2017-18 国際交流プログラム委員会・活動中間報告

2017-18 国際交流プログラム委員会・活動中間報告

 

委員長 筑波大学医学医療系教授・水戸協同病院

矢野(五味)晴美

 

国際交流プログラム委員会では、2012年に発足し、前支部長の小林祥泰先生、およびカリフォルニア支部長のDr. Soma Waliのご尽力により、カリフォルニア大学ロサンゼルス校(UCLA)の教育病院であるオリーブビューメディカルセンターにて総合内科を中心とする臨床見学プログラムを中心とする活動を行ってまいりました。これまで通算16名の派遣者を輩出しました。残念ながら2017年8月を持ちまして、この臨床見学プログラムは終了いたしました。2017年8月以降、ハワイ大学に2名派遣することが決まり、活動しております。

 

以下で2017-18年の当委員会の活動の中間報告をさせていただきます。

 

1. これまで達成したこと

a. 国際交流委員会では、2012年より活動開始し、同年よりカリフォルニア大学ロサンゼルス校(UCLA)の教育病院であるオリーブビューメディカルセンターにて総合内科を中心とする臨床見学プログラムが開始されました。2017年8月に本プログラムが終了するまでに合計16名が渡航し本プログラムに参加しました。

b. 委員会では、渡航候補者の英文の履歴書や志望書の作成などをサポートしてきました。

c. 各渡航者には、委員がメンターとして担当してサポートしました。

d. ACP日本支部幹部、委員、派遣者、派遣修了者が登録された同窓会メーリングリストを発足しました。派遣者は、臨床見学中、毎週1回、臨床見学の振り返り・学び・経験などを投稿してもらいました。振り返りを関係者で共有できとてもよい機会になりました。

2. 現在、取り組み中のこと

提出予定の英文の履歴書および志望書を委員会でレビューし建設的なフィードバックを行っております。

3. 取り組み始めたこと

a. 昨年度から、派遣者を戦略的にリクルートしております(2017年8月以降、一時、中断しております)。

b. 2017年11月のNews Letterで委員が自己紹介文が掲載されました。

c. 2017年8月にUCLAのプログラムが終了後、ハワイ大学での臨床見学プログラムで渡航者が2名います。

4. 今後、計画中のこと

a. ACP日本支部の若手会員、非会員および米国での臨床見学希望者にどのように臨床見学に関する情報を届けるかを検討しております。

b. UCLAでの臨床見学プログラムが終了したため、ACP会員向けの適切な臨床見学プログラムが必要な状況になっております。

c. 臨床見学目的の渡航に関する助成について議論をしております。

FACP昇格の挨拶 – Dr. Yasuaki Hayashino

FACP昇格の挨拶

Dr. Yasuaki Hayashino, MD, PhD, FACP, MPH

天理よろづ相談所病院 内分泌内科 部長

天理よろづ相談所病院内分泌内科の林野と申します。この度はACP日本支部の関係者の多くの方々のご支援により、FACPに昇格させて頂きました。糖尿病、代謝疾患、内分泌疾患を中心に臨床に従事するとともに、糖尿病患者を対象とした疫学研究を行っております。実臨床、医学教育、疫学研究を通して内科学の研鑽に励むと共に、ACP日本支部の今後の発展に貢献できるよう努力させていただきます。今後ともどうぞよろしくお願い申し上げます。

支部長挨拶

松村理司先生のHonorary Fellowship受賞を讃える!

 

ACP日本支部長 上野文昭

その昔,日本で卒後研修の場と言えば大学やその関連病院がほとんどであった頃,京都にユニークな病院がありました.大学の看板も権威もないその病院では,本場の“大リーガー医”を招聘し,徹底的に米国式の臨床研修を行っていました.当時は卒業したら自分の大学で研修するのが当たり前でしたが,やがて多くの若者が保護者のような卒業校から離れ,その病院で世間の荒波に揉まれはじめました.他流試合で成長し,大リーガー医に感化された若者たちが数多く渡米し,本場の臨床研修に身を晒しさらに成長を遂げました.舞鶴市民病院でこの仕組みを創られた松村理司先生は,その後音羽病院に移られ,そこでも同じシステムを継続されました.この2つの研修プログラムのOBたちは今や日本にとって欠くことのできない臨床指導医として,全国の研修施設においてさらに多くの優秀な臨床医を育んでいます.

ACPの会議に出席して驚いたことは,「Tadashiは元気?」と多くの人たちに声をかけられたことです.現プレジデントのDr. Ende,現支部長会議議長のDr. Cooneyや,Dr. Gibbons,Dr. Chow,日本にもなじみの深いDr. Meyerなど,ACPの中枢に数多くの舞鶴・音羽指導医OBがいます.その他にもDr. Constant,Dr. Willis,Dr. Sapira,Dr. Tierneyなど教育者として高名な方々が“大リーガー医”として招聘されてきました.

ACPのAwardの一つにHonorary Fellowshipというものがあります.従来,世界内科学会など米国外の学会長に与えられるAwardで,これまで日本でも数名の方々が受賞しています.もちろん大変優れた先生方ではありますが,個人というよりもその役職に対するAwardという性質のものです.このたび松村先生の日本の臨床研修に対する功績が高く評価され,4月にNew Orleansで開催されるInternal Medicine Meeting 2018 において,Honorary Fellowshipが授与されることが決定しました.これは異例中の異例のことで,何ら組織の背景もない一個人の医師がその功績により受賞するわけなのです.いかにACPの評価が高いかがおわかりいただけるでしょう.そして今回の受賞をサポートしていただいた多くの大リーガー医(黒川初代支部長を含む)の皆さまに感謝いたします.

Governor’s Newsletterで個人の受賞を讃えるのには,少しためらいがありました.それでもやはりこの喜びを私だけでなく,会員の皆さま方と分かち合いたいとの思いで,あえて公表いたしました.今でこそ卒業大学を離れることはそうめずらしくありませんが,旧態依然たる当時の日本の研修体制では,不安の募る医学生を惹きつける何かが必要でした.魅力溢れる研修プログラムを構築され,長年にわたって実践されたことは,卒後臨床研修に対する考え方を根本から変えたといっても過言ではないでしょう.

敬愛する松村先生,おめでとうございます!ご承諾を得ずに先生を登場させてしまったことをお詫びいたします.

Student Committee

I would like to introduce Student Committee members

(PRC chair, Dr. Oshima)

 

Student Committee
Member

Hideta Teshirogi

Institution
 
Gunma University
Department/Division
 
3rd Year
Message
 
温故知新
Student Committee
Member

Yusuke Matsumoto

Institution
 
Kindai University
Department/Division
 
4th year
Message
 
Peace bigins with a smile.
Student Committee
Member

Masahiro Kato

Institution
 
Kindai University
Department/Division
 
4th Year
Message
 
"The goal comes first, then we perceive. We don't perceive first."
Student Committee
Member

Yuki Shima

Institution
 
Gunma University
Department/Division
 
5th year
Message
 
優希
Student Committee
Member

Erika Hiraga

Institution
 
Osaka City University
Department/Division
 
5 th Year
Message
 
Do my best
Student Committee
Member

Ai Suzue

Institution
 
Kindai University
Department/Division
 
5 th Year
Message
 
Persistence makes perfect
Student Committee
Member

Satoshi Inaba

Institution
 
Kyoto Prefectural University of Medicine
Department/Division
 
5 th year
Message
 
ancora imparo
Student Committee
Vice Chair

Rika Terashima

Institution
 
Gunma University
Department/Division
 
4 th year
Message
 
I am grateful for all of the opportunities ACP has provided me. I have met many wonderful people through ACP and I am very excited for the next ACP Japan chapter!
Student Committee
Chairman

Tomohiro Hirai

Institution
 
Mie University
Department/Division
 
5 th Year
Message
 
“Keep going, even if it is just a little”
Student Committee
Chairperson

Natsumi Momoki

Institution
 
Kanazawa Univesity
Job Title
 
student
Message
 
to feel brave, act as if we were brave
Student Committee
Vice chairperson

Shungo Oka

Institution
 
Nara medical university
Department/Division
 
faculty of medicine
Job Title
 
5th-year student
Message
 
One life, one chance.
Student Committee

Fumie Osuga

Institution
 
University of Occupational and Environmental Health
Department/Division
 
faculty of medicine
Job Title
 
5th grade
Message
 
Where there's a will, there's a way.
Student Committee

Rika Terashima

Institution
 
Gunma University
Department/Division
 
School of Medicine
Job Title
 
3rd year student
Message
 
I am very excited to work with everyone in the student committee and I look forward to learning from the physicians presenting at the 2018 ACP JC conference.
Student Committee

Mitsuki Kawabe

Institution
 
Kanazawa Medical University
Department/Division
 
faculty of medicine
Job Title
 
5th grade
Message
 
I want to learn about the American medicine. By comparing the differences in American and Japanese clinical medicine, I want to introduce the good points of U.S. medicine to Japanese medicine.
Student Committee

Tomohiro Hirai

Institution
 
Mie University
Department/Division
 
faculty of medicine
Job Title
 
student
Message
 
work with diligence and modest
Student Committee

Tsuyoshi Mandai

Institution
 
Nara medical university
Department/Division
 
faculty of medicine
Job Title
 
Fifth year medical student
Message
 
Being satisfied about the present, there will be no growth !!
Student Committee

Kotaro Yoshita

Institution
 
Kanazawa University
Department/Division
 
Department of medicine
Job Title
 
Student
Message
 
It doesn’t matter
Student Committee

Hitomi Miyake

Institution
 
Nara Medical University
Department/Division
 
facalty of medicine
Job Title
 
3rd grade
Message
 
Without haste ,but without rest.

Dr. Kitano was appointed vice chairperson of PRC

Dr. Kitano was appointed vice chairperson of Public Relations Committee (PRC)

When the fiscal year began in July 2017,  Dr.  Kitano, Yuka participated in PRC taking charge of the ‘in the clinic’ project. In order to become more active as a responsible in charge of ‘in the clinic’, she began to be a vice chairman from January 2018.  Thank you very much. The council of ACP Japan has approved it, and the web page of the activity policy of PRC and the description of the web page of the official committee introduction of the Japan Chapter have been  updated.

(PRC Chairperson Yasuo Oshima)

Report of International Exchange Program Participant – Dr. Fujisaki

ACP Japan Chapter IEP

Exchange period: 2017/10/31-2017/11/21

Through the ACP Japan Chapter International Exchange Program, I was privileged to observe Hospital Medicine and Family Medicine in Hawaii. I would like to thank Dr. Nogi, Dr. Tokeshi, and everyone else involved in the Program, for helping me to gain invaluable insight into the significant differences between the way health care systems are organized from country to country.

<Hospital Medicine>

I performed the observation of Hospital Medicine by shadowing a hospitalist Dr. Nogi at the Queen’s Medical Center (QMC) in Honolulu.

Firstly, I learned that Hawaii’s population is quite diverse. Almost 40% of the state’s 13.6 million residents have Asian roots, including 15% Japanese; a quarter of the population is White; Native Hawaiian and other Pacific Islanders account for 10%; and finally, African Americans about 2 %. Of the above, 10% also count themselves Hispanic, and 25% overall identify as two or more races. In view of the Compact of Free Association between the United States and the three Pacific island nations: the Federated States of Micronesia, the Marshall islands, and Palau, as the biggest hospital in the region, QMC accepts a variety of transferred patients reflecting a diversity of race, creed, and other characteristics. In this way, severely ill patients in the vast area will converge at QMC, and hospitalists at QMC, together with numerous consultants, must deal with a wide range of diseases. For example, I witnessed a hospitalist consulting oncologists for a chemotherapy regimen, a palliative care team for management of side effects, infectious doctors for febrile neutropenia, and specialists in the main land about the Car-T therapy to treat a patient diagnosed with B-cell lymphoma. Throughout the observation, I also learned that hospitalists are required to show leadership like an orchestral conductor to convey harmonic medical care with many specialists. Especially because of Hawaii’s great diversity, the local hospitalist’s competency as a team leader required both familiarity with the medical resources in the hospital and the skill to operate as a communication hub for directing the best multidisciplinary care.

More broadly, I learned that the number of “hospitalists” in the United States has grown from a few hundred to more than 50,000 over the last decade?larger than any other subspecialty in internal medicine. I also learned that hospitalists bring reductions in hospital costs, lengths of admissions, and rates of readmission. It is for these reasons that approximately 75% of U.S. hospitals now hire hospitalists. Some specialists predict that the number of hospitalists will further increase, although this new type of specialty has its disadvantages, such as discontinuity of care from outpatient to inpatient care or medical field overlap with other specialists.

Meanwhile, the number of hospitalists in Japan is as few and far between as they were a decade ago in the United States. Because of Japan’s rapidly growing aging population, the myriad diseases and intense need for acute hospital care common to this group will require new strategies. I anticipate the number of Japanese hospitalists who play a leadership role in those settings may increase over the next decade, following the footsteps of the United States.

<Family Medicine>

I performed Family Medicine observation by shadowing Dr. Tokeshi who is a clinical professor of Family Medicine at John A. Burns School of Medicine at the University of Hawaii. Dr. Tokeshi has been serving his male and female patients of all ages from the cradle to the grave for almost 40 years. As a matter of fact, he is the primary care physician for 5 generations of one family. Shadowing him was truly inspiring and I learned that the family doctors’ approach to health problems is through longitudinal continuity of the patient/doctor relationship?one seldom established in the relatively short-term clinical relationships within other specialties. Furthermore, personal life histories were meticulously taken. For example, I learned that Japanese descendants in Hawaii often have unique life histories influenced by migration or world war. Those factors proved indispensable in interpreting health problems in the physical, psychological, social, cultural, and spiritual dimensions. These problem-solving strategies appeared to be core elements to a professional primary care physician’s repertoire in Hawaii.

From a wider perspective, family doctors are the first gates in primary care and have important roles as coordinators and advocates for the health of the community. When it comes to the health care system in the United States, I learned that it is difficult for ill or poor people to purchase insurance contracts and gain easy access to primary care. I understand that in 2010 the Affordable Care Act (“Obamacare”) was made to improve the situation, and as a result, the number of people who have insurance is expected to increase by 2020 and bring more fairness in primary care.

Japan, by contrast, offers medical insurance for the whole nation and people there have ease of access to medical care. On the other hand, Japan does not yet have qualified training programs for primary care physicians; and although the Japanese Medical Specialty Board has been preparing for establishing a new training system in each medical field by April 2018, there remains a shortage of family doctors. Consequently, Japanese patients are rarely seen by their officially trained primary care doctors, but are seen instead by providers whose specialty is on the boundaries of medical fields divided by anatomical and physiological systems.

With the number of Japanese elderly, multi-morbid patients skyrocketing, I imagine the number of Japanese trained as primary care physicians like the family doctors in Hawaii?who approach and can manage any health problems from holistic perspective, will increase, once global standard primary care training programs are established here in Japan, in the near future.

Tomohiro Fujisaki, MD 2018 January

Interim Report from Student Committee 2017

ACP Japan Chapter Student Committee

Interim Report

Date(December 19, 2017)
Committee(Student committee)
Chair(Natsumi Momoki)

1. What We Accomplished

a. Information meeting was held to promote for admission to ACP member at workshops for medical student.

2. What We Were Already Working On

a. Planning about workshop at next annual meeting.
b. Adding motivated person to student committee member

3. What We Plan To Initiate

a. a workshop held by student committee member for promotion is under discussion. Although the contents are not yet confirmed, it includes seminar about medical English or study abroad for medical students.

Interim Report from Credentials/Membership Committee 2017

(1)Activity of Credentials/Membership Committee since July 2017

Since July 2017

  • Reviewed 6 application forms for FACP advancement and judged the applicants’ qualifications.

  • The three new fellows were approved for election by the Credentials Committee in November:

Junya Ako, MD FACP

Yasuaki Hayashino, MD FACP

Takahiko Tsutsumi, MD FACP

  • Modified the qualification requirements for Resident/Fellow Members and Student Members to be adapted to Japanese medical schools and training system

 

(2)Credentials/Membership Committee

  • Review application forms for FACP advancement and judge the applicants’ qualifications by online.

  • Respond to queries from members and board of ACP Japan Chapter regarding membership in collaboration with secretary.

 

Eiji SHINYA, MD PhD FACP

Chair, Credentials/Membership Committee, ACP Japan Chapter

Annual Meeting of ACP Japan 2018 – greeting E

Welcome to ACP Japan Chapter Annual Meeting 2018

Dear Colleagues

It is my great pleasure to welcome you again to the ACP (American College of Physicians) Japan Chapter Annual Meeting 2018, which will be held on June 2nd and 3rd, 2018 at Kyoto University International Innovation Center as well as Kyoto University Clock Tower Centennial Hall.

The theme of the Meeting this year is “Mind & Arts as Essentials for Internists: Beyond Evidence & Technology”. Since the entrance exam to medical school in Japan is becoming more and more competitive reflecting the economic downturn in Japan, the young physicians are smarter and ambitious in getting knowledge and skills. However, since the patients’ needs are not merely medical treatment or cure but also relief and comfort, sincere attitude or sympathy, compassion of doctors and medical staff to listen to their mental as well as physical sufferings. Medical school tends to teach only skills and knowledge but not professional or affective attitude or mindfulness. Japan is now facing the skyrocketing increase in elderly population, so the patients are also getting older and more frail, and guideline-oriented management is not enough to make these patients happy. So, in the plenary session of the Meeting, we would like to discuss how we can teach medical students/residents/fellows an affective aspect of medicine or “mindful” practice as well as technical part of medicine. We would have Dr. Jack Ende, who is an immediate past president of ACP you to present the medical education in USA with special attention on teaching affective aspect of medicine or mindful practice in plenary lecture before the plenary session with Japanese seasoned physicians. In addition, we will offer sessions like Dr’s Dilemma (an inter-institutional Quiz tournament by teams of residents), Native English-speaking clinician educator session, the poster-discussion session, as well as the ACP update by Dr. Jack Ende. As with previous meetings, you can also enjoy many informative lectures and luncheon seminars.

Our meeting is made by volunteers from ACP Japan Chapters and does not seek support from industries, so it is the meeting of the clinicians, by the clinicians, and for the clinicians. We are confident that you will get more than a return on your participation investment for this meeting with high satisfaction and benefit.

We are very much looking forward to seeing all of you in Kyoto in its best season.

 

Yugo Shibagaki, MD, FACP
Chair, ACP Japan Chapter Annual Meeting 2018


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