Medical exchange project for students and young doctors between Japan and Russia

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Abstract

For more than 25 years Niigata University School of Medicine has been organizing medical exchanges with universities of the Russian Far East and Siberia. This exchange has turned out to be mutually beneficial for both universities, giving motivation to medical students and young doctors to strive for knowledge of international medicine. “Program for priority placement of foreign students sponsored by Japanese government” and “Re-inventing Japan project” initiated by Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT) were adopted in 2014, so it gave us a perfect opportunity to expand the existing program. In 2017, the MEXT approved the application of Niigata University together with Hokkaido University for «Program of Globalization in the field of university education (in cooperation with Russia), the creation of a platform for interaction”. We hope advances in the field of medicine and medical care achieved as a result of such unique cooperation between Japan and Russia will greatly contribute not only to the welfare of citizens of both countries, but also to the development of industry and economy. We would like to share experience gained by our university in the sphere of Japanese-Russian medical exchanges and educational programs, as well to describe the prospects for further development.

Abstract

For more than 25 years Niigata University School of Medicine has been organizing medical exchanges with universities of the Russian Far East and Siberia. This exchange has turned out to be mutually beneficial for both universities, giving motivation to medical students and young doctors to strive for knowledge of international medicine. “Program for priority placement of foreign students sponsored by Japanese government” and “Re-inventing Japan project” initiated by Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT) were adopted in 2014, so it gave us a perfect opportunity to expand the existing program. In 2017, the MEXT approved the application of Niigata University together with Hokkaido University for «Program of Globalization in the field of university education (in cooperation with Russia), the creation of a platform for interaction”. We hope advances in the field of medicine and medical care achieved as a result of such unique cooperation between Japan and Russia will greatly contribute not only to the welfare of citizens of both countries, but also to the development of industry and economy. We would like to share experience gained by our university in the sphere of Japanese-Russian medical exchanges and educational programs, as well to describe the prospects for further development.

Introduction

Globalization actively changes the content of scientific medical knowledge, influences the processes of its obtaining and understanding by medical staff [1]. It is important to pay attention to those aspects that should be taken into account in the organization of medical education [2]. Though in recent years the number of undergraduate and graduate students who are trained abroad is gradually increasing [3, 4]. Not very many Japanese medical students take part in international exchange programs at this point [5]. In order to increase the number of Japanese medical professionals who can act on the international level, we need to follow the progressive globalization and do our best to make students interested in foreign medicine, as international experience positively influences their careers [6]. So Niigata University aims to foster healthcare professionals with global medical knowledge who can meet all society’s expectations [7, 8, 9, 10].

Historically Niigata was a gateway of friendship between Japan and Russia. It is still the city deeply connected with Russia, and this is also evident from the fact that there is the Consulate General of Russia in Niigata. The history of exchanges between Niigata University and Russian universities is long and can be traced back to 1992. At that time a member of the House of Representatives Taro Nakayama established the Japan-Russia Medical Exchange Foundation as a humanitarian aid to victims of the Chernobyl accident. So at first, the Endoscopic Training Center was established in Krasnoyarsk and first Japanese experts were sent there. Exchanges with three universities – Krasnoyarsk State Medical University (KrasSMU), Far Eastern State Medical University, Khabarovsk (FESMU) and Pacific State Medical University, former Vladivostok State Medical University (PSMU) – started in 1993, agreements on the faculty level were concluded in 1998. Since that moment, Niigata University has established close collaboration between Japan and Russia and it has become one of the pillars of its international activity. To date, more than 320 medical students have participated in various exchange programs. In addition, Niigata University has accepted about 70 doctors and nurses from all over Russia, teaching them various advanced medical technologies, including endoscopy.

Methods

The credit system measures study time and compares learning achievements, helping students easily transfer credits from one institution to another. This idea was originated in the United States of America and introduced to Japan during the post-World War II era. Soviet education system didn’t use credits at all and Russia joined the Bologna process only in 2003. Russian universities mainly use ECTS (European Credit Transfer System) which is an important element of the Bologna process. Both countries have peculiarities in education and credit transfer systems that is why it as discussed in detail with Russian side before the project have started.

Full doctoral course in Japan is basically a four-year course, while in Russia it is a three-year course. During the whole study period Russian graduate student has to get 180 credits, while Japanese student has to get 30 credits.

The number of study hours needed to get 1 credit in Russia and Japan is very different. In Russia, 1 credit equals 36 study hours, one study hour is 45 minutes. In Niigata University 2 credits equal 15 study hours, 1 study hour is 90 minutes. In other words, in order to get one credit, Russian students have to study twice longer.

Based on these differences and consultation with the Russian side, mutual understanding on compatible credits was reached.

That is why the following scheme of credit transfer system was accepted for Double Degree Program. The student has to get 30 credits in four years. Niigata University accepts up to 10 credits from the Russian University, so the rest of credits student gets in Japan.

Regular PhD students who stay in Niigata University for the short term have a limit on compatible credits according to the study period.

Results

G - MedEx project and its management

As mentioned above, medical exchange with Russia was always one of the outstanding features of our university. So we decided to step forward to further the development of our relationships. Thus, we submitted two applications for “Program of priority placement of foreign students sponsored by Japanese government” and “Re-inventing Japan program”, and they were both adopted by Japanese MEXT in 2014. As for “Priority placement program” only outstanding international students are accepted as government-sponsored students. They study as graduate students; their tuition fees and living expenses are paid. The aim of “Re-inventing Japan” program is to foster young leaders who can cope with recent rapid internationalization of medicine.

Close partnership is very important for bidirectional exchange programs, as it is essential to develop an interaction strategy, to settle differences in academic systems and educational standards [9]. KrasSMU, FESMU and PSMU became our main partners. Thus, we created a bridge between Russia and Japan that helps to expand medical cooperation between two countries. Furthermore, we have created an educational framework to educate «global medical leaders» that will contribute to the advancement of the world medicine [7]. So, we had two projects with different target groups and program content, but with one ultimate goal. Therefore, to achieve mutually potentiating effect, «G-MedEx Project (Globalization and Medical Exchange Project for Career Development of Young Students in Japan and Russia)» was created, with a center that simultaneously manages and evaluates both projects.

First of all, it is necessary to emphasize that these projects are the activities of the entire Niigata University. The «control center» was created under the leadership of the university president and established in the faculty of medicine (Figure 1). It plays a central role in the management of the G-MedEx project. It consists of 4 faculty and administrative staff members, who are involved in project management, student performance management, clerical work, etc. In addition, it is responsible for entire project activation, including «quality assurance» of education and sharing the results with other university faculties. All the members of G-MedEx Control Center can fluently speak Russian or English. The University Steering Committee decides the details of the project in cooperation with the supervising center. In addition, steering committees were established in each of the three Russian universities, and KrasSMU which was selected as the main university with the closest connection with Niigata University. It helped to organize interaction with other Russian universities. The Japanese side and the Russian side jointly manage the project, working closely with staff of the control center. A feedback system that objectively monitors the progress of the project and its results is needed in order to make the project successful. To this end, we have the Internal Evaluation Committee consisting of four professors from the Niigata University School of Medicine and the External Evaluation Committee consisting of four experts from other universities. Each time we receive an evaluation of our project by experts at annual meetings, we try to improve it.

Figure 1

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Figure 1

Project management and evaluation system. Control Center is responsible for «guarantee of quality”, project follow-up and information sharing. Steering committees were established in Niigata University and all three Russian universities. The Japanese side and the Russian side jointly manage the project, working closely with staff of the control center. Internal Evaluation Committee consisting of four professors from the Niigata University School of Medicine and the External Evaluation Committee consisting of four experts from other universities make an assessment during annual meetings.

Citation: Medical University 1, 1; 10.2478/medu-2018-0005

Types of exchange programs

Our project can be divided into «Medical (undergraduate) student exchange» and «Graduate student exchange» (Table 1). Although undergraduate student exchanges are short time exchanges, their aim is to motivate students to study international medicine and to develop future exchanges with other countries. Graduate student exchanges are essential for educating future global medical leaders’ of Japan and Russia, as most postgraduate participants work as doctors. Based on the requests from both countries, we create programs that take into account unique characteristics of each university. The main language of all program participants is English. Participants undergo a rigorous selection based on academic performance, English language proficiency and the results of the interview.

Table 1

Student exchange numbers, 2017

※ Bold numbers-hit target

Student exchange201520162017
Total numberClassificationPlannedAchievedPlannedAchievedPlannedAchieved
Outbound111311161320
Inbound161916212029
Overall273227373349

※ Bold numbers-hit target

Program typeClassificationPlannedAchievedPlannedAchievedPlannedAchieved

1 Summer exchange program for medical studentsOutbound71077812
Inbound711712918
2 Medical research training programOutbound212725
Inbound0103
3 Regular PhD programOutbound222233
Inbound444466
4 Double Degree programInbound323330
5 Special of foreign program students for priority placementInbound222122

А. «Medical (undergraduate) student exchange» includes the following programs.

  • Summer Exchange Program

It is an exchange program which lasts about 10 days during summer holidays. One academic credit is given after the program is finished.

We receive approximately 7 Russian students a year. Students are given lectures on Japanese medicine and medical care, its present situation. They also have some practical trainings in chosen department and hospital field trips.

We also send about seven second-fourth-year students of Niigata University School of medicine to Russian Universities we have agreements with. It is very important for Japanese students to learn about the level of medicine in other countries. They have the opportunity to choose an internship department in advance in accordance with the desired specialty. Students receive not only theoretical knowledge, but practical as well, studying directly at the patient’s bedside.

  • Medical Research Training Program

Within the framework of this program, we send two third-year students to Russian partner universities every year for two months. There they conduct individual research work under the guidance of local teachers. Upon returning home, they do a poster presentation and receive seven academic credits.

At first this program was not intended to be bidirectional, but in order to meet the needs of Russian partners, it was decided to accept Russian undergraduate students for about a month of training during summer holidays. So, Russian students also have a chance to get some research experience abroad in the field of medicine they are interested in.

B. «Graduate student exchange» also includes a variety of programs

  • Double Degree Program (DDP)

According to DDP we accept one student from each of three Russian universities. In case of this program, orchestrated efforts of research groups on both sides are needed. Therefore, it was decided that this would be a four-year program, during which the first two years a student studies in Russia, and the second half of the term at Niigata University. The research project is usually discussed in detail by two parties immediately after the candidate’s entrance examinations and during his/her studies. Based on the rules of our university, part of the credits received in Russia is transferred to the student according to credit transfer system. The student has to publish at least one basic and one additional article in an international journal in his research field. It is also necessary to prepare an oral presentation of the published article. An article should be approved by the representatives of Niigata University School of Medicine and International Cooperation Steering Committee. Due to the fact that the duration of the postgraduate course in Russia is three years, the student returns for a certain period to Russia to complete necessary official procedures. Certain research themes are decided taking into account the request of the Russian side. They are infectious diseases, lifestyle diseases, community medicine.

  • Regular PhD Program (RPP)

Participants of the program are graduate university students. They have a short-term internship at a partner university and receive credits according to the credit transfer system accepted. Niigata University has the largest medical facility located on the shores of the Japanese Sea and it is famous for its high medical standards. Therefore, Russian students can have great merits studying at our university even during a short period of time. In order to meet the needs of our partners RPP is quite flexible about topics and period students would like to study in Niigata University. 4 graduate students a year are accepted. This program is very useful for Japanese students as well. The imbalance in the location of medical institutions due to regional disparities and the uneven distribution of the population, especially in the Far East of Russia, will in the near future become urgent problems for Japan. This is connected with the aging of the population and the depopulation of some certain areas of Japan. In addition, Japanese students will be able to learn more about infectious diseases which cannot be widely seen in Japan and it will also improve the training of Japanese medical personnel. Proceeding from the above, it was decided that such topics as infectious, cardiovascular diseases and preventive medicine, will become the most interesting, and also will allow to use strong points of Russian universities. According to our plan two graduate students a year will go to Russia. The study period is flexible from 2 weeks to 2 to 3 months.

  • Special program for priority placement of foreign students sponsored by Japanese Government

Participants of this program are supported by Japanese government. Every year, Niigata University School of Medicine accepts two PhD students. They study for four years as the Niigata University PhD students to obtain a degree. They carry out scientific research in the field of infectious diseases using advanced research techniques.

Support of students

Students who go to study abroad have a lot of fears and expectations which the university they are attending should think about. They worry about the access to university places, the provision of financial aid, social support, cultural integration, etc. [10, 11]

This is the reason why G-MedEx project provides extensive student support. In addition to full support of the accommodation which is always the greatest concern of foreign students, we always think about health care. The special health care center consisting of several doctors, including a psychiatrist was established in order to support students.

The official language of the project is English, but since 2016 students are offered to attend Japanese language courses to learn Japanese that can be used in everyday life. Furthermore, we invite leading Japanese scientists to our university to give special lectures that also contribute to the deepening of knowledge and a better understanding of Japanese culture.

For Japanese students who plan to visit Russia, orientation events and seminars are held in advance to provide sufficient safety information and caution. In addition, we have organized the «Japan-Russia emergency contact network», which allows us to support students around the clock.

It is also extremely important to support student’s career path. A special support system is necessary, as students can actively work as doctors and researchers. The supervising center plans to cooperate closely with the steering committees of the Russian universities and prepare some positions where students can establish themselves after graduation.

We have also launched an alumni association page in Facebook and provided a place for program graduates to communicate freely. They share information with each other and have career counseling.

Discussion

At the very beginning of two projects, we went to Russia in order to provide sufficient mutual understanding and explain the essence of the interaction, but during the implementation some misunderstandings inevitably happen. In order to prevent them and react quickly, we hold joint meetings with our Russian partners several times a year (Faculty Development). We also hold seminars to promote further development of G-MedEx project in Japan and Russia, report on the progress of the project and achievements in the field of education and research. Since 2016, the «Japanese-Russian Medical Symposium» has been held annually with the participation of all three partner universities. This is a very valuable opportunity to talk and discuss various topics related to education and research in the field of medicine, as well as to report on the achievements and results of cooperation.

Within the framework of the G-MedEx project, every two years we hold an event supported by city and prefectural government for citizens of Niigata. The goal is to explain the essence of the project in simple language and to introduce the Russian culture. All activities carried as a part of G-MedEx project are widely covered in brochures, on the project’s website and annual reports that are issued at the end of each year. Three Russian universities have been our main partners to date, but G-MedEx project has gradually gained wide popularity and some other Russian medical universities show their willingness to cooperate with us (Figure 3). Therefore, in 2017 we decided to accept students from 3 new universities: St. Petersburg State University, Kazan Federal University and North-Eastern Federal University. The first two universities are located in the European part of Russia, North-Eastern Federal University is located in Yakutsk, the capital of the Sakha Republic, which is known for its great medical facilities. In addition, an exchange with Kazan State Medical University and Moscow State Medical University started in 2018. Expansion of the list of partner universities that are now located all over Russia, and not just in Siberia and the Far East, allows us to learn more about the problems of community medicine faced by universities, for example, regional disparities, and to give impetus to the further development of the project.

In order to carry out exchange programs (such as the Special program for priority placement of foreign students, DDP and RPP) smoothly and effectively, close communication between faculty members is necessary [12]. In addition, in order to reach a higher level of medicine and medical services development in both countries, it is very important to conduct joint international research. Currently, the main focus is on infectious diseases (especially tuberculosis) and Alzheimer’s disease. We are confident that the development of joint research will further strengthen the education framework.

The goal of the program for globalization in the field of university education (creation/construction) of a platform, which was mentioned at the beginning, is to create/construct the platform for gathering and exchanging information, as well as accumulating experience of inter-university exchanges between Japan and Russia. In addition, the «economic cooperation plan, consisting of 8 points» was presented at the Japan-Russia Summit in May 2016. «Japan-Russia University Association» which was established during Japan-Russia Summit in December 2016 was requested to formulate a concrete action plan.

Together with Hokkaido University we have made the project proposal. It is planned that the universities of both countries, in cooperation with industrial enterprises and local authorities, will contribute to the expansion and development of Japan-Russia relations in the following areas: ‘health and medicine’, ‘urban development’, ‘cooperation among small and medium-sized companies’, ‘energy’, ‘promotion of industrial diversification’, ‘industrial development of the Far East’, ‘cooperation on advanced technologies’ and “expanding people-to-people exchanges”.

In particular, together with other Russian universities, we are planning to create a consortium which will unite stakeholders of both countries. We will participate and work together on human resource development and promotion of the program. Our university became the leader of «health and medicine» section. Besides, Japan-Russia Medical Symposium was held in Vladivostok last year in September. It was also attended by the Deputy Minister of Health of the Russian Federation, the Deputy Minister of Japanese MEXT. Within the framework of the symposium, all presidents of Russian partner universities reported on the results of the project. Furthermore, the establishment of a coordination system between universities was confirmed. So we will be steady in our purpose, organizing various exchange events in the future.

Although G-MedEx is a program specialized in the medical field, we hope that it will be a starting point for a wide range of international exchanges. We hope that using the achievements of G-MedEx project and accumulated knowhow in the field of international exchange we will spread our initiative and create a platform, so all our efforts will lead to revitalization of Japan-Russia exchanges. We are looking forward to further deepening of friendship between Russia and Japan.

Figure 2

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Figure 2

Niigata University and eight Russian partner universities. Partner universities in European Russia: 1-Moscow State University, Faculty of Fundamental Medicine; 2-St. Petersburg State University, Medical Faculty; 3-Kazan Federal University, Institute of Fundumental Medicine and Biology; 4-Kazan State Medical University. Partners in the Russian Far East: 5-Krasnoyarsk State Medical University, 6-Far Eastern State Medical University; 7-Pacific State Medical University; 8-North-Eastern Federal University, Institute of Medicine.

Citation: Medical University 1, 1; 10.2478/medu-2018-0005

Acknowledgements

The authors acknowledge the contribution and assistance of Krasnoyarsk State Medical University faculty members – President Ivan Artyukhov, Vice-president Alla Salmina, Vice-president’s assistant Tatyana Konkova, Head of Graduate Department Elena Teplyashina.

Conflict of interest

Conflict of interest statement: All authors state that there are no conflicts of interests to declare.

References

1

Bateman C, Baker T, Hoornenborg E, Ericsson U. Bringing global issues to medical teaching. Lancet. 2001;358(9292):1539-42. https://doi.org/10.1016/S0140-6736(01)06552-7

2

Houpt ER, Pearson RD, Hall TL. Three domains of competency in global health education: recommendations for all medical students. Acad Med. 2007;82(3):222-5. https://doi.org/10.1097/ACM.0b013e3180305c10

3

Suzuki T, Nishigori H. National survey of international electives for global health in undergraduate medical education in Japan, 2011-2014. Nagoya J Med Sci. 2018; 80(1):79-90. http://doi.org/10.18999/nagjms.80.1.79

4

Mutchnick IS, Moyer CA, Stern DT. Expanding the boundaries of medical education: evidence for cross-cultural exchanges. Acad Med. 2003;78(10 Suppl):S1-5. PMID: 14557080

5

Nishigori H, Takahashi O, Sugimoto N, Kitamura K, McMahon GT. A national survey of international electives for medical students in Japan: 2009-2010. Med Teach. 2012;34(1):71-3. https://doi.org/10.3109/0142159X.2012.638014

6

Ramsey AH, Haq C, Gjerde CL, Rothenberg D. Career influence of an international health experience during medical school. Fam Med. 2004;36(6):412-6. PMID: 15181553

7

Wallace AG. Educating tomorrow’s doctors: the thing that really matters is that we care. Acad Med. 1997;72(4):253-8. PMID: 9125939

8

Boelen C. Prospects for change in medical education in the twenty-first century. Acad Med. 1995;70(7 Suppl):S21-8; discussion S29-31. PMID: 9125939

9

Cuellar NG. Study Abroad Programs. J Transcult Nurs. 2016;27(3):209. https://doi.org/10.1177/1043659616638722

10

Huhn D, Huber J, Ippen FM, Eckart W, Junne F, Zipfel S, et al. International medical students’ expectations and worries at the beginning of their medical education: a qualitative focus group study. BMC Med Educ. 2016;16:33. https://doi.org/10.1186/s12909-016-0549-9

11

Heck JE, Wedemeyer D. A survey of American medical schools to assess their preparation of students for overseas practice. Acad Med. 1991;66(2):78-81. PMID: 1993106

12

Rohrbaugh R, Kellett A, Peluso MJ. Bidirectional Exchanges of Medical Students Between Institutional Partners in Global Health Clinical Education Programs: Putting Ethical Principles into Practice. Ann Glob Health. 2016;82(5):659-664. https://doi.org/10.1016/j.aogh.2016.04.671

Journal Information

Figures

  • View in gallery

    Project management and evaluation system. Control Center is responsible for «guarantee of quality”, project follow-up and information sharing. Steering committees were established in Niigata University and all three Russian universities. The Japanese side and the Russian side jointly manage the project, working closely with staff of the control center. Internal Evaluation Committee consisting of four professors from the Niigata University School of Medicine and the External Evaluation Committee consisting of four experts from other universities make an assessment during annual meetings.

  • View in gallery

    Niigata University and eight Russian partner universities. Partner universities in European Russia: 1-Moscow State University, Faculty of Fundamental Medicine; 2-St. Petersburg State University, Medical Faculty; 3-Kazan Federal University, Institute of Fundumental Medicine and Biology; 4-Kazan State Medical University. Partners in the Russian Far East: 5-Krasnoyarsk State Medical University, 6-Far Eastern State Medical University; 7-Pacific State Medical University; 8-North-Eastern Federal University, Institute of Medicine.

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