University of Washington, Akiyo Tsuchiya (6th year, Department of Pharmacy, Faculty of Pharmacy *at the time)

I visited Northwest Hospital & Medical Center (Seattle, USA), a hospital affiliated with the University of Washington, and together with a classmate, I underwent four weeks of ward practice training in the intensive care unit.

Throughout the training, I was consistently involved in the pharmaceutical management of patients admitted to the intensive care unit. By engaging in the pharmaceutical management of patients whose conditions changed from moment to moment and who were admitted and discharged daily, I was able to acquire a great deal of knowledge and skills, thereby enhancing my clinical abilities. Our supervising pharmacist, Dr. Lee, treated us like new pharmacists and had us perform all kinds of tasks. He also actively gave us opportunities to speak with doctors and patients, making it a very fulfilling training experience.

Through the Advanced Overseas Practice, I learned about the connection between culture and medicine. For example, an infectious disease physician taught me that the litigious culture of the United States influences the choice of antimicrobial drugs. Furthermore, I learned that a law was enacted to prohibit hospitals from refusing admission through the emergency room because many hospitals were turning away homeless patients who could not afford treatment. This provided a good opportunity to consider what is unique about Japanese culture and how it affects medicine.

The United States, which has undergone repeated professional reforms for pharmacists, may seem like an advanced country for the profession. However, after my training, I came to believe that this is not necessarily the case. Instead of merely following the US, we should pursue a system that fits Japan's culture and social conditions, one that leverages the strengths of Japanese pharmacists. If we remain in a limited world, we may not even realize the shallowness of our understanding of our own culture and characteristics. I strongly encourage others to participate in the Advanced Overseas Practice to broaden their perspectives.

(Mr. Tsuchiya's experience was published in Farumashia, Vol. 55, No. 12, 2019, pp. 1160-1161)