Japan trip offers global perspective to MUSC professor

By Dr. Jeffery G. Wong

In 2012, after eight incredibly fulfilling years as the senior associate dean for medical education in the College of Medicine, I was transitioning to a new, and as yet undefined, role in my development and growth as a medical educator. In doing so, I applied and had the good fortune to be selected as the Kimitaka Kaga Visiting Professor at the University of Tokyo in the International Research Center for Medical Education (IRCME). I was humbled to be selected for this position as several of the top medical educators in the world had previously served in this role and I wondered what additional skills or expertise I might bring to bear during my time in Japan.

The six-month sabbatical, which lasted from October 2012 through March 2013, was a wonderful opportunity to get outside of my comfort zone, both professionally and personally. Living outside of the United States for such an extended period and being separated from family and friends compelled me to re-think many pre-existing assumptions about how the world works and my role within it.

While most all of my soon-to-be colleagues at the University of Tokyo spoke English, few in the small neighborhood in which I lived did. I have never been particularly skilled in foreign languages, but I made it a point to spend hours each evening listening to my Japanese language CDs and learning to write and read the hiragana and katakana alphabet as well as the kanji characters that make up the Japanese written language. Gradually, over the course of weeks, I grew better able to communicate with others, express my thoughts and ask my questions, but even more importantly, understand them.

Besides language, other cultural differences became very clear. It had been my intention to try to set up educational and research projects ahead of time in order to “hit the ground running” when I first arrived at the IRCME. However, my Japanese hosts, not knowing my skills, abilities, or personality, preferred a more gradual inculcation into academic life. While I was initially internally frustrated by what I perceived as avoidable delays, I gained valuable insight through observing staff interactions within the IRCME, the IRCME’s role within the University of Tokyo, and the importance of the University of Tokyo within the larger realm of medical education within the country of Japan.

This understanding of one’s place within the system is akin to the Japanese concept of Kensho in the Zen Buddhism tradition: Ken meaning “seeing” and sho meaning “nature or essence.” It is sometimes used interchangeably with the word satori meaning “comprehension or understanding.” By taking this approach, I was able to gain the trust of my new colleagues and very soon thereafter became extremely busy with multiple educational projects working with medical students, residents-in-training, and clinical teaching faculty. Administratively, I was asked to help them analyze some of the larger questions regarding institutional accreditation for the country’s medical schools and significant curricular reforms within the medical school for the clinical clerkship rotations for medical students.

Some of the greatest joy I experienced at the University of Tokyo was in doing the same activities that have defined my academic career to date - working closely with young people along their journey to becoming clinical physicians. I discovered that most medical learners in Japan are similar to those in America – hard-working, extremely bright, intellectually curious, and generously altruistic. And while the general educational style of Japanese medical schools tends to be didactically driven with lectures and seminars, the interactive teaching methodologies that I shared with them were welcomed and enjoyed.

Interestingly, I also had the experience of becoming a mentor to one of the young junior faculty members in the IRCME. In so doing, it compelled me to think more deeply about my own journey in academic medicine and how I could use that experience to help others. I became more fully aware of faculty concerns within the larger institution and how the institution’s policies regarding tenure, promotion, reimbursement, and position expectations can impact their job satisfaction and quality of life. It also highlighted the critical role that leadership plays in making the institution successful and that faculty members of any given institution are its most important resource.

Living abroad for six months also allows one to get out of “tourist” mode and begin to see world events from a completely different perspective. The horrific shootings in Newtown, Conn., occurred during my stay there. This event served to heighten the fear that an already frightened Japanese people had of the dangerous place that is the USA. How can one explain that? The WikiLeaks revelations, Edward Snowden, and the National Security Agency's surveillance programs were also becoming items in the mainstream news. How can America hope to take the moral “high ground” in the world with these things happening? Seeing our country like others in the world see us is enlightening, frightening, and vastly different than the parochial perspective provided by our country’s news media, but extremely important as we journey into the future.

The columnist David Brooks of the New York Times recently wrote an editorial titled, “The Leadership Revival.” He opines about the difficulties that persons in politics or public life have in executing their visions of what needs to be done. One of his admonishments struck a chord with me as I reflect on my time abroad: “…take a reality bath. Go off and become a stranger in a strange land. Go off to some alien part of this country or the world. Immerse yourself in the habits and daily patterns of that existence and stay there long enough to get acculturated. Stay there long enough so that you forget the herd mentality of our partisan culture … You have to walk away from the partisan tunnel vision to see how things really are.”

I was fortunate enough to be able to do that and believe that I am a better person for it. I urge you to take any opportunity you can to expand your own horizons in your own personal journeys.

This article was reprinted with permission from MUSC Newscenter. Dr. Jeffery G. Wong is a professor of medicine at the Medical University of South Carolina.