April 2024

31

What is VIS ?
The International Relations Division of the Faculty of Medicine issues VIS to send out the live messages from International Studentsof Graduate School of Medicine, Graduate School of Biomedical Science, and School of Medicine, and to promote the exchange ofintercultural information. We hope VIS helps to cultivate intercultural communications and boost international exchanges.
VIS の発行の目的は、医学院・医理工学院・医学部医学科の留学生の生の声を発信することと、異文化間の情報交換を促進することです。
VIS が異文化間のコミュニケーションを養い、国際交流を実行していくうえで役立つことを望みます。

WELCOME EXCHANGE STUDENTS
From Nanyang Technological University, Singapore

Ispent two weeks with the Rheumatology department in Hokkaido University
Hospital, and it was truly one of the best postings I've had in medical school. In

this short duration, I managed to see many interesting and rare conditions, such as
TAFRO syndrome and Takayasu arteritis, among many others which I have not seen
before. I learnt how to manage them as the team discussed these cases during
ward rounds. It was an enriching experience seeing the doctors interacting with thepatients in both the inpatient and outpatient settings.
The department here was also very warm and welcoming, and introducedus to everyone in the department on our first day here. Despite the language
barrier, the doctors here were all very patient and took the effort to speak to us in
English and even translated medical terms so that we could be more involved intheir discussions. We were invited to a variety of activities, including the groupconference and English seminar, and even had a farewell dinner with the team.
I also learnt a lot about the Japanese healthcare system through our conversations
with the doctors and medical students here. I really enjoyed my time here, andwould love to spend more time with the rheumatology department in Hokkaido
University Hospital in the future!

Chong Wei Ming
Department of Rheumatology
Period: September 25－October 6, 2023

Voice of the International Students

1April 2024

31

WELCOME EXCHANGE STUDENTS
From Nanyang Technological University, Singapore

Ispent 2 weeks doing a posting with the Rheumatology department at the Hokkaido
university hospital. I've learned so much in this short time, and I'm so grateful for theopportunity to have worked with such a dedicated and skilled team of doctors, especially
Professor Hisada, Professor Fujieda and Professor Kono.
I was able to see a wide range of rheumatic diseases during this posting, some of which I
have not seen before in Singapore. I've had the opportunity to learn about patients with avariety of conditions, from common conditions such as rheumatoid arthritis, osteoarthritis,and dermatomyositis to rarer conditions such as TAFRO. This has given me a broad
understanding of the different ways that rheumatic diseases can present themselves, andthe different treatment options that are available.
In addition to learning about rheumatic diseases, I've also had the opportunity to develop
my clinical skills. I've learned how to perform physical examinations on patients with rheumatic

Eu Jonathan Wen Wei
Department of Rheumatology
Period: September 25－October 6, 2023

diseases, and I've also learned how to interpret laboratory results and imaging studies.
Overall, I've had an incredibly rewarding experience at the rheumatological department in
Hokkaido University Hospital. I'm grateful for the opportunity to have had this experience,and I'm confident that it will be invaluable to me in my future career.

From China Medical University, Taiwan

T

he two weeks in the Plastic and Reconstructive Surgery Department were fruitful! In the operation room, I have seen one-stage surgery of cleft lip
and palate, wide excision of buttock basal cell carcinoma, osteotomy of malocclusion, and so on. So glad that I have the chance to scrub my hands

to see clearly beside the surgical table.
In the outpatient clinic, I learned how to evaluate flap condition, saw the device for preparation of cleft palate and lip surgery, and the helmet for alteringchildren's head axis.
In addition, I also joined the suture class for medical students and tried different types of ties and simple sutures. The teachers taught us step by stepand finally, I successfully made the surgical ties myself.
On the Thursday of the second week, I was assigned to present in the morning meeting. I chose the topic of cleft lip and palate and presented therelated papers. In addition, I also gave a brief introduction to Taiwan. It was a challenging task for me and luckily I finished It successfully! Thanks a lot for
the feedback that day!
In the surgical team, I observed the surgery for the excision of melanoma near the nail, extramammary Paget's disease with graft, and excision of basal
cell carcinoma. Surgeons in the Dermatology department all treated me kindly and gave me some chance to do small procedures.
In the outpatient and the ward, I saw many kinds of skin diseases like Psoriasis vulgaris,angiosarcoma, dermatitis, and so on. I also learned many ways of wound care. For example,
negative-pressure wound therapy helps wound healing, and pads with Ag are useful forwound care and infection control.
Moreover, I was so grateful to be treated to lunch and dinner so many times. During the meal,
we chatted with each other and understood more about medical education in each other's
country. I found some similarities, for example, there are both two years of post-graduate year
training before choosing a specific department. Also, there are many differences. For instance,
we have only two years of clerkship before graduation, but Japanese medical students havethree years instead.
In the end, I want to express my sincere appreciation to all the professors, doctors, staff,
and medical students whom I have met for the whole month. Thank you for taking me here
and there, translating and teaching medical knowledge, and treating me to delicious food.
Choosing Hokkaido University for my clinical elective is definitely one of the best choices I've
made in my life. Next time you come to Taiwan, please don't hesitate to contact me! I will takeyou to good places and treat you to delicious food!

2

Voice of the International Students

Ting Yong-Jie
Department of Plastic and Reconstructive Surgery
Department of Dermatology
Period: October 16－November 10, 2023

WELCOME EXCHANGE STUDENTS
From National Yang Ming Chiao Tung University, TaiwanT

he internship at the department of diagnostic imaging started with a focus on neuroradiology. Daily activities included lesson plans and reviewing
images with specialized physicians. This immersive learning model significantly enhanced my ability to identify various brain abnormalities.

Notably, I encountered a rare case of Creutzfeldt-Jakob Disease, a neurodegenerative disorder. The patient's imaging exhibited cortical ribboning, adistinctive feature of CJD. This unique case underscored the importance of recognizing rare conditions. The second week delved into general radiology,covering respiratory, abdominal, and musculoskeletal conditions. Interpreting chest CT images proved challenging but rewarding, with progress inidentifying common pulmonary features. Abdominal imaging presented both tedious and fascinating aspects, requiring meticulous examination andoffering a sense of achievement when identifying lesions, such as cases of suspected intestinal
obstruction.
Nuclear medicine at Hokkaido University Hospital provided insights into SPECT and PET imaging
principles. A notable technology discussed was FAPI PET, holding promise for tumor imaging. FAPI,
targeting tumor stroma, coupled with PET, offered advantages over traditional FDG PET, especiallyin challenging areas like the brain and gastrointestinal tract. The week also included observations ofI-131 treatment for thyroid cancer. The final week centered on observing interventional radiology.
Noteworthy was a case involving a young patient with pancreatic neuroendocrine tumor. The day
before total pancreatectomy, transarterial embolization was performed to minimize intraoperativebleeding risk. The procedure involved skilled occlusion of arteries using embolic materials and coils.
Throughout the internship, exposure to various imaging modalities broadened my understanding.

Hong, Bin-Syuan

Additionally, encounters with rare cases like CJD and discussions about emerging technologies likeDepartment of diagnostic imaging
Period: November 6–December 1, 2023

with specialized physicians, made the clinical exchange program at Hokkaido University Hospital a“B

FAPI PET enriched my learning. The hands-on exposure to diverse cases, combined with interactions
valuable and enriching experience.

lasting X-rays at tumors had become my passion.” This is how I felt after four weeks of clinical elective placement in the Department ofTherapeutic Radiology at Hokkaido University Hospital.

I am very thankful to all the staff from the Department of Therapeutic Radiology for treating me kindly and patiently explaining the knowledge,guidelines, and details of radiotherapy in English. Learning from doctors with diverse specialties, I gained invaluable experiences in lectures, ward
rounds, case conferences, outpatient clinics, research meetings, touring the proton beam facility, witnessing the RALS procedure, and most engagingly －treatment planning.
Initially, I learned how to use the treatment planning software and contour organs on CT images. Then, I started learning how to configure photon
beams and fine-tune the MLCs, angles, weights, and wedges to optimize the treatment plan. One day, after contouring for SBRT lung cancer treatmentand arranging the beams, my Sensei chose my plan to treat the patient because it met all the requirements. I will always remember how the plan waspresented at the case conference with my name credited as the “plan designer.” Later, I observed the patient undergoing SBRT from the surveillancecamera, witnessing how each parameter I adjusted was actualized in treatment. This was the first time in my life that I treated a patient for his illness.
Throughout the month, I dedicated hours daily to treatment planning,
mentored by different doctors, and planned for 3D CRT, SBRT, and evenproton beam therapy. I really enjoy tracing the patient’s anatomy andidentifying the GTV with image fusion techniques, while considering
the best beam angles and wedging for effectively targeting tumors.
In addition to clinical and research work, I had numerous opportunities
for cultural exchanges. I deepened my understanding of Japaneseculture, healthcare policies, and the day-to-day life of a radiation
oncologist in Japan. Also, I gave a presentation about medical
education in Taiwan, which led to some discussions comparing medicaleducation and policies between Taiwan and Japan.
I am extremely grateful for this month-long experience and extend
my heartfelt thanks to everyone who made my exchange possible,
especially Professor Aoyama and Dr. Uchinami, who cared a lot about
my studies and helped me to make the most out of my elective

Kuan-Yuan Chen
Department of Therapeutic Radiology
Period: November 6－December 1, 2023

program in the Department of Therapeutic Radiology.

Voice of the International Students

3April 2024

31

WELCOME EXCHANGE STUDENTS
From the Medical University of Vienna, AustriaM

y name is Paula Hoefinger and I am a 5th year medical student from the Medical University ofVienna.

I had the unique opportunity to complete a 12-week medical elective at Hokkaido University Hospital,

spending four weeks in pediatrics, neurology, and emergency medicine, respectively. Each department
provided distinct experiences, but a shared commitment to teaching made the most of our limited
time. The doctors and nurses showed exceptional kindness, bridging language gaps by explaining in
English and assisting with Japanese documents and conversations, for which I am very thankful.
In neurology, I enjoyed gaining insights into deep brain stimulation for Parkinson’s and observing
one of those surgeries. Emergency Medicine exposed me to diverse trauma cases, giving me acomprehensive understanding. In pediatrics, participating in the cath lab and improving my ultrasoundskills were highlights. I always felt fully included in
the pediatrics department, presenting patients during
rounds, joining doctors for lunch, and even receiving
an invitation to their year-end party.
Additionally, I got to know some Japanese medical
students during my rotations, who helped me aroundthe hospital, and I enjoyed getting to know them.
With a few, I was able to form friendships, which

Paula Hoefinger
Department of Pediatrics
Department of Neurology
Department of Emergency Medicine
Period: October 2–December 22, 2023

improved my experience outside of the hospital, as
they showed me around Sapporo and brought me closer to Japanese culture.
All in all, my elective at Hokkaido University was a memorable and educational experience that I
believe will benefit my future endeavors and career. I would do it again without hesitation and amvery thankful for my time there.

Voice of the International Students 医学研究院 国際連携部門だより Vol. 31
Issued by the International Relations Division, Faculty of Medicine, Hokkaido University
Correspondence to : relation@med.hokudai.ac.jp
Website URL : https://edu.med.hokudai.ac.jp/international-relations/4

Voice of the International Students