Young People These Days | Shohei Onishi (Dean, Graduate School of Health Management)
September 14, 2006
The year I graduated from the School of Medicine, 1977 (Showa 52), was a year of both brilliant events, such as Sadaharu Oh of the Yomiuri Giants setting a new world record with his 756th home run, and tragic ones, like the Dacca Japan Airlines hijacking incident. At that time, after graduating and passing the National Examination for Medical Practitioners, medical students would begin their careers as doctors in their desired departments, such as internal medicine, surgery, or obstetrics and gynecology. The system of medical education was essentially an apprenticeship, where as resident doctors, we received one-on-one guidance from physicians who were five to ten years post-graduation, gaining a wide range of experience. Resident doctors began their rounds around the time patients woke up, before 7:00 a.m. They would draw blood if necessary, and then the patients would have breakfast. Delaying a patient's meal for a morning blood draw, a practice known as "enshoku," was out of the question. The patients' fixed daily schedules were the top priority. We had to finish documenting our findings from the rounds before our supervising physicians appeared on the ward, so we would frantically organize the medical charts. Then, we would do another round of rounds with our supervisors, who would raise further issues—or, to put it plainly, scold us. Reflecting on their feedback, we would go to the library and, rubbing our sleepy eyes, study up on what we lacked. In the mornings, we often worked in the outpatient clinic or participated in various examinations, and it was commonplace for our lunch breaks to be delayed. If a particularly strict supervising physician (though he was also the most dedicated) happened to find us having lunch in the cafeteria, he would yell at us in front of patients and their families, "Do you have time to be eating? Get back to the ward, now!" We would quickly finish our meals and return to the wards or the library to study. From the evening onward, there were conferences to study various patients' illnesses. Then, between the patients' dinner and their 9:00 p.m. bedtime, we would conduct a second or third round of examinations, organize and evaluate the day's new data, and formulate future treatment plans. We would then wait for our supervising physicians to return from their outside duties, give them a brief explanation, receive their guidance, and finally finish our day around 10:00 or 11:00 p.m.
It may seem like all we did was work, but that was not the case. Of course, we were young and full of energy back then. Many of us residents would wait until the nurses' evening shift ended around midnight or 1:00 a.m. Since we were at Keio University Hospital, we would all go out drinking or dancing in Roppongi or Akasaka to blow off steam, sometimes not returning until the early morning, only to start our shifts again. I wonder how long we kept up that daily routine. Saturdays and Sundays did not exist for us. And we were on call about twice a week. Looking back now, I'm amazed we were able to keep it up.
They say that for a doctor, stamina is more important than intellect. It's a test of physical endurance. Studying and playing in the brief moments between our busy schedules was our daily routine.
Today, there are no young doctors who endure such a grueling schedule. Their schedules and health are well-managed. They get a day off after being on call. Saturdays and Sundays are also days off. Of course, their workday ends at 5:00 or 6:00 p.m., after which a system is in place to hand over patient care to the doctor on call. The educational system is also becoming well-established. When I think back to the old days, it feels like a different era. The truth is, while I feel a sense of envy, I also have mixed feelings.
(Posted: September 14, 2006)