I started my AOSAP fellowship training in OUH on 6th Feb 2017 as already planned. To be able to start my fellowship on time, several document have to be prepared for acceptance to OUH for advanced surgical training. It really aids me to learn how to prepare to work in a hospital in a developed country and make me understand how much the system there in OUH, is given attention to details. I left Yangon Airport on 4.2.17, by ANA Airline and arrived at Okayama Airport on 5.2.17, where I was warmly greeted by one of the subordinates of my spine center director, and helped to be allocated in my apartment. My spine center director and his staff have prepared almost everything that I may need during my stay in Okayama and Japan, including internet and some food and beverages & sightseeing plan. I felt surprised by their helpfulness and well planning.
Next day when I reached OUH, I cannot be more than fascinated by my sight. The hospital itself was more splendid than I have expected. There were several departments and infrastructures, facilitated for all the doctors, staff, patients, attendants and visitors. The government, the administrators, the doctors and the people are all in harmony to achieve the welfare of patients. By the same time, I felt sorry for the difference between the health facilities and situation in Okayama and those of my country. That made me get heartache for my colleagues and patients in my own country. Actually during my stay in Okayama, I had been treated with meals for several times and on the day of my arrival, they made a welcome dinner for me. My director and team brought me to a restaurant where I got my very first experience of trying authentic sushi and sashimi, which is the most favorite and expensive dish in Japanese society. I tried various kinds of Japanese traditional cuisines, and found very delicious, i.e., in Japanese words, O-ishi ! I could feel not only the various dish but also their culture, including how to eat sashimi, how to drink Odon soup, how to taste ramen and how to enjoy green tea. It was really worthy to learn their culture.
My academic clinical and surgical training in OUH was really rewarding. Basically, the routine working hours in the center was much more than ours, starting from about 7:20 AM through 9:00 PM, although there were some variations. The schedule was well and all the doctors and staff are strictly punctual. The operation and conference started on exact minute without any delay. On the other hand, there was recognized place, time and facilities like computer, internet, intranet, library for academic studies. Thus, I could get not only advanced surgical training but also their good life style: punctuality, discipline, hospitality, helpfulness, respect, and care, that really exceed my former expectation before coming here.
The surgical techniques were fascinating. Not only my spine center director but also his subordinates could carry out sophisticated techniques. They allowed me to actively participate in surgical procedures that included spine exposure, navigation assisted pedicle screwing, occipital, cervical, thoracic, lumber, sacral and iliac screwing, TLIF, OLIF, MIS, scoliosis and various advanced operations. And I felt much delighted when I myself could do these procedures under their supervision. The facilities available were really helpful and O-arm, navigation, neuro-monitoring, cell saver, arterial monitoring, intermittent pneumonic compression device, ultrasonic tumor surgery device, endoscopes and microscopes were widely and routinely used, with resultant very few risk of complications. Radiation hazards to spine surgeon was dramatically reduced because navigation is used instead of C-arm in almost all every case let alone accuracy in spinal procedures. During my stay, neurological, hemodynamic and infective complication incidence was very few and there was not any case of mortality noted. Because of the help of facilities and team’s technical experience, the surgeons seemed to be comfortable in their surgeries. I am envious of their talents, skills and facilities.
During my fellowship period, I could discuss on several spine problems including scoliosis and ASD through conference, workshop, seminar, journal club, conversation and even on online frequently with my director and his subordinates. I could get learnt a lot and my opinions were also appreciated during discussion. The mutual respect an every occasion is their culture. The relationship among surgeons, junior doctors, anesthetists, staff and patients were very smooth with respect and care to each other. There is culture to use the word su-mi-masen, that means ‘ I am sorry or excuse me’ on every occasion that may make embarrassment to others, to show their respect, both postural and verbally.
Before my departure, I was treated farewell party by the spine team as well as by the orthopedic department. I felt sorry when I heard their words expressing our relationship, my good points and funny points, their wish for my coming back again, and I understood that we had very strong attachment between us. At last, I could have completed my fellowship training in OUH successfully and I had made up my mind to share my knowledge and skills to my colleagues, juniors and society. Besides, I would like to improve my standard of care, my culture, my habit, my attitude as well as to help others to adopt the good culture of hospitality and punctuality and mutual respect. I strongly believe that 8 weeks of spine training fellowship directed me to a positive track in my life indeed.