Bomi D Ryang, University of Iowa

From May to June 2025, I had the invaluable opportunity to participate in a six-week pharmacy rotation in Japan through Keio University. This international experience provided me with invaluable clinical, research, and cultural learning opportunities, while allowing me to explore the similarities and differences between the U.S. and Japanese pharmacy systems. The first week was largely introductory, filled with site visits and lectures. We toured several facilities including Keio University Hospital, Tsuruha Drugstore, the Tsumura Kampo Museum, and the National Institute of Health Sciences. These visits offered a broad overview of how traditional Kampo medicine and modern clinical pharmacy coexist in Japan and set the stage for the more immersive experiences to come. The second week was one of the most enriching parts of the rotation, as I had the opportunity to work in both wet and dry lab of Dr.Ohtani's lab. In the wet lab, under the guidance of Dr.Akioshi, I conducted experiments examining CYP enzyme metabolism, which helped reinforce my understanding of drug metabolism in a hands-on setting. The dry lab allowed me to engage with other lab members' projects and share my own research from the University of Iowa, fostering meaningful academic exchange. The third week consisted of observational visits to clinical and regulatory institutions, such as Juntendo University Nerima Hospital, the PMDA, and the National Cancer Center Hospital. These visits gave me insight into Japan's healthcare structure, especially the integration of traditional and modern practices and the country's robust regulatory framework. The fourth week marked the clinical core of my rotation. I was placed in the Neurology department at Juntendo University Hospital and paired with a second-year resident named Misaki. Each morning, we reviewed medication lists and rounded on patients, providing medication guidance and follow-up. Although I couldn't communicate directly with patients due to the language barrier, Misaki served as a helpful translator, ensuring I remained engaged. I had the chance to follow four different patient cases, which I presented in a final case discussion comparing clinical approaches in Japan and the U.S. This immersive experience greatly deepened my understanding of inpatient pharmacy and clinical collaboration. The last two week involved wrap-up activities, including regulatory discussion forums, joint clinical case studies with Keio students, and training in pharmacokinetics and pharmacometrics. These sessions tied together the clinical, research, and policy components of the rotation and reinforced the importance of interdisciplinary thinking in pharmacy practice. In summary, this rotation was a formative experience that expanded my clinical and scientific knowledge while strengthening my global perspective on pharmacy. I'm incredibly grateful for the opportunity to learn from such dedicated professionals and peers, and I hope to carry these lessons forward into both my research and future patient care.