I was honored to be the 2017 American College of Surgeons (ACS) Traveling Fellow to Japan. My husband and sons and I traveled to Japan in April. We began our journey in Tokyo, where we were greeted at the airport by Prof. Seiichiro Yamamoto, MD, a colorectal surgeon and my husband’s cousin. My husband had not seen Seiichiro since he was eight years old, but somehow they were able to spot each other in the sea of passengers at Narita International Airport. Professor Yamamoto helped us settle into our lodgings in Tokyo and then returned to work. Because of the time change and long trip, we all slept well, but we woke early and ready to explore Tokyo. We walked the streets and watched the sunrise and headed to the Tsukiji fish market, which was bustling with tourists and employees. The rest of the day was spent exploring the Imperial Palace gardens, temples, and shrines.
Although I was unable to observe operations at Jikei University, Prof. Katsuhiko Yanaga, MD, PhD, FACS, President of the ACS Japan Chapter, kindly arranged to meet at Jikei with some of the general surgeons, followed by dinner with his colleagues, including Taigo Hata, MD, at Andaz Tokyo Toranomon Hills hotel in downtown Tokyo. Though it was a rainy night, the view of the city was expansive, and the surgeons explained that many buildings, especially hotels, are being constructed in anticipation of the 2020 Olympic Games scheduled to take place in Tokyo.
I was pleased to learn that many of Dr. Yanaga’s colleagues had spent time at the University of California, San Francisco (UCSF), both with Lawrence W. Way, MD, FACS, professor emeritus of surgery, division of general surgery, and in the pediatric surgery group. Professor Hata was keen to spend time at UCSF in the future to learn more about surgical oncology or hepatobiliary surgery.
Kyoto University Hospital
Prof. Shigeo Hisamori, MD, PhD, facilitated my visit to Kyoto and Kyoto University Hospital. We took the Shinkansen train from Tokyo to Kyoto—one of the highlights of the trip for my sons. We were lucky to be in Kyoto at the height of the cherry blossom season. The rivers and canals lined with cherry blossoms were beautiful as were the temples and shrines.
I spent the day with Dr. Shigeo and the residents and medical students. I observed a laparoscopic low anterior resection in the operating room and was most impressed to observe the precise and deliberate surgical technique and speed with which the operation was conducted. The team performed multiple emergency procedures the same day, including perforated diverticulitis and appendicitis. I enjoyed hearing more about the medical school, residency, and transition to practice structure in Japan, and I shared how it contrasted with the U.S. approach. The medical students and residents in particular were keen to have a chance to either do research or some clinical training in the U.S.
Japan Surgical Society
It was an honor to be included in the welcome dinner and the presidential dinner at the Japan Surgical Society Meeting in Yokohama. The pride and history of Japanese surgery was evident at the welcome dinner, during which I had the pleasure of dining with the president of the German Surgical Society, Tim Pohlemann, MD, PhD, and his traveling fellow and Japanese hosts. It was interesting to learn of the longstanding exchanges between Japanese and German surgeons. The presidential dinner was more intimate but equally beautiful, and it was a privilege to speak with world leaders in colorectal surgery, including Antonio M. de Lacy Fortuny, MD, PhD, Barcelona, Spain, and Michael Solomon, MB, BCh, BAO, MSC, FRACS, Sydney, Australia.
I attended a few of the international sessions at the meeting, including those led by Dr. Lacy and then-ACS President Courtney M. Townsend, Jr., MD, FACS. The following day, at the suggestion of Katsuhiko Yanaga, MD, PhD, FACS, and by the invitation of Kazumi Kawase, MD, FACS, I attended the Japan Association of Women Surgeons meeting. Many of the women surgeons brought their young children to the meeting. Hideko Yamauchi, MD, FACS, a breast surgeon at St. Luke’s International University, translated for me as the women in the room went around and introduced themselves, describing their surgical role/training, family situation, and goals. The themes were familiar—the stresses of balancing work and family, challenges with figuring out how to advance both spouses’ careers, and so on. The one difference was the training structure and the variability of years of training and the timing of the transition from training to practice. Dr. Yamauchi mentioned that there is great interest in formalizing the training process along the lines of the American Board of Surgery. It was inspiring to see the interest in surgery from young Japanese women, including both university and medical students. The future is bright for women surgeons around the world.
Finally, Dr. Yamamoto invited me to his medical school (class of 1991) get-together at a pub. The camaraderie and long-term friendships that were evident reminded me that no matter where you are in the world, the unique nature of surgery and team-based care that we practice leads to intense and lasting friendships that always seem to pick up right where they left off, no matter how long it has been since you have seen a colleague.
In summary, it was a great privilege to visit Japan as the ACS Traveling Fellow to Japan. Everyone was incredibly kind and hospitable, and I hope that one day I will be able to reciprocate the warm welcome.