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[KungFuPanda123]

I'm a current GI fellow and want to spend some time in Japan. I think that it'd be very interesting to see how medicine is practiced there and see how they do things differently in terms of management. Already, I can tell that people who train in Asia are much more talented at unsedated colonoscopies than in the US where we can rely on anesthesia. I have elective time, and I'm sure that I can convince my program to allow me to do an international elective in Japan if such a thing exists. I have no fluency in Japanese, so it would presumably have to be at one of the international hospitals.

Anyone know if any hospitals allow international trainees to do rotations at their locations? I have seen this offered for students but not necessarily for people in residency/fellowship from what I've seen.

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[DarkBluMage]

I'm a current GI fellow and want to spend some time in Japan. I think that it'd be very interesting to see how medicine is practiced there and see how they do things differently in terms of management. Already, I can tell that people who train in Asia are much more talented at unsedated colonoscopies than in the US where we can rely on anesthesia. I have elective time, and I'm sure that I can convince my program to allow me to do an international elective in Japan if such a thing exists. I have no fluency in Japanese, so it would presumably have to be at one of the international hospitals.

Anyone know if any hospitals allow international trainees to do rotations at their locations? I have seen this offered for students but not necessarily for people in residency/fellowship from what I've seen.

Going to spend a portion of your training as a physician in a country where you don’t even speak the language is crazy to me…

 

[KungFuPanda123]

Going to spend a portion of your training as a physician in a country where you don’t even speak the language is crazy to me…

I'm confused. International hospitals are specifically designed to treat non-local language speakers, and the clinical staff speak English. Many attendings at my institution who only speak English have spent a month in a non-English speaking country to learn particular advanced techniques so that they can utilize these in their US practices. I don't envision myself learning innovative advanced techniques at my level of training, but I do think that spending time abroad could definitely enrich my training/future practice here in the States. I have absolutely no idea how feasible my proposition is, and it's the holiday weekend so would rather wait until the week to reach out to my attendings who have gone abroad to see if they've heard about if anything like this exists for fellows. Are you an MS3?

 

[DarkBluMage]

I'm confused. International hospitals are specifically designed to treat non-local language speakers, and the clinical staff speak English. Many attendings at my institution who only speak English have spent a month in a non-English speaking country to learn particular advanced techniques so that they can utilize these in their US practices. I don't envision myself learning innovative advanced techniques at my level of training, but I do think that spending time abroad could definitely enrich my training/future practice here in the States. I have absolutely no idea how feasible my proposition is, and it's the holiday weekend so would rather wait until the week to reach out to my attendings who have gone abroad to see if they've heard about if anything like this exists for fellows. Are you an MS3?

Yea I’m an MS3. Just seems asinine to spend a month in a country somewhere that you don’t even speak the language of. Can’t imagine that being anything but disorienting rather than an actual beneficial experience during such an intense time in medical education. Going somewhere for vacation vs education are two entirely different environments. Just imagining myself taking an elective to go to another country while in medical school learning to be a doctor and it seems crazy to me. This is hard enough while being able to speak the language.

 

[NotAProgDirector]

You're asking a complicated question. Yes, it's possible to do international rotations. We have a Global Health pathway as part of our IM residency where some international experience is often included. But there are many variables and roadblocks.

You'll need both the program and the institution to be OK with the plan. Our GME office usually draws the line at "is this an experience you can't get locally?" Chances are just saying "I want to see how things are done in Japan" isn't going to fly. The idea of learning hor to do unsedated colos may be interesting and more reasonable -- but is it practical? Even if you learn how to do them, would you actually be able to do them here? Your salary is supported by CMS payments -- which completely stop when you're not in the US. Then there's the cost of flights, and of having somewhere to stay.

Next, your program will likely need a PLA agreement with the hospital for your training. You'll need someone there to be your supervisor -- and it would be better if they had US training. You'll need medical insurance (unless the country has univ health care that would cover you), and we usually purchase MedEvac insurance in case something terrible happens.

And then there's licensing issues. You won't have a license in Japan, so unclear what you'd actually be able to do there. And then there's credentialing at the hospital (if that's a thing), orientation with the EMR, and any other policies / processes they may have. Most of our Glob Health rotations are in resource restricted countries where these issues are less of a problem.

So, yes it's possible. But it's quite difficult. If they don't have the infrastructure in place already, it may be impossible. And it's not really clear what you would get out of it that would be practical. It's not clear to be that an unsedated colo is any different than a sedated colo -- other than the expectations of the patient.

 

[KungFuPanda123]

You're asking a complicated question. Yes, it's possible to do international rotations. We have a Global Health pathway as part of our IM residency where some international experience is often included. But there are many variables and roadblocks.

You'll need both the program and the institution to be OK with the plan. Our GME office usually draws the line at "is this an experience you can't get locally?" Chances are just saying "I want to see how things are done in Japan" isn't going to fly. The idea of learning hor to do unsedated colos may be interesting and more reasonable -- but is it practical? Even if you learn how to do them, would you actually be able to do them here? Your salary is supported by CMS payments -- which completely stop when you're not in the US. Then there's the cost of flights, and of having somewhere to stay.

Next, your program will likely need a PLA agreement with the hospital for your training. You'll need someone there to be your supervisor -- and it would be better if they had US training. You'll need medical insurance (unless the country has univ health care that would cover you), and we usually purchase MedEvac insurance in case something terrible happens.

And then there's licensing issues. You won't have a license in Japan, so unclear what you'd actually be able to do there. And then there's credentialing at the hospital (if that's a thing), orientation with the EMR, and any other policies / processes they may have. Most of our Glob Health rotations are in resource restricted countries where these issues are less of a problem.

So, yes it's possible. But it's quite difficult. If they don't have the infrastructure in place already, it may be impossible. And it's not really clear what you would get out of it that would be practical. It's not clear to be that an unsedated colo is any different than a sedated colo -- other than the expectations of the patient.

Greatly appreciate the response! It was a long-shot, but I thought I'd ask to get a better sense of exactly what opportunities are out there since I know a minimal amount of this subject matter.