My Internship Experience By Zsófi (Semmelweis University)

日本で体調を崩したときは？

In this blog post, I would like to share a little about my summer internship at BLEZ Pharmacy, which I had the opportunity to complete as a third-year pharmacy student from Hungary.

Motivation

Last summer, in addition to completing my two-week internship in a community pharmacy in Hungary, I had the opportunity to spend two weeks in a hospital pharmacy in Germany through the Pannónia Scholarship Programme. This experience provided me with a great deal of new knowledge, not only professionally but also linguistically, and it also made me increasingly certain that after graduating I would like to work in a community pharmacy. By my third year of university, we were no longer studying only introductory and foundational subjects, and I wanted not only to put the knowledge I had acquired into practice in my home country, but also to apply it abroad and, even more importantly, expand it further. Therefore, this year in addition to my two-week community pharmacy internship in Hungary, I decided to spend four weeks in a community pharmacy abroad. Thanks to the scholarship programme, I had the opportunity to complete my professional internship abroad, specifically in Tokyo. This allowed me not only to broaden my pharmaceutical knowledge, but also to gain insight into the healthcare system and culture of a distant country, improve my language skills, and, last but not least, fulfil a huge personal dream. Although I speak very little Japanese, this did not cause any difficulties thanks to my mentor’s excellent command of English.

Preparation

I decided in December that I would like to take advantage of the scholarship opportunity again this year, and that was when I started organising my internship. My first step was to look for a community pharmacy in Japan with English-speaking staff, which turned out to be much more difficult than I had expected. There are not many pharmacies in the country with English-speaking employees, and often the only contact information provided is a telephone number. I tried contacting several universities and hospitals as well, and although everyone was extremely helpful, unfortunately they were unable to offer me a concrete solution. Eventually, completely unexpectedly, I received a positive response from BLEZ Pharmacy, informing me that they would be able to host me. This was followed by the scholarship application process and, after being awarded the scholarship, the completion of all the necessary documents. I had everything ready by the beginning of June, and after that I only had to wait for the date of my departure.

Travel and Arrival

There was never really any question that I would travel by plane, as I had approximately 9,000 kilometres to cover. On my way to Japan, I arrived in Tokyo after 16.5 hours of travelling, with a stopover in Shanghai. Although this was only the second time I had ever flown and I had never been outside Europe before, fortunately everything went smoothly. I hope that my 15.5-hour journey home from Osaka, with a stopover in Seoul, will be just as trouble-free. It took me a little over an hour to get from Narita Airport to Tokyo. My first real shock came when I arrived: it was not only 38 °C and extremely sunny, but the temperature was accompanied by 70–80% humidity. The complicated public transportation system was another challenge. According to my internal sense of time, it was only around 1 p.m., while in reality it was already approaching 6 p.m. Since I had barely been able to sleep during the journey, I was quite exhausted and maybe thanks to this, fortunately I managed to overcome the jet lag within two or three days. Despite all this, I had no difficulty finding my accommodation.

Accommodation and Living Arrangements

I live in a small apartment with three roommates: a French, a Chinese and a Turkish girl. We have our own bathroom and kitchen, and the nearest metro station (Nihombashi) is only a three-minute walk away, so it took me just 15–20 minutes to get to my internship site.

BLEZ Pharmacy and my Role, Professional Experiences

I completed my internship at BLEZ Pharmacy, from 20 July to 14 August. From the very first moment, my mentor, Shogo-san, the Pharmacist in Charge treated me with incredible patience and kindness, so we quickly found common ground. During the second and third weeks, we were joined by a Croatian pharmacy student. Over the course of the four weeks, I was able not only to gain insight into the daily tasks carried out in the pharmacy, but also to visit several other institutions and attend an official dinner with staff members and trainees from the other institutions.

First, I would like to talk a little about the tasks I performed at the pharmacy. During the first week, under Shogo-san’s guidance, I studied the pharmacy’s OTC products in detail. We discussed which products could be recommended for different symptoms, and I also became familiar with several traditional Japanese medicines known as Kampo medicines. These topics came up again and again during the following weeks, which helped me consolidate and deepen the knowledge I had acquired.

In addition, I learned a great deal about prescription medicines during the four weeks. Both the prescription-writing process and the dispensing system differ considerably from what I am used to in Hungary. In my country, prescriptions are submitted electronically, whereas in Japan they are still submitted on paper. The subsequent administrative process, known as SOAP, is also different from what we use in Hungary and initially seemed rather intimidating. However, thanks to my mentor’s guidance, I soon realised that it was not as complicated as it had first appeared.

Perhaps one of the most surprising differences for a European is that prescription medicines in Japan are prescribed and dispensed by individual units rather than by boxes. I also had the opportunity to improve my communication skills with patients, as most of the people visiting the pharmacy were foreigners. Therefore, I was usually able to communicate with patients in English, but sometimes I also had the opportunity to speak German or even Hungarian when taking their medical history and recommending OTC products. Under Shogo-san’s supervision, I also practised how to provide patients with appropriate information about prescription medicines.

I certainly must not forget to mention the enormous amount of theoretical and pharmacological knowledge I gained during my internship. It was particularly interesting to compare differences in the dosing of certain active substances, such as ibuprofen and codeine, and to learn about the enzyme differences between European and Asian populations that may contribute to these differences. We also discussed numerous drug interactions and side effect profiles.

In addition to my professional duties, I was able to take part in promoting the pharmacy. On different occasions, I wrote social media posts, created posters or videos, wrote blog posts (you can find it in the website of BLEZ Pharmacy), and even participated in the distribution of tissues. I also learned about how the Japanese health insurance system works, various government regulations, and the operation of the emergency healthcare system in connection with the earthquakes that unfortunately recently occurred around Kumamoto.

I would also like to briefly talk about the visits to various institutions. Before my arrival, I prepared a 20-minute presentation about the role of Hungarian pharmacists and pharmacies, which I had the opportunity to give on several occasions to university professors and students, clinical doctors, and pharmacists.

During our visit to Keio University, we gained insight into the Japanese education system, which differs considerably from the European system, as well as the research being conducted there on anticancer therapies. At the end of the day, we were given a tour of the university pharmacy and even had the opportunity to undergo various health tests ourselves.

At the Cancer Institute Hospital of JFCR, we were introduced to the different stages of anticancer therapy. We were also able to try preparing medication for individual patients and had the opportunity to work in a sterile laboratory.

In addition, we spent an entire day at another pharmacy (Kenko-do pharmacy), where we were introduced to the world of Japanese compounding. We prepared ointments, syrups and powders, and we were also able to try out an automated medication dispensing machine. This was probably our favourite activity of the day.

Last but not least, I had the opportunity to visit two clinics, the eHealth Clinic Shinjuku and Imamura Asakusa Clinic. At Imamura Asakusa Clinic, consultations were conducted exclusively in English, which allowed me to observe the Japanese healthcare system even more closely.

It also provided an opportunity to gain further multicultural insights: an online presentation delivered by one of BLEZ’s Thai manager, Yo-san gave us a glimpse into the intricacies of the Thai healthcare system.

Everyday Life and Local Culture

In addition to the professional experience, the four weeks also gave me the opportunity to get to know the local culture more closely, which differs significantly from Hungarian in many ways. On the one hand, I experienced this through using the local infrastructure on a daily basis, whether it was public transportation or shopping. On the other hand, during our visits, I was able to gain insight into how various institutions operate.

I also owe a great deal to Shogo-san, who was not only always happy to answer my questions, but also shared a new and interesting fact or piece of information with me every day, whether it was a restaurant recommendation, a suggestion for a weekend activity, or something completely different. I was also able to tell him a great deal about my own country and culture, both from a professional and an everyday perspective.

In the afternoons and on my days off, I had the opportunity to explore Tokyo, and over the next two weeks I will also be travelling to Hokkaido and Osaka and the surrounding area.

Challenges and Lessons Learned

The biggest challenge during my internship was undoubtedly the language barrier. Although I can communicate in Japanese at a very basic level, unfortunately I can only read and write hiragana and katakana. As a result, for example, going grocery shopping is practically impossible without using a translation app. Fortunately, information on the streets and in the subway is also provided in English, which made my everyday life considerably easier.

Another difficulty was the fact that only a relatively small proportion of Japanese people speak a foreign language. However, they make up for this with incredible kindness and helpfulness. Whenever I encountered a problem, someone was always willing to help me solve it quickly. The public transportation system was another challenge that I would definitely mention.

Conclusion and Recommendations

To sum up, I am extremely grateful for this opportunity provided by BLEZ Pharmacy and I would encourage every phramacology students to take advantage of it, because it truly offers the chance to gain experiences that can last a lifetime. Although it was not always easy and there were certainly challenges along the way, I do not regret taking the opportunity for a moment.

Professionally, I developed a great deal and significantly broadened my perspective. It was also an extremely valuable linguistic experience: not only was I able to improve my English, but I also developed my Japanese language skills. Beyond all of this, it is difficult to put into words how incredible it was to get to know a country so different from my own.

So instead of trying to describe it, I will simply let a few pictures speak for themselves.

ありがとうごやいます！