● The Experience of a Lifetime Life in the Kyoto University ED
Charles Soliman July 2011

I am now in my last year of residency at the University of Oklahoma specializing in emergency medicine.  Since visiting Japan as a foreign exchange student several years ago, I have been curious as to how the Japanese medical system works especially in regard to emergency medicine.  I decided to try and spend my fourth year elective here in Kyoto, a city I had come to love as an exchange student.
I was well aware of the prestige and academic prowess of the University of Kyoto.  I was also well aware that emergency medicine is a relatively new specialty in Japan thus academic training programs seem to still be few and far between.  With this in mind I sent an email to the Chairman of Kyoto University’s department of emergency medicine, Professor Kaoru Koike, who promptly and graciously arranged for me to spend the month here.
I can say from first hand experience that technologically, academically, in research and resources Kyoto University is and has consistently been well ahead of the curve in Japan and around the world.  As such, I knew the caliber of the attending physicians and residents here would reflect the amazing talent that such an institution can attract.  What I did not expect was how graciously I would be welcomed into the department and what a joy it would be to come to this hospital daily.  The level of acuity was amazing.  They way which the staff, who trained in a variety of specialties such as critical care, trauma surgery, cardiology, interventional neurology, cardiothoracic surgery, gastroenterology, orthopedic surgery, and infectious disease, interacted with each other and each patient was remarkable.  Even for someone coming from an American academic program, I was amazed to see the value of such diversity of expertise in practice in an emergency department.  Not only were the emergency medicine attending physicians and residents skillful, knowledgeable and hard working but the consultants were amazingly prompt and this combination made ED throughput astonishingly expeditious and efficient.  Perhaps the most accurate reflection of Japanese society as a whole are the patients themselves.  In the midst of extreme hardship and suffering, to a person, they found a way to express their gratitude, humility, respect and show absolute trust in their physicians.
These qualities were by no means unique to this university hospital.  I was also afforded the opportunity to visit several other emergency departments in and around Kyoto.  The physicians there also demonstrated total devotion to their patients.  As a result of my experiences here I am further inspired and motivated to be the best physician I can be.  I am inexpressibly grateful for this experience, and I will take what I have seen, heard, felt, and learned here with me for the rest of my life.
Thank you Dr. Koike.  Thank you Kyoto University Department of Emergency Medicine!