Haley Nguyen, University of Florida

I had an incredible and memorable experience immersed in Japan's unique and vibrant culture! The students of Keio University showed me different aspects of Japanese life and traditions. They took me beyond the usual tourist areas and showed me the intricate beauties of Japan through a local's perspective. This internship included an enriching cultural exchange that left a lasting impact on me and deepened my love for Japanese culture!  

As a student from the University of Florida's College of Pharmacy in America, I was given the opportunity to attend an APPE rotation at Keio University's Faculty of Pharmacy. There I experienced many aspects of Japanese pharmacy practice ranging from clinical to retail. I got to witness Japanese pharmaceutical research first-hand, something not commonly found in pharmacy in America.  

During my first week at Keio, I was welcomed in the pharmacodynamics lab. In America, we do not have research embedded into our curriculum so this was a unique experience. Throughout the week, I shadowed various students to get an extract of their experiments. We worked on various techniques and tools such as liquid spectrum chromatography, gel electrophoresis, DNA isolation, and tissue sampling.  

During the hospital aspect, I noticed that a lot of the medication preparation was automated by pharmaceutical machineries. In America, we rely on technicians to do a lot of medication dispensing. In Japan, there are no technicians with pharmacists instead doing all the duties, but seem to still have less autonomy compared to pharmacists in America. There were many divisions of the pharmacy teams in the hospital. They focus on a more collaborative approach with the rest of the healthcare team with specific roles.  

I learned about Japan's universal health care system. This insurance is different compared to America's private insurance which faces high costs leading to a lot of income disparities. Since Japan's healthcare is controlled by the government, there is a percentage for copay and a cap on the deductible for major treatments. This makes it so the healthcare is more affordable for its civilians where I surprisingly saw many patients pay for their hospital visits the same day.  

Keio University included retail pharmacies for me to explore in Japan. I also noticed that retail pharmacies did not have any technicians which is vastly different to the American model of 1 pharmacist and 3 technicians. They all had Kampo medicine stocked and was very popular among the drugs of choice in the patients. There was a lot of single dose packaging that had the time and when to take the medications which is different because in America we just give the patient a whole bottle and do not separate. Pharmacists were very involved in the consultation of each drug provided to the patient in order to prevent any adverse outcomes.  

Japan's regulatory affairs are similar yet distinct from America. The National Institute of Health Sciences in Japan conducts testing, research, and studies towards the proper evaluation of the quality, safety, and efficacy of pharmaceutical products, foods and numerous chemicals in the living environment. Their major responsibilities include extensive testing and research to ensure quality, efficacy, and safety of chemical substances that are closely related to people's lives.  

Another interesting concept was Kampo medicine. I learned that Kampo medicine had its roots from ancient China that was introduced to Japan in around the 5th to 6th century. The museum was very interesting as I got to see the manufacturing process of the plant. At the museum, I got to see materials for crude drugs being delivered to the warehouse and processed to be sent out for distribution.  

This APPE rotation was an extremely invaluable and unique experience where I had the chance to learn about Japanese pharmacy practice. The students and faculty were extremely helpful and kind. I am thankful for this opportunity and hope to return to Japan in the near future!