2016 HICARE/IAEA Internship Report
Osamu Hisatomi
4th grade student, Department of Medicine, Hiroshima University
Overview of the internship
Duration: 1/10/2016 – 31/12/2016
Dispatching agency: Hiroshima International Council for Health Care of theRadiation-exposed (HICARE)
Agency: International Atomic Energy Agency (IAEA)
Section: Applied Radiation Biology and Radiotherapy,
Division of Human Health,
Department of Nuclear Sciences and Applications
Purpose:To give an opportunity for or educate a student to understand themeaning and importance of medicines relating to radiation. The student will be apart of the human resources that successfully perform and achieve therapy forradiated patients in Hiroshima.
With aid from HICARE, I did a 3-month internship at the IAEA in Vienna, Austria.
Hiroshima University provides a 4-month term for all the medical students to do
any medical research. I am interested in the kind of research an internationalorganization does and how that research is used to make effective and concretedeclarations or guidelines. During the internship, the ARBR section was in charge ofaccepting my internship and I worked with them mainly. More details about thetasks I performed are written below.

1Each task in detaili.

Studying about SDGs and collecting data from GHO
In the first week, my direct supervisor was away for a conference in anothercountry. Mr. Rubio gave me an opportunity to learn about the Sustainable
Development Goals (SDGs) and I made a ppt. for feedback. Regarding the SDGs,
I collected all the data from the Global Health Observatory (GHO) by indicator.

ii.

Assisting with research
Ms. Fidarova and Mr. Rosenblatt were doing a survey of the clearing situationand quality of radiotherapy in Post-Soviet countries. The project was started in2012 and all the data were already collected. I checked the data (answers from
centers participating in this survey) and contacted representatives of eachcountry to clarify whether or not there was any misunderstanding about thequestions. After clearing data, the data were calculated according to eachindicator with excel and I made graphs for some outcomes. With tasks relating
to this project, I could grasp the situation about countries participating in thissurvey, and I could also see a kind of standard for rating or comparing thequality of medicine, especially in radiotherapy. In spite of my lack ofprofessional experience and knowledge, Ms. Fidarova let me be involved inmany parts of this survey. It was a good experience. This survey is strongly
related to the workshop written below; it means I was able to attend theworkshop with a greater understanding.

2iii.

Attending IMIC
From 10 October to 14 October, the Nuclear
Medicine and Diagnostic Imaging Section(NMDI) in the Division of Human Health held
an international conference, the “InternationalConference on Integrated Medical Imaging in
Cardiovascular Diseases” (IMIC 2016). All thepresentations were broadcasted and recorded
via an internal network for staff in the IAEAbuilding. I watched some of the presentations.
Some presentations included example cases forwhich test doctors had to choose patients andexplain about pre-test probability to them. I could see how much evidence based
medicine (EBM) was focused in medical fields nowadays.

iv.

Visiting laboratory and annual meeting
In October, there was an annual Division meeting. It was usually held inside
the IAEA building (VIC), but this year it took place in a laboratory inSeibersdorf. The laboratory was under construction and we could visit and see
what research or activities were being done in the laboratory. The tour wasprovided to all the staff in the Division. The staff staying in VIC and also
working in the Monaco office attended via videophone.

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v.

Attending the Task Force Meeting (TFM)
Mr. Prasad invited me to attend a meeting on 24th and 25th October. Mr. Prasad
was in charge of a survey to clarify the situation of radiotherapy in Africa. Staff
from the IAEA and 2 representatives attended this meeting. The object of thismeeting was to shed light on the problems associated with collecting correct
data and to find a solution. I could see how difficult it is to contact and collectaccurate information or answers from centres in Africa. After the meeting, I
also worked on transforming the answers into a form of useful data. I did notfinish collecting answer sheets, so I submitted the data sheet only with theanswer sheets that I had. I hope as many centres recognised as possible willanswer and cooperate on this survey.

vi.

Participating in AFRONET
Many radiation therapy departments in Africa were isolated geologically.
Radiation oncologists working in such centres do not have enough colleagues todiscuss with or ask advice from regarding diagnosis to post-operation. The
object of the AFRONET is to provide a place for isolated doctors to discuss withother professionals. The AFRONET is held once a month to discuss some cases
for which participants wanted to hear the opinions of others. I attended 3 times,
2 of these 3 were with cases and, for the last AFRONET, there was no casesubmitted so Mr. Rubio did a presentation about brachytherapy. A participant
does a presentation about a case submitted usually with paper evidence andthen a discussion follows. I could see how important having a place fordiscussion is and AFRONET worked very well as such a place.

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vii.

Participating in section meetings
The ARBR has a section meeting every 2 weeks.
During my internship, it was rare that every staff
could gather in one place because staffs had to go
abroad for their work. So I was only able to attend 2section meetings. In the section meetings, all themembers shared each other’s work and discussed
future plans. The ARBR will hold an international
conferenceinJune

2016,

the“InternationalConference on Advances in Radiation Oncology”(ICARO2), so I could see what the preparation is andobviously staff got busier as the days passed.

viii.

Making SharePoint for a lecture course
Mr. Belyakov provides a lecture course on the internet with contributors outsideof the IAEA. He tried to make another renewed course, and I partly helped tomake it. SharePoint can be used to make a webpage with the system allowing tochoose visitors of the webpage. Mr. Belyakov is the first person who adopted
SharePoint in the section. After being introduced at a section meeting, some
had an interest in the system and other staff will start to consider using it. (E.g.
after the workshop written below, after the meeting with Latin Americancountries.)

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ix.

Helping to manage a workshop
There was a workshop hosted by Ms. Fidarova, “Workshop on Status andQuality of Radiotherapy Services in the former USSR Countries” held from
19/12/2016-21/12/2016. The representatives were from Armenia, Azerbaijan,
Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova,Russian Federation, Tajikistan, Ukraine, and Uzbekistan. As a preparation, I
helped to make a ppt. for the survey. The presentation had a meaning as somefeedback or premier of the survey. This workshop can be said as one of influenceor results the survey gave and I was very glad I could be involved in such agreat presentation. During the workshop, I collected all the presentation
showed and made a webpage (SharePoint) for sharing them with all theparticipants. In the workshop, there were presentations mainly from the IAEA.
I learned about each service and collaborating work the IAEA provided. Also 3presenters attended to present the ideal or example medical services systemand to discuss it. I learned about know various medical systems in Europeancountries.

6x.

Checking Japanese translations
The Division of Human Health published “Health in Disasters Handbook: AScience and Technology Studies Practicum for Medical Students andHealthcare Professionals”. The original version was written in English and theIAEA is planning to publish the book translated in Japanese. There was alreadya book translated completely, but Mr. Scholz, who is in charge of publishing thisbook, wanted another opinion about the translation. I read the book andhighlighted some parts that I found could be improved. Changing thetranslation directly could make differences with what the book would want tosay originally, and that is why we chose this way of correction. Mr. Scholz
wanted as many people as possible to read and understand the content of thisbook. So I just focused on whether the Japanese in this book was natural or not.
The translation was almost perfect and the content was so interesting for me
because it focuses on medical professionals in many chapters. I could not finish
all the checking, so submitted only the parts I did and left some comments forMr. Scholz.

xi.

Helping to write a paper
I asked Ms. Abdel-Wahab to give me some kind of tasks. Considering that I am
interested in disease and treatment for Head & Neck, she gave me an
opportunity to help her paper with research finished but written content
incomplete. The research focused on the relation between radiotherapy
techniques and their side effects in the treatment for Head & Neck diseases.
There were difficulties for me to understand the outcome because I wasinvolved after the research was finished and did not have actual experience
with cases. But Ms. Abdel-Wahab was patiently trying to understand thequestions I had and leave me to do as much as I could do.

7xii.

Collecting county data for updating DIRAC
To find geological inequity for radiation therapy provided in the United States, I
collected some data on the US. The IAEA provides database - The Directory ofRadiotherapy Centres- and there was no information more specific than statesexcept centres in large cities. I collected county and city data (population, landarea, total area) from the 2010 Census and the database was updated with thatinformation. I could not finish clearing the situation of radiotherapy in the US,
but I left the work I did and hope someone else will use it with the 2015 Census.

xiii.

Finding a failure in module
There are many lectures on the Internet which the IAEA provides (NUCLEUS).
The ARBR also provides lectures as well. There was a comment from a studentthat the certification system does not work well and he could not get it when hefinished. So I tried to find what the problem in the lecture was by taking thelecture course. We were able to find a possible failure in the system and also
some solutions. However the solution could not be achieved by an intern. It wasbeyond my responsibility, so I just left the rest of the work to other staff. Though
the task could not be finished, I was able to learn a lot about radiation physics
and biology from the lecture course during the process of finding a reason forthe malfunction.

8xiv.

Collecting references by using EndNoteEndNote was adopted for writing papers. I have never experienced writing apaper, so under instruction from Mr. Belyakov, I collected references for somepapers. The way the system works was a little too difficult for me, but I think it
was a good experience for my future work.

xv.

Collecting data about small countries and SIDS
Mr. Rubio worked for a project with Small Island Developing States (SIDS) andmany members of the SIDS were also involved in the small countries initiative.
A small country is a country whose population is under 1 million. So I collected
the data, especially population, from DataBank and made an Excel sheet withinformation on participation in the UN, SIDS and Small Countries Initiative.

In VIC, there are many conferences every day. What interested me besides the tasks
written above was a conference with Latin American countries. All the participants
talked in Spanish. I thought a regional conference would be very useful as a first step.
Because forcing participants or people who needed help from the internationalorganization could be a huge difficulty for them and prevent them from contacting theorganization. I felt that not only English but also other languages popular in particularregions are also useful especially for the first stage that involves forming relations witheach other.

9Conclusion
Through the tasks and works during the internship, I was able to experience a lot andlearn a great deal whether directly or indirectly. Directly, I had academic experiences
especially relating to medicine, writing a paper, doing a survey, etc. Indirectly, I could
see the attitude and ideas of working as a professional, talking with people who have apassion for their own job. All the people working there are willing to help others. They
try to share the knowledge or experience and do something needed that has never been
done. I also was blessed with their minds. They let me get involved in their ongoingproject without hesitation. I cannot show my appreciation for them and for that
opportunity enough. And I would also like to thank the people at the Hiroshima
prefecture centre and Hiroshima University for giving me this opportunity.

(With all the staff in the ARBR section except J.S.Gage or U.Monks)

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