Cross-cultural communication （28）　

28）Visitor from the United States
Ayako looked completely Caucasian, with almost no Asian features. However, as her first name suggests, her mother was Japanese and her father was American. She first contacted me via email. - I majored in chemistry and Japanese at university in the US. I am currently living in Osaka, teaching English. In the near future, I would like to go to medical school in the US. I heard from a friend of a friend that Dr. Kido is also fluent in English and teaches medical students and residents at his clinic. I am not a medical student, but would it be possible for me to join them?

There was no reason to refuse, so I invited her to come. I thought her Japanese would be no problem at all, as she was Japanese, had majored in Japanese at university, and had lived in Japan for six months on her own. However, to my surprise, Ayako's Japanese was very halting, and perhaps because of this, she was shy and reserved for an American. She spoke Japanese with the clinic staff, but she begged to speak English with me.

For the next six months until she returned to the US, Ayako visited Kido Clinic once a week. During that time, she also took the M-CAT exam to gain admission to medical school in the US. As you might expect, she took a break from her observation at Kido Clinic for the month before the exam to study, and she also reduced the amount of work she did as an English teacher. The M-CAT is held several times a year, and it is possible to take the test from anywhere in the world using the internet. Even in the US, getting into medical school is difficult, and it seems that you have to get a certain score on the M-CAT in order to be granted permission for an interview. She said that she had graduated from university over a year ago and wasn't very confident, but when she came to visit the clinic after taking the test, she had a big smile on her face and reported that she had scored satisfactorily.

After successfully completing the M-CAT exam, her motivation for medicine increased even more, and she would always send me questions by email the day after she came to visit. These were very thought-provoking and precise questions, including ones about how patients express themselves in Japanese and about Japanese customs. She also started to come with me on house calls, and although she was a little confused by the housing situation in Japan, which was so different from her home country, she enjoyed it.

As such a bright and intelligent person, I felt a little guilty about having her observe Japanese medical practice, where it is not uncommon for doctors to see 50 to 60 patients in a morning, which is hard to believe from an international perspective. However, she was well aware of the situation and praised the good points of Japanese medical care, such as the good access and low cost of medical care.

On the last day of her visit, she brought the staff at the clinic some homemade cookies. She was sent off by all the staff and returned to her home country.
A few months later, I received an email asking for a letter of recommendation for a medical school interview. The email also included a personal statement written by Ayako herself. It was written in elegant English and expressed her confidence and passion for medicine. I hesitated to write the letter of recommendation, thinking that it would be difficult to compare it with her English, but I managed to finish it. It was a single A4 sheet that emphasized her ability to gather information and adapt to life in a foreign country.

Almost a year after I sent the letter of recommendation, I received an email from Ayako telling me that she had been accepted into medical school. I was relieved and happy to hear the news, and I sent her a reply email congratulating her, thinking that my clumsy letter of recommendation had been of some use.
I have been secretly hoping that she will take the Japanese National Medical Practitioners Qualifying Examination after graduating from medical school.

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