OJT

Today I attended on the job training in a hospital.

My attending doctor has high quality funduscope and otoscope. One of my friends also brought a good stethoscope. I tried to use them. This was my first time to watch fundus oculi so clear. Those equipments are expensive, but after using them and knowing the quality I want to buy them.
One of my mentors told young doctors that we should use funduscope and otoscope the beginning of training. When we used to check fundus and tympanic membrane from first, we always do that through our whole life-long work.

It is difficult for patients to change their life-style or action only from brief time of meeting with a doctor. We should approach more efficiently. For example, one of another mentors approach patients by handing in a paper which mentions about what he want them to do. I think it is good, because just only speaking people forget easily. But there is a paper, they can remind it.

Mock exam

Today, I didn't go out, just stayed home. I tried to do mock exam. The real exam is 8 blocks an hour each, and total an hour rest time. It was so tough for me to do that.

Previous exam was 7 blocks. I was used to long time test than first time. But the end of mock test, final block was difficult for me to concentrate.

We don't have enough time to think deeply to answer each question. We need to answer average 1 minute for each question. I should adjust this test style, and become "dog of Pavlov."

I hope these overwork experience will be available for me to be more mentally tough.

Tomorrow, suddenly I'll go to Mito to attend On the job training. I hope to become busy, and get a lot of clinical experience.

Conservative aspect

In this country, we sometime face to too conservative side.
I can partly understand to those aspect to maintain a system. From technological thinking, it is better to follow previous way until its function keep well. But sometime those conservative aspect effect bad, for example challenge new things.

We have to hide our private challenging for colleague. This is because some colleague don't think positive for these challenging. I think these phenomenon are not good for our mental health and society.

Our society should become tolerant to other thinking, other career, and other way of life.
Typical Japanese tend to prefer context rich environment.

Almost all Japanese know that this country slide down gradually when we keep same attitude as former. But they are hesitate to change, persist in closed mind, and stay domestic.

I'm sorry today's article to mention too abstract, but  I could not mention directly.
Today's experience is over all Japanese weak point in miniature.

World wide economic shrink especially in Japan

After World wide economic shrink, the economic condition in Japan is not good.
The beginning of the economic crisis was sub-prime loan.
After that, many countries try to recover their economy by increased export. On the other hands, Japan couldn't do that enough because of strong Yen.
Recently, Japan recover little, but not so much like other countries.

Many countries which has rich national resource like oil, coal, or rare metal, try to make good use of sustainable noninflationary growth. Japanese society failed to use the interest from high-growth period from postwar. It means Japan couldn't use our economic advantage well.

I'm really afraid of Japan becoming like Greece, where filed bankruptcy and suffered financial reverses.
What is a good way for Japan to survive in the world? We consider it and find the answer quickly. We don't have enough time to wait the answer. 

Anyway, today I got message from one of my English teachers on the Internet. It was really glad to me. Even if all technology develop, it is important for us to keep good relationship.
Even if I'm so busy, I don't want to loss my humor.

Merry Xmas

Today was Xmas. However, I spent my time as usual.

I got a phone call from one of my friends who is postgraduate student from Bangladesh. I was really glad to get his call. From his voice, he looked good.

When I visited Bangladesh, many Bengali people helped me. This is my turn to help exchange students.
My schedule is really tight. Three big exams remain before April 2011 when I start my junior residency program in Okinawa. But I want to make my time to visit Kyushu to see him.

philosophy

Wikipedia links about Michael Sandel is the following.
Japanese
English

I had a chance to talk with a post-graduate philosophy student. We told about Michael Sandel.
I explained that there is some boom for him, because he visited Japan to teach us the "Justice."
Of course, I tried to apply the lecture. Unfortunately I couldn't attend it, so watched in TV program.

We agreed that his lecture is attractive, because he tries to connect philosophy and real issue. For example, "Ichiro's salary is higher than President Odama, is it fair?"

"When you drove a train that brake is broken, you could only save passengers or mechanics on the track. Which do you choose?"
There is no simple answer for those complicated problems. Which you choose or whether agree or disagree depends on a individual sense of worth. We need to think deeply for complicated problems. It is because we don't have a time when we just face to these emergency situation.

Communication with people whose major is different is important for us to keep our mind broaden.

case10 -persistent cough-

I have to improve the following points.

• Asking more detail about suptum
• Asking more detail about sick contact
• When I suspect tuberculosis, I should ask last PPD
• Don't ask the detail of sexual activity which is not directly related to the situation in this time-limited situation
• advice her to do a standard protection to prevent around her

One expert of infectious diseases taught us that his big mistake was related to tuberculosis.
It is easy to say "suspect of Tb" retrospectively. But it is difficult to do that prospectively.