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Post-graduate training

Second Department of Surgery

1. Outline

  At Wakayama Medical University Second Surgical Seminar, we implement a post-graduate training program with the aim to train world-leading surgeons.

  Initially, for three or four years after graduation, you will gain experience as a gastroenterological surgeon in a major regional hospital. During this time you will be responsible not only for gastroenterological surgery, but also for emergency and general surgery.  The Second Department of Surgery has relationships with more hospitals than any other department within the Wakayama Medical University, which will allow you to gather sufficient experience of cases within your two years of postgraduate training.

  After this, you will progress to the University’s graduate school, and learn the philosophy of clinical medicine while engaging in surgical research. Surgeons who can engage in fundamental research will be able to implement excellent surgical medicine in the future. For this reason, we strongly recommend that you progress to graduate school. While in graduate school, you will engage in research at the same time as working part-time as a doctor in one of our partner hospitals, allowing you to support yourself economically.
Doctors wishing to specialize in pediatric surgery will be posted domestically to specialist institutions with the highest number of pediatric cases in Japan in order to qualify as pediatric specialist surgeons. In addition, we offer training and placements at cutting-edge facilities in the field of gastroenterological surgery both in Japan and overseas.

  Once you are qualified, we recommend that, depending on your research area, you take the opportunity of further research overseas, at a cutting-edge institution in the USA. Doctors remaining in the University and working on surgical medicine as gastroenterological surgeons offer clinical and research guidance to their juniors, whilst at the same time publishing the results of their own clinical research in international journals. Furthermore, they are given posts of responsibility at leading hospitals in both Wakayama Prefecture and southern Osaka Prefecture, in order to engage in surgical medicine.

  In this way, at Wakayama Medical University Second Surgical Seminar, we offer committed, long-term support to ensure that your ambitions are realized.


2. Training in third and fourth years after graduation

  Once you have completed initial training with the department, you will engage mainly in clinical training within partner hospitals.

  Our department has partnerships with many related institutions, both public and national hospital organizations (formerly national hospitals) throughout Wakayama Prefecture and southern Osaka Prefecture, among which our trainees have the opportunity to be assigned to hospitals with 300 or more beds, or which deal with 300 or more cases requiring full anesthesia per year, in order to undertake training in gastroenterological surgery, emergency surgery and general surgery. At the same time, you will be able to learn techniques such as gastroenterological endoscopic examination and contrast examination.
In addition, almost all the institutions with which this hospital has partnerships are either designated by or related to the Japan Surgical Society’s specialist program, or are specialist training institutions or institutions related to the Japanese Society of Gastroenterological Surgery.
   Given this, and the fact that in two years with this department you will be able to experience an extremely high number of cases, this department is one of only a small number of training institutions in Japan where, within only five years of graduation, you will be able to qualify as a specialist doctor.


3. Fifth year from graduation and onwards

① Progression to graduate school
   After spending two years training at a related facility, you are able to progress to graduate school. During your first year as a graduate student, you will take part in clinical research at the University hospital in order to further develop your clinical techniques, and acquire basic skills in regard to research. You will also prepare to undertake your own research.

  From the second year onwards, you will leave hospital training and engage in your own research towards acquiring a medical doctorate.  Research in the Second Department of Surgery is mainly related to oncology, including the genetic diagnosis of gastroenterological cancers, cancer immunity treatment and genetic therapies, but we are also engaged in a broad spectrum of research, including trials of hepatic regeneration by gene transfer and the pathophysiology of  biliary tract obstruction. Depending on your area of research, you may also be assigned to the Japanese Foundation for Cancer Research or the National Cancer Center Research Institute.

  At whichever facility you engage in research, our excellent staff will offer guidance and instruction to assist you in placing papers in leading international journals.

②  Pediatric surgery specialist training
   Doctors wishing to specialize in pediatric surgery may undertake two or three years of clinical training at a pediatric surgical specialist institution (the surgical department of either Osaka Medical Center or Research Institute for Maternal and Child Health, or Hyogo Prefectural Kobe Children’s Hospital, at which more than 500 cases are treated per year). We currently have doctors assigned to both Hyogo Prefectural Kobe Children’s Hospital and Osaka Medical Center and Research Institute for Maternal and Child Health.

  This will allow you to obtain the training points required to take the examination to qualify as a specialist with the Japanese Society of Pediatric Surgeons. Training a large number of pediatric specialists and teaching doctors facilitates our University hospital to be approved by the Society, and so the department is supportive of its doctors acquiring specialist status.

  In addition to this, our doctors are engaged in gastroenterological surgical training and assignments in leading institutions both domestically and overseas. In Japan, we have engaged in rectal surgery at the Tokyo Metropolitan Komagome Hospital, and overseas, and overseas we have carried out liver transplant training at UCLA. We plan hepatic surgery training at Tokyo University’s Department of Surgery, as well as pediatric surgery training at UCSF and pancreatic surgery training at Johns Hopkins University.


4. Progress from nine years after graduation onwards

  Once you have a degree and a certain amount of clinical experience, you will be ready to choose from the following three options, as a fully qualified gastroenterological surgeon.

  The first choice is to remain within the University as an assistant, and engage in clinical practice to gain specialist knowledge.  Doctors at the Second Department of Surgery work in three groups – those working on the upper gastrointestinal canal (mainly the esophagus and stomach), those working on the lower gastrointestinal canal (mainly the small and large intestines), and those working on the liver, kidney and pancreas, so you will join one of these groups and gain specialist clinical knowledge and techniques. By proactive participation in academic conferences and the preparation of clinical research papers, you will come to play a central role in the future of the department.

  The second option is to utilize the research techniques you have gained during graduate school, etc., overseas. We constantly have two or three doctors trained in our department working in the USA, at NIH, UCLA, UCSF, City of hope, Baylor College of Medicine, UT MD Anderson Cancer Center, Vanderbilt University and other institutions.  These placements are usually for a period of two years, after which you will return to Japan and join one of the clinical teams noted above, engaging in clinical practice while also teaching graduate students as a research leader.

  The third option is to be assigned to a related hospital and to work as a member of the gastroenterological surgical staff team.  We have more related hospitals than any other department, and former Second Department of Surgery doctors now work as directors, deputy directors, heads of surgical departments or lead physicians at Osaka Minami Medical Center, Izumiotsu Municipal Hospital and Hannan Municipal Hospital among others in Osaka, Wakayama Rosai Hospital, Kainan Iryo Center, Naga Hospital, Hashimoto Municipal Hospital, Nokami Kosei Sougo Hospital, Arita Municipal Hospital, Saiseikai Arita Hospital, Hidaka General Hospital, Minami Wakayama Medical Center and Kozagawa Hospital, among others in Wakayama Prefecture.

  Gaining experience at one of these related institutions will allow you to attain specialist status with the Japan Gastroenterological Endoscopy Society, the Japan Surgical Society or the Japanese Society of Gastroenterology nine years after graduation, while twelve years after graduation you may attain specialist status with the Japanese Society of Gastroenterological Surgery.  Once you obtain specialist status, you can be promoted to lead physician or head of department, and work as within management at a leading community hospital.