Khon Kaen University: Saki Masuda (6th Year, Department of Pharmacy, Faculty of Pharmacy *at the time)

I participated in a five-week internship at Khon Kaen University in Thailand. I applied for this program because I wanted to broaden my perspective by seeing overseas medical sites with my own eyes.

During the internship, I spent the first four weeks in the oncology ward of the university hospital, learning about cancer patient care alongside pharmacist interns and pharmacy students. In the mornings, I was mainly involved in medication therapy management in the ward, and in the afternoons, I participated in case reports and journal clubs under the guidance of my supervising professors. For the case reports, I had to organize the patient's medical history, previous regimens, side effects, and potential next treatment options, while also reviewing supporting clinical trials and papers. This made me deeply realize the depth of knowledge required to support a single patient. Since the guidelines, approved drugs, and insurance systems differ from those in Japan, learning while experiencing those differences was a very interesting experience. In the final week, I observed the palliative care team, the TDM team, outpatient oncology pharmacists, and the university-affiliated pharmacy.

What left the strongest impression on me through this internship was the significant impact that differences in medical systems have on treatment choices. In Thailand, the drugs covered by medical insurance are designated, and there were patients who could not use certain medications for economic reasons, even if those drugs are covered by insurance in Japan. On the other hand, I also learned about a system called PAP (Patient Assistance Program), where pharmaceutical companies cover part of the cost of expensive drugs. While the same medicines support people regardless of the country, I was confronted with the reality that some cannot receive optimal treatment due to their economic background. This made me re-recognize the value of Japan's universal health insurance system, where everyone can receive medical care equally, and I felt strongly the difficulty and importance of "delivering necessary medicines to the people who need them."

  Outside of the internship, I fully enjoyed Thai culture, with professors and friends taking me to temples, night markets, and lovely cafes, and enjoying Thai cuisine.

Participating in this internship was a challenge that felt like a bit of a stretch for me—it was my first time studying abroad and my first time traveling overseas alone—but thanks to the support of many people, I was able to spend fulfilling days. I hope that anyone interested will take on the challenge of this precious opportunity to experience overseas clinical sites firsthand.