Japanese Exchange

OHSU Family Medicine and Japan Association for Development of Community Medicine (JADECOM) both benefit from an international exchange program.

JADECOM residents have the opportunity to visit OHSU Family Medicine in Portland, Oregon for rotations that typically last one to two months. During their rotations JADECOM residents participate in a variety of activities including resident conferences, meetings, Faculty Development sessions, clinical observations, and rotations in rural health care centers located throughout Oregon.

Faculty

JADECOM faculty are able to visit OHSU Family Medicine for a two-week exchange. Faculty have individual meetings depending on their area of interest, attend weekly conferences and spend time in clinic / hospital with OHSU faculty and residents. 

Research fellows

Selected JADECOM faculty are able to travel OHSU Family Medicine for two years to do a research project, attend conferences, visit sites to expand their research knowledge.

JADECOM medical students are able to visit OHSU Family Medicine for a two-week exchange. JADECOM students learn fundamentals of family medicine in clinical observation in clinic / hospital settings, attend clerkship presentations / workshops with OHSU medical students, and are able to attend any other educational activities happening during their visits.

OHSU Family Medicine residents are given opportunities to visit Japan for two weeks to explore their health care system. Residents are able to observe in urban hospitals or in rural settings depending on the individual's interests. Residents usually visit Japan during JADECOM conferences or resident retreats, where residents give presentations and interact with JADECOM residents, faculty and sometimes medical students. Family medicine physician, Daisuke Yamashita, M.D. is the director of the international exchange program and the JADECOM endowed scholar.

Dr. Masahiro “Masa” Nishimura

Joining us this month is our new JADECOM visiting research fellow, Dr. Masahiro “Masa” Nishimura. He and his wife Miwa and daughters Nanao and Mao will be in Portland for the next two years. Masa has visited OHSU twice before, as part of a 2016 JADECOM delegation, and through a JADECOM faculty program in 2017. Dr. Masa shared the following short bio with us:

I grew up in Shikoku, in the western part of Japan. When I was in medical school in Osaka, I vaguely wanted to be a pediatrician, but after I worked in a local city hospital ER during my residency, I decided to become a "generalist." I was fascinated by the methods and ideas of generalists, and I jumped into JADECOM in Nara while I was a PGY3. I later graduated from the JADECOM Family Medicine/General Medicine (FM/GM) residency program, which included rural medicine, and received a certification as a specialized family medicine doctor in Japan.

Since then, I have spent many periods as a hospital generalist. However, I started to work at a rural clinic in 2017. Much of this work is seeing outpatients and conducting home visits… finally, I am able to focus on primary care!

I am now interested in quality improvement initiatives within the clinic. In addition to patient care, I also have a role as a vice director of the JADECOM FM/GM residency program. This is third time I have visited Oregon, and I look forward to seeing familiar faces at OHSU again.

Hiroki Nishizako

Hometown: Kaseda, Kagoshima, Japan

School: Nagasaki University School of Medicine

Brief description of your hometown and your family:

Kaseda is a rural town located in the south region of Kagoshima, Japan, with a population of about 20,000 people. There are four people in my family; my parents always give me good advice, and I have a good relationship with my brother.

Education:

2015 – present: Nagasaki University School of Medicine

Brief description of your school:

Nagasaki University encompasses nine schools, including Global Humanities & Social Sciences, Education, Economics, Medicine, Dentistry, Pharmaceutical Science, Engineering, Environmental Science, and Fisheries. Our university has a total of 7,603 students, with 1,132 of these enrolled as medical students.

Nagasaki University School of Medicine is one of the oldest medical schools in Japan; it informally began on November 12, 1857, when Dutch army surgeon Pompe van Meerdervoort gave a medical lecture in Dutch to government physician Ryojyun Matsumoto and 11 other people. This medical school became known as Igaku Denshusho, and later became the School of Medicine at Nagasaki University.

Other info:

My interests include family medicine, hiking, cycling, swimming, table tennis, mountaineering, and gardening.

Mr. Nishizako is a 5th-year medical student and will be with us August 5-16, 2019.

Kosuke Muto

School: National Defense Medical College

Brief description of your hometown and your family:

My hometown is in Akita prefecture, in northern Japan. Akita is famous for rice and sake, and for Akita dogs; Vladimir Putin (the president of Russia) and Alina Zagitova (a professional skater) both keep them as pets. Akita is a rural area, and these days the number of young people there is decreasing. There is a possibility that Akita may disappear by 2040 due to depopulation.

My family includes my father, mother, and younger sister. My father is a psychiatrist and my mother is a pediatrician. They are running a long-term care health facility in Akita prefecture, which has about 100 patients. My sister is a high school student and she will take an entrance examination for Akita Medical University.

Education:

2015 – present: National Defense Medical College

2012 – 2015: Toho High School

2009 – 2012: Toho Junior High School

Brief description of your school:

The National Defense Medical College is a six-year university-level military academy under control of the Ministry of Defense. The school’s objectives are to train future military officers who are also medical doctors and current military doctors. Students graduate with an advanced level of theory and application of medical sciences required to conduct the missions of the Japan Self-Defense Forces, and acquire clinical medicine training and research capability in related fields. Students are paid a salary and a semi-annual bonus as employees of the Ministry of Defense. All students have to live in a dormitory for 6 years.

After graduation the graduates are posted to an Officer Candidate Training School in one of the three forces. They then take the national medical doctor examination. After passing the examination they take a two-year internship and are posted to Self-Defense Force hospitals and the battalions.

Other info:

  • My hobby is playing music; I play alto saxophone, guitar and harmonica.
  • I would like to major in cardiovascular medicine.
  • In March 2018, I visited The Queen’s Medical Center in Hawaii. This was my first study abroad tour visiting medical sites.
  • In May 2018, I planned a medical study tour of a remote island called ‘Amacho’. On this tour, I looked around many medical facilities, clinics, senior care homes, and nursing homes, etc.

Yu Kaorashi

Hometown: Toyama, Japan

Hometown and your family: Toyama prefecture is located in the north of the Chubu region, facing the Sea of Japan. About 1 million people live in Toyama, and the fishing industry thrives there. Toyama bay is famous for amberjack fish, firefly squid, and Japanese glass shrimp. My father has retired from his career, but he still farms and takes his dog for frequent walks. My mother is a hardworking person who is always active.

Currently studying at: Oita University, Oita, Japan. Oita University is a national university in Oita, Oita Prefecture, Japan. It was established in 1949, and in 2003 absorbed Oita Medical University, which was established in 1976. The university currently offers courses in economics, education, engineering, international studies, and medicine.

I am sensitive to what I eat and to new environments, so sometimes I have stomach troubles; I preventatively take herbal medicines for this. Despite these sensitivities, I am keen to be adventurous and seek out new experiences, like hiking and cooking.

Kenta Obata

Hometown: Nagoya                                        

School: Iwate Medical University

Brief description of your hometown and your family: My hometown, Nagoya is the 3rd biggest city in Japan. There are about 2,300,000 people in Nagoya. The population density there is 7,108 ppl/km^2. Nagoya is famous for Nagoya castle and Miso Katsu (Pork cutlet with miso sauce). I have one younger brother and one younger sister and parents. My aunt lives in Phoenix, Arizona.                                                          

Education: I graduated form a university, majoring in biochemistry and molecular biology. After that, I was working in Japan as a loss adjuster. After that, I got into this medical school.

Brief description of school: Iwate Medical University (IMU) is the private medical university in Morioka, Iwate. Iwate is famous for the Great East Japan Earthquake that occurred in 2011. IMU was established in 1897.

Other info (family, special interests, etc.): My father was a clinical laboratory technologist. My mother is a nurse. They work in the same hospital. My special interest is in family medicine.

Mami Narita

Brief description of your hometown and your family: I was born in a large family with six people, my father, mother, older sister, twin sister, me, and a younger sister. My twin sister is also in medical school. We don`t live together, but we often talk on the phone. When something bad happens, we encourage each other. She is very precious to me.

My hometown is a kind of rural city, and is located in the North of Kanto District. However, the public transportation has been developed well, so you can go to Tokyo in one hour by train. My favorite place in my hometown is Koga General Park. In my free time, I visit the park and enjoy running. In spring, I also enjoy cherry blossoms there. And the biggest event of my city is a firework festival in August. This festival is one of the largest firework festivals in Kanto, so many people visit my city for fireworks.

Brief description of school / hospital / clinic: My university consists of many departments: science, biology, economics, art, sports, and so on. As for the educational program of the department of medicine, at first, we study in the lecture hall for three and half years, and then in the hospital for one and half years. During this internship, we basically study in the university hospital. It has about 700 beds, and treats many patients with complex problems. Students take charge of some patients, and we listen to what they are suffering from. In addition, we have chances to study in municipal hospitals. During this internship, we can study very practically. After that we take classes again to prepare for the national test. In this way, we are educated to become good doctors.  

Other info (family, special interests, etc.): I am open-minded person, and I like experiencing new things. My hobby is exercising (running, volleyball, golf, skiing, snowboading, and so on), traveling abroad, cooking, taking pictures, and talking with my friends and family.

In October, the Japan Association for Development of Community Medicine made a gift which will establish a permanently-endowed professorship, one of the highest honors in academic medicine and higher education.

"These kinds of endowed positions are incredibly important for OHSU," explained senior vice president and provost, Elena Andresen, Ph.D., "for the faculty, for the University, for the students, and for research. This kind of gift is able to propel faculty forward…[it] allows them to engage in activities, and to work with students in ways that they could not otherwise do."

The scholarship is an addition to an already long-standing partnership between JADECOM and OHSU Family Medicine. Both organizations have enjoyed a strong partnership for many years, with students and faculty from both countries building educational programs and forging lifelong friendships.

Members of both groups celebrated the signing of the endowment in Portland, Oregon with a reception and the gift of a Japanese doll (Momoyama) to symbolize the sincerity of the relationship between both parties.

The endowment

At the signing, Daisuke Yamashita, M.D.was pronounced the JADECOM Endowed Scholar of Family Medicine. Dr. Yamashita first arrived at OHSU in 2006 to join the Family Medicine residency and completed his training in 2009. He currently serves as the Medical Director of the South Waterfront clinic, and has recently been a leader of OHSU's efforts to expand access to primary care for Portland's communities.

Dr. Yamashita worked closely with JADECOM founding member Takashi Yamada, M.D. prior to coming to Portland. At the time, Dr. Yamada was the president of the Japanese Academy of Family Medicine and led the young family physician group within the academy. At the endowment signing, Dr. Yamashita committed to making the exchange between OHSU and JADECOM "even more active and meaningful."

Why Japan?

The JADECOM-OHSU relationship began with a conversation between Michiyasu Yoshiara, M.D. in Japan, and Bob Taylor, M.D. at OHSU. The two physician leaders had a dream of a partnership that would benefit both organizations. And indeed, both have learned from each other to this day.

The nature of health care in Japan in unique – much of the country is made up of rural areas or fishing villages, requiring doctors to care for families across many miles. The ratio of physicians to families also means doctors must be experts in caring for all generations, with all kinds of needs. Community connections are not a luxury, they are a necessity. For that reason, explains former OHSU Family Medicine Chair, John Saultz, M.D., our job is to "figure out how to emulate the degree to which [JADECOM's] doctors and hospitals are connected to the needs of the community they serve."

Current OHSU Family Medicine Chair, Jennifer DeVoe, M.D., D.Phil., describes her first experience with the JADECOM exchange program. As one of the first OHSU residents to travel to Japan as a group, Dr. DeVoe worked with founding program member Dr. Yamada. "Dr. Yamada taught me many things about community medicine, population health, family medicine," she said, "including home visits with patients that were over 100-years-old living with their families, rounds in nursing homes, doing many procedures as well."

"It's very inspiring," Dr. DeVoe recalled, "the procedures and the competence of physicians in Japan. I have learned a great deal from our JADECOM colleagues about community medicine."

From OHSU, JADECOM has been able to strengthen the development of additional skills in primary care research and education. A theme OHSU has built upon this year in welcoming its inaugural postdoctoral fellow from JADECOM, Takahiro Mochizuki ("Mochi"), M.D. 

A celebration of friendship

In his closing remarks, Dr. Saultz perfectly summed up the nature of this venture between two parties: "I have not done anything in my career that has made me prouder than I am of the association we have with the work you've done in Japan, and to commemorate that at this stage, I think is just a wonderful tribute to that friendship."

"So, this is a different kind of philanthropy, a philanthropy that comes out of a celebration of friendship, and a sharing of information, from organizations that both can learn a great deal from each other."

Dr. John Saultz Shares Anniversary Letter

Last week, OHSU Family Medicine and the Japan Association for Development of Community Medicine celebrated 30 years of collaboration and exchange. Over the years, OHSU Family Medicine residents have traveled to Japan to explore their healthcare system and use their cultural experiences to inform their practices in the States. Likewise, Japanese residents have flown to Portland to participate in classes, meetings, clinical observations, and rotations in rural health care centers throughout Oregon. 

In honor of the occasion, a group of OHSU Family Medicine residents, faculty, and medical students flew to Japan to celebrate. John Saultz, M.D., kicked the celebration off with a heartfelt greeting, included below: 

JADECOM anniversary greeting

June 10, 2016

My colleagues from OHSU and I are honored to share this celebration with our friends from JADECOM on the occasion of your 30th anniversary. I am well aware that 30 years is a long time because OHSU's partnership with JADECOM spans over half of those 30 years. Furthermore, in three weeks, I will celebrate my own 30th anniversary of joining the faculty at OHSU. So I'd like to pay tribute tonight to both your accomplishments and to our friendship.

Friendships are strongest when they are built of a foundation of shared values. It was clear from our earliest meetings that we share a belief that successful health care is based on a strong and simultaneous commitment to service and education.

Service is the principle that drives how we deliver health care to our patients and communities. It is about caring for people now in the most efficient and effective way. It is about putting the needs of those we serve ahead of our own, thereby living up to the promises physicians have made dating back to Hypocrites.

Service is about the present; Education is focused on the future. Education is about planting seeds long before we will enjoy the shade of trees that grow from them. JADECOM and OHSU Family Medicine share a belief in serving in the present while investing in the next generation. Dr. Yoshiara and Dr. Yamada and many other JADECOM leaders over the years have planted the seeds of human potential and now a new generation is taking up their cause. They understand that education allows service to be sustained and to grow exponentially. The future is in good hands because of their efforts.

The same process is underway in our department at OHSU. I am grateful to you for allowing us the privilege of helping in this work. Both of our organizations understand that young people learn to serve by serving under the guidance of mentors in the real world of community practice. Whenever the times have been tough, it has helped to know we are not alone in these beliefs.

Over the past 30 years, both of our organizations have grown and thrived, sometimes in challenging times. Our friendship is one of the things I am proudest of in my own career and I speak for our entire faculty when I tell you that your belief in the importance of communities and your confidence in the next generation inspires us and many others around the world.

 In 1841, one of my favorite authors, Ralph Waldo Emerson, published an essay on friendship. In that essay, he stated, "The only reward of virtue is virtue;the only way to have a friend is to be one." JADECOM is built on the twin virtues of service and education, virtues that have and will continue to stand the test of time. And JADECOM is and will remain our friend because we share your belief in these virtues and because you have taught us much about what it means to be a friend. Congratulations.

Rita Aulie Travels to Japanese Primary Care Conference, Discusses OHSU's Family Medicine Interest Group

By Rita Aulie, OHSU Medical Student

This summer, I had the special opportunity of being invited to travel to Japan with OHSU Family Medicine faculty and residents for the 7th Annual Japan Primary Care Conference, where I had the chance to speak to medical students about our Family Medicine Interest Group programing. 

Family medicine has unfortunately been unpopular among medical students in Japan, with only one percent of graduates joining family medicine residencies. Consequently, students and doctors at the conference were highly interested in hearing about the reasons family medicine is attractive to students at OHSU, and strategies for building up student engagement through programs like the FMIG. 

I primarily spoke about the programing that our OHSU FMIG provides to expose students to family medicine during the pre-clinical years of medical school. In Japanese medical schools, there are four pre-clinical years and two years of clerkships. It is a high priority for them to keep the students interested in general practice engaged, motivated, and connected to their community over four years of textbook studying. At the conference, there was a half-day student-led FMIG symposium organized by Dr. Anna Tamai, where I had the opportunity to give a presentation about our OHSU FMIG and talk to many students from all over Japan about our shared passion for community medicine.

After the conference in Tokyo, we traveled to Miyazaki prefecture in the south of Japan to meet with students from a newly-founded FMIG. Under the guidance of family doctor Manabu Yoshimu and six student leaders, the Miyazaki University FMIG had grown to fifty members in only three months. Earlier in the year, I had the chance to Skype with the student leaders and talk to them about putting on FMIG workshops, so to me it felt like a happy reunion to finally meet them in person. I was constantly touched by their hospitality, generosity and enthusiasm.

In Miyazaki, I joined with two third-year medical students from the University of Hawaii to give presentations and lead small group discussions on FMIG activities. English-language classes are part of Japanese medical school curriculum, and we had the chance to participate in English classes for first-year and fourth-year students. Each of us led a small group about taking a medical history in the clinic setting. It was challenging to try to teach English and medicine at the same time, but it was the most rewarding experience for me of the whole trip. 

Scott Fields, M.D., was our faculty leader during the trip to Miyazaki, and by following in his footsteps I observed how the themes of primary care that I find so impactful and inspiring can reach students across cultures and language barriers. I am excited to stay in touch with the medical students in Tokyo and Japan and see where that inspiration takes primary care in their communities and their country.