a medical school in China. Our new diverse and international members have widened our horizons and brought unique perspectives to our projects.

Survey: Japanese medical students’ view on their future international career

We conducted an online survey to bring to light Japanese medical students’ current thoughts on pursuing an international career in the future. The aim of our survey was to use the results to provide better educational opportunities and much-needed information to medical students. We had 549 participants from 58 universities, covering 70% of Japanese medical schools.

Public relations (Facebook page / Twitter Account)

In an effort to present our work to the public, we have created an ACPJC student committee Twitter account in addition to the Facebook page we already have. We have posted self-introductions of each committee member and meeting reports so that viewers feel closer to our organization. Our Facebook page has reached over 148 follows and 9639 views.

・ACPJC Student Committee Facebook
page: https://www.facebook.com/ACPSCJapan
・ACPJC Student Committee Twitter: https://twitter.com/acpsc_japan

2. PLAN: What we are going to do

Using the data we collected from the survey, we plan to hold seminars that respond to the participants’ needs and wishes. The topics include practicing international standardized medical history taking and learning how to pursue an international career as a Japanese physician. Simultaneously, we will prepare for the ACPJC Annual Meeting’s student session for next year and continue our SNS activities on Facebook and Twitter.

March 7, 2021

Resident-Fellow Committee

American College of Physician Japan Chapter: Interim Report 2020

Resident-Fellow Committee

Koma Hotta, MD
Department of General Internal Medicine
Aso Iizuka Hospital

【Report (What we have done)】

Our committee (Resident-Fellow Committee; RFC) held a seminar called “The 6^th RFC Seminar featuring infectious disease in November 2020. Holding “RFC Seminars” is one of our main projects to broaden the community of RFC in Japan. In November, more than 100 Japanese medical students, junior residents and fellows gathered on web seminar to learn together to strive for excellence in internal medicine frontlines.

Also, we posted an article about RFC semiar on ACP Japan Chapter RFC Facebook page on purpose of increasing the number of ACP members.

【Plan (What we are going to do)】

We are planning to organize a new seminar, by which junior residents and fellows can enhance the quality of postgraduate internal medicine training. At the same time, it is intended to become a “communication and collaboration hub”. We will find the best way to enhance the quality of postgraduate internal medicine training with the COVID-19 outbreak.

March 7, 2021

Local Nominations Committee

American College of Physicians Japan Chapter Interim Report 2020

Local Nominations Committee

Chair: Masao Nagayama
Vice-Chairs: Toshihiko Hata and Takeshi Yanagawa
Members: Mio Ebato, Mikio Hayashi, Yohei Goto, and Yoshihisa Matsumura

Report: What we have done

We nominated Dr. Keijiro Saku, MD, FACP (ACP# 01075550), President of the Fukuoka University, for the mastership, and he was successfully attested by the ACP Awards Committee to be the Master of the ACP (MACP) at the initial application just like Dr. Katsuhiko Takabayashi last year. He is the eighth MACP from Japan following Shunichi Fukuhara, Hiromi Ishibashi, Shotai Kobayashi, Kiyoshi Kurokawa, Katsuhiko Takabayashi, Fumiaki Ueno, and Tsuyoshi Watanabe in alphabetical order.

PLAN: Where we are going to go

– Started preparation of the nominating for the Sakura Award、the Volunteerism Award、the ACP Japan Chapter Contribution Award (ACPJCCA), the ACP Japan Chapter Academic Award (ACPJCAA), and the Mastership nominee.
– Started preparation to launch the new Awards by the ACP Japan Chapter based on the encouragement by the ACP which may include the following awards;
- ACP Japan Chapter Young Leadership Award (ACPJCYLA)
- ACP Japan Chapter Women Leadership Award (ACPJCWLA)
- ACP Japan Chapter Senior Contribution Award (ACPJCSCA)

March 7, 2021

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.

American College of Physicians Japan Chapter Interim Report 2020

Women’s Committee

Chair: Noriko Yamamoto MD, FACP

Report: What we have done:

Session Plan:

Facebook Page

Plan: What we are going to:

American College of Physicians Japan Chapter Interim Report 2020

Scientific Program Committee

SPC Chair Sugihiro Hamaguchi

American College of Physicians Japan Chapter: Interim Report 2020

Student Committee

Chair: Hideta Teshirogi Vice-Chair: Takeshi Matsushita

1.REPORT: What we have done

Recruited 11 new student committee members

Survey: Japanese medical students’ view on their future international career

Public relations (Facebook page / Twitter Account)

2. PLAN: What we are going to do

American College of Physician Japan Chapter: Interim Report 2020

Resident-Fellow Committee

Koma Hotta, MD Department of General Internal Medicine Aso Iizuka Hospital

【Report (What we have done)】

【Plan (What we are going to do)】

American College of Physicians Japan Chapter Interim Report 2020

Local Nominations Committee

Chair: Masao Nagayama Vice-Chairs: Toshihiko Hata and Takeshi Yanagawa Members: Mio Ebato, Mikio Hayashi, Yohei Goto, and Yoshihisa Matsumura

Report: What we have done

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

Chair: Hideta Teshirogi
Vice-Chair: Takeshi Matsushita

Koma Hotta, MD
Department of General Internal Medicine
Aso Iizuka Hospital

Chair: Masao Nagayama
Vice-Chairs: Toshihiko Hata and Takeshi Yanagawa
Members: Mio Ebato, Mikio Hayashi, Yohei Goto, and Yoshihisa Matsumura

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

Chair: Hiroshi Ono
Vice-chair: Masato Ito