Global Experience at Keio University

During my rotation in Japan, I had the opportunity to participate in a wide variety of learning experiences that enhanced my understanding of pharmacy practice, healthcare systems, and patient care. This journey not only broadened my academic knowledge but also allowed me to explore different aspects of pharmacy that I had never encountered before.

At Keio University and its affiliated institutions, I observed and engaged in various pharmacy environments, including hospital pharmacies, community pharmacies, and regulatory agencies. One of the most impressive aspects was the integration of advanced technologies into everyday pharmacy practice.

Additionally, I gained insights into the Japanese approach to holistic and patient-centered care. I was introduced to Kampo medicine and observed how pharmacists collaborate closely with other healthcare professionals to provide customized care, especially for elderly patients and those with complex conditions. These experiences inspired me to think more deeply about the role of pharmacists beyond dispensing, as healthcare providers who actively work to improve patients' quality of life.

What made this internship truly meaningful was the kindness, generosity, and support of everyone I met. I would like to express my heartfelt gratitude to all the professors, pharmacists, and student members at Keio University who shared their expertise, provided thoughtful guidance, and welcomed me warmly. Your mentorship not only broadened my academic perspective but also boosted my confidence to grow as a future pharmacist.

This experience has left a lasting impression on me. The knowledge and skills I have gained here will be highly valuable in my future career in Thailand.

Finally, I sincerely thank the Keio University International Exchange Program for making this opportunity possible. It has truly been a valuable experience both professionally and personally, and I am deeply grateful to have been part of it.

My time in Japan began with a week filled with enriching tours and site visits that provided an excellent foundation for everything that followed. I had the chance to learn about Japan's pharmaceutical regulatory framework through visits to key institutions like the National Institute of Health Sciences (NIHS), and to explore the long-standing tradition of Kampo medicine, which remains a respected and widely used part of healthcare in Japan. I also visited a Keio University-affiliated community pharmacy, where I saw how pharmacists operate and how personalized services, such as Kampo preparation and single-dose packaging, are integral to patient care. Following this, I spent a week in the Keio University School of Pharmacy's research laboratory, where I joined a team working in Molecular Oncological Pharmacy. It was truly inspiring to witness the complexity, rigor, and quality of pharmaceutical research in Japan. The students welcomed me with warmth and enthusiasm, often taking me out to eat and share in their favorite local foods, which became a wonderful part of my cultural immersion. Next, I had the opportunity to join the clinical team at Juntendo University Hospital, where I participated in the care of patients in the pediatric department. I was able to contribute to discussions by reviewing international treatment guidelines, helping with patient interviews, and exploring options for optimizing therapy. It was an incredible learning experience that strengthened both my clinical reasoning and confidence as a future pharmacist. I also spent time at Kyoto University Hospital and Keio University Hospital, where I observed hospital pharmacy operations and the specific roles pharmacists play in Japan's highly coordinated healthcare teams. These experiences highlighted both the precision of Japan's pharmaceutical systems and the unique structure of the pharmacist's role in inpatient care compared to the U.S. Overall, my time in Japan was profoundly educational and personally meaningful. I gained a broader understanding of pharmacy practice, research, and healthcare policy, while also forming lasting friendships and memories. I'm deeply grateful for the opportunity and hope to return to Japan in the future to continue learning and contributing!

During my six-week international APPE rotation in Japan, I trained at Keio, Juntendo, and Kyoto University Hospitals, several community pharmacies, and a biochemistry research lab. This diverse experience gave me a broad perspective on pharmacy practice, traditional medicine, and scientific research in Japan.
In hospitals, I observed organized, safety-focused pharmacy operations. Pharmacists were central to medication verification, sterile compounding, chemotherapy preparation, and therapeutic monitoring. Automation and barcode systems enhanced efficiency, and I was struck by the strong interprofessional collaboration and trust in pharmacists to ensure patient safety.
At community pharmacies, I saw pharmacists deliver respectful, patient-centered counseling; often with handwritten instructions and visual aids. They were highly accessible and served as trusted healthcare providers, with a clear emphasis on privacy and professionalism. A highlight was learning about Kampo, Japan's traditional herbal medicine. I observed pharmacists preparing and counseling on Kampo formulations, deepening my appreciation for culturally integrated, holistic care.
In the biochemistry lab, I worked on a gut immunity project involving M cells and Peyer's patches, using cell markers and gating to quantify immune cells. I also engaged with students who shared their research, which strengthened my understanding of collaborative lab science.
Beyond academics, I adapted to Japan's culture and lifestyle, built meaningful relationships, and fully immersed myself through daily life and shared living experiences. This rotation reinforced my commitment to patient-centered care and broadened my view of pharmacy's global impact. I'm grateful for the opportunity to learn from such a thoughtful and innovative healthcare system.

From May to June 2025, I had the invaluable opportunity to participate in a six-week pharmacy rotation in Japan through Keio University. This international experience provided me with invaluable clinical, research, and cultural learning opportunities, while allowing me to explore the similarities and differences between the U.S. and Japanese pharmacy systems. The first week was largely introductory, filled with site visits and lectures. We toured several facilities including Keio University Hospital, Tsuruha Drugstore, the Tsumura Kampo Museum, and the National Institute of Health Sciences. These visits offered a broad overview of how traditional Kampo medicine and modern clinical pharmacy coexist in Japan and set the stage for the more immersive experiences to come. The second week was one of the most enriching parts of the rotation, as I had the opportunity to work in both wet and dry lab of Dr.Ohtani's lab. In the wet lab, under the guidance of Dr.Akioshi, I conducted experiments examining CYP enzyme metabolism, which helped reinforce my understanding of drug metabolism in a hands-on setting. The dry lab allowed me to engage with other lab members' projects and share my own research from the University of Iowa, fostering meaningful academic exchange. The third week consisted of observational visits to clinical and regulatory institutions, such as Juntendo University Nerima Hospital, the PMDA, and the National Cancer Center Hospital. These visits gave me insight into Japan's healthcare structure, especially the integration of traditional and modern practices and the country's robust regulatory framework. The fourth week marked the clinical core of my rotation. I was placed in the Neurology department at Juntendo University Hospital and paired with a second-year resident named Misaki. Each morning, we reviewed medication lists and rounded on patients, providing medication guidance and follow-up. Although I couldn't communicate directly with patients due to the language barrier, Misaki served as a helpful translator, ensuring I remained engaged. I had the chance to follow four different patient cases, which I presented in a final case discussion comparing clinical approaches in Japan and the U.S. This immersive experience greatly deepened my understanding of inpatient pharmacy and clinical collaboration. The last two week involved wrap-up activities, including regulatory discussion forums, joint clinical case studies with Keio students, and training in pharmacokinetics and pharmacometrics. These sessions tied together the clinical, research, and policy components of the rotation and reinforced the importance of interdisciplinary thinking in pharmacy practice. In summary, this rotation was a formative experience that expanded my clinical and scientific knowledge while strengthening my global perspective on pharmacy. I'm incredibly grateful for the opportunity to learn from such dedicated professionals and peers, and I hope to carry these lessons forward into both my research and future patient care.

I had the incredible opportunity to spend six weeks in Tokyo, Japan, with the generous support and kindness of so many people at Keio University and beyond. It was truly a once-in-a-lifetime experience--one that I believe could even change the course of my life. Though six weeks may seem like a short time, it was long enough for me to visit a variety of institutions, including hospitals and pharmacies, and to gain a deeper understanding of Japan both culturally and systemically. More than just broadening my perspective, this experience allowed me to form meaningful connections--relationships that I could never have made anywhere else, and ones that I will always treasure. Japan's healthcare and pharmacy education systems differ in many ways from those in the U.S. For example, the pharmacy curriculum in Japan has a different structure, and Keio University stands out with its strong emphasis on research, which contrasts with the practice-oriented training often found in the U.S. One particularly memorable part of my experience was learning about Kampo, a traditional Japanese herbal medicine. Since herbal medicine isn't commonly used in the U.S., visiting places like the Tsumura Kampo Museum and observing the dispensing of Kampo medicines in pharmacies gave me a rare opportunity to engage with this field firsthand. I am deeply grateful to the professors who supported this program and to the students who shared this journey with me. If given the chance, I would love to return to Japan in the future.

This month-long program at Keio University provided comprehensive exposure to Japanese healthcare and pharmaceutical practice. In hospital settings, I observed central inpatient pharmacists manage responsible for drug distribution and clinical pharmacists provide direct patient care as part of interdisciplinary teams. Drug information specialists handled complex pharmacotherapy consultations, while infectious disease pharmacists demonstrated expertise in antimicrobial stewardship. In the community setting we visited Health Support Pharmacies that go beyond typical services to provide oral health screenings, medication therapy management, and chronic disease support services. These pharmacies integrate Kampo medicine seamlessly, with pharmacists demonstrating deep knowledge of traditional herbal formulations alongside conventional treatments. Our visit to the Pharmaceuticals and Medical Devices Agency (PMDA) provided insight into Japan's regulatory framework, including rigorous approval processes for both conventional and traditional medicines and their comprehensive post-marketing surveillance systems.

It was inspiring to witness the seamless integration of Kampo medicine with Western pharmaceuticals throughout Japan's healthcare system. From PMDA's scientific oversight treating both traditional and modern medicines with equal rigor to clinical practice where practitioners confidently prescribe integrated approaches, Japan demonstrates how evidence-based integrative medicine functions within modern healthcare frameworks. This experience solidified my commitment to incorporating integrative medicine into future practice, believing it essential for optimal patient care. Equally impressive was Japan's universal healthcare system delivering high-quality, accessible care to their vast population through efficient resource allocation and care coordination, demonstrating that universal coverage and healthcare excellence are complementary goals.

The most transformative aspect was the incredible hospitality from Keio University students and faculty, who went beyond academic collaboration to organize cultural activities ensuring a truly unique immersion. From shared meals and cultural site visits to participation in traditional festivals, these experiences provided deep cultural understanding that enhanced our healthcare learning context. The genuine friendships formed created meaningful cultural exchange opportunities extending well beyond the classroom. This experience provided exceptional professional education and profound personal growth through cultural immersion and human connections. The comprehensive pharmaceutical education, exposure to innovative integrative medicine practices, and Japan's efficient healthcare system has fundamentally shaped my vision for future pharmacy practice. I am so grateful for the extraordinary hospitality that transformed this academic exchange into a life-changing experience that will guide my approach to patient care throughout my career.

My global Advanced Pharmacy Practice Experience (APPE) at Keio University in Japan was a transformative journey that deepened my understanding of pharmacy practice through a global lens. Over the course of the rotation, I had the opportunity to engage with healthcare professionals across hospitals, community pharmacies, academic institutions, and regulatory agencies. This diverse exposure allowed me to explore the cultural, clinical, and technological dimensions of Japanese pharmacy practice. Here are some highlights from my rotation!

◼️Cultural Competency and Community Engagement
One of the most impactful aspects of my experience was witnessing Japan's community-first approach to healthcare. Pharmacists play a vital role in home visits, neighborhood wards, and patient education, fostering strong relationships and continuity of care. I was especially moved by the respect and infrastructure dedicated to elderly care, which reflects Japan's cultural values and holistic approach to aging.

◼️Global Health Perspective
Through lectures and site visits, I gained insight into Japan's universal healthcare system and its emphasis on accessibility and public health. The challenges Japan faces--particularly in caring for an aging population--mirror those in many developed countries, offering valuable lessons in policy and system design.

◼️Medication Use and Safety
Japan's cautious approach to medication regulation and its integration of traditional Kampo medicine alongside Western pharmacotherapy stood out. I was impressed by the use of advanced technologies such as robotics and AI in pharmacy operations, which enhance safety and efficiency. Visits to the Pharmaceuticals and Medical Devices Agency (PMDA) and academic institutions highlighted Japan's commitment to culturally relevant pharmacovigilance and innovation.

◼️Role of the Pharmacist
The rotation showcased the evolving role of pharmacists in Japan, especially in Health Support Pharmacies where pharmacists are empowered to provide chronic disease management and public health services. I also observed the potential for growth in inpatient pharmacy roles, particularly in clinical research and multidisciplinary collaboration.

◼️Research and Education
Keio University's emphasis on original research and its integration into pharmacy education was inspiring. I had the privilege of working in the Integrative Clinical Pharmacology Laboratory, where I experienced a collaborative and mentorship-driven environment. The focus on population-specific research reinforced the importance of culturally attuned evidence-based practice.

Overall, this experience has reshaped my perspective on pharmacy practice and global health. The hospitality of Keio University students and faculty, the thoughtfully designed rotations, and the cultural immersion made this APPE both professionally enriching and personally memorable. I am grateful for the opportunity and look forward to applying these insights in my future career.
どうもありがとうございます！

While it was eye-opening to see the similarities and differences between pharmacy practice in Japan and the U.S., my favorite part about this rotation has to be the students I encountered at Keio University.
Japanese culture is unlike anything I have ever experienced before, so it did not go unnoticed that the students went above and beyond to ensure that Megan and I felt comfortable.

Our global network has really expanded, and it is comforting to know that we have a family that will welcome us with open arms if we ever go back to Japan!

My favorite part of our global rotation in Japan was learning about Kampo.
Herbal medicine is not typically included in the pharmacy school curriculum in the United States.
The depth of knowledge and tradition embedded in these techniques provided a unique perspective on health and wellness.

My rotation at Keio University will be an unforgettable experience that will stay with me forever. During this time, I immersed myself in Japanese culture and gained a comprehensive understanding of Japanese medicine and health practices. And fortunately, I made numerous international connections and lifelong friendships with Keio University students, faculty, and many pharmacists in Tokyo and Kyoto.

The opportunities I encountered during this rotation exceeded my expectations. I participated in wet lab research, working with expensive machinery, live cell cultures, and mice specimens. It was truly inspiring to see the individual research being conducted by Keio University Students and their dedication to expanding their knowledge and understanding of medication. I engaged in activities related to Traditional Japanese Medicine, or Kampo Medicine. Visiting the Tsumura Kampo Museum, attending Kampo lectures and Kampo clinic, and mixing Kampo Decoctions in the pharmacy has provided me with a solid foundational understanding of Kampo medicine. With this knowledge, I look forward to educating American pharmacists about the utilization of herbal medicine and hope to see its integration into American medical practice in the near future. I was also fortunate to visit a variety of hospitals, community pharmacies, and pharmaceutical companies allowing me to gain a well-rounded understanding of different pharmacy practices in Japan.

Having the experience of learning another country's culture and medical practices is invaluable and will profoundly impact my future career. This experience has equipped me with advanced knowledge of pharmacy practice and the diverse perspective necessary to advance pharmaceutical practices in the United States. I am so grateful to have had this opportunity with Keio University which has provided me with a culturally enhancing and remarkably diverse international rotation!

I had an incredible and memorable experience immersed in Japan's unique and vibrant culture! The students of Keio University showed me different aspects of Japanese life and traditions. They took me beyond the usual tourist areas and showed me the intricate beauties of Japan through a local's perspective. This internship included an enriching cultural exchange that left a lasting impact on me and deepened my love for Japanese culture!

As a student from the University of Florida's College of Pharmacy in America, I was given the opportunity to attend an APPE rotation at Keio University's Faculty of Pharmacy. There I experienced many aspects of Japanese pharmacy practice ranging from clinical to retail. I got to witness Japanese pharmaceutical research first-hand, something not commonly found in pharmacy in America.

During my first week at Keio, I was welcomed in the pharmacodynamics lab. In America, we do not have research embedded into our curriculum so this was a unique experience. Throughout the week, I shadowed various students to get an extract of their experiments. We worked on various techniques and tools such as liquid spectrum chromatography, gel electrophoresis, DNA isolation, and tissue sampling.

During the hospital aspect, I noticed that a lot of the medication preparation was automated by pharmaceutical machineries. In America, we rely on technicians to do a lot of medication dispensing. In Japan, there are no technicians with pharmacists instead doing all the duties, but seem to still have less autonomy compared to pharmacists in America. There were many divisions of the pharmacy teams in the hospital. They focus on a more collaborative approach with the rest of the healthcare team with specific roles.

I learned about Japan's universal health care system. This insurance is different compared to America's private insurance which faces high costs leading to a lot of income disparities. Since Japan's healthcare is controlled by the government, there is a percentage for copay and a cap on the deductible for major treatments. This makes it so the healthcare is more affordable for its civilians where I surprisingly saw many patients pay for their hospital visits the same day.

Keio University included retail pharmacies for me to explore in Japan. I also noticed that retail pharmacies did not have any technicians which is vastly different to the American model of 1 pharmacist and 3 technicians. They all had Kampo medicine stocked and was very popular among the drugs of choice in the patients. There was a lot of single dose packaging that had the time and when to take the medications which is different because in America we just give the patient a whole bottle and do not separate. Pharmacists were very involved in the consultation of each drug provided to the patient in order to prevent any adverse outcomes.

Japan's regulatory affairs are similar yet distinct from America. The National Institute of Health Sciences in Japan conducts testing, research, and studies towards the proper evaluation of the quality, safety, and efficacy of pharmaceutical products, foods and numerous chemicals in the living environment. Their major responsibilities include extensive testing and research to ensure quality, efficacy, and safety of chemical substances that are closely related to people's lives.

Another interesting concept was Kampo medicine. I learned that Kampo medicine had its roots from ancient China that was introduced to Japan in around the 5th to 6th century. The museum was very interesting as I got to see the manufacturing process of the plant. At the museum, I got to see materials for crude drugs being delivered to the warehouse and processed to be sent out for distribution.

This APPE rotation was an extremely invaluable and unique experience where I had the chance to learn about Japanese pharmacy practice. The students and faculty were extremely helpful and kind. I am thankful for this opportunity and hope to return to Japan in the near future!

My internship experience at Keio University has been incredibly valuable to me as a pharmacy student from Khon Kaen University in Thailand. Encountering new things here has made me very happy and eager to learn. The first significant aspect was meeting the students from Keio University. Each of them was kind-hearted and considerate, assisting me in every way I needed. They also became good friends, taking me to various places in Japan and teaching me about Japanese culture and language. This experience has fostered a lasting friendship.

Additionally, interning at various hospitals and pharmacies in Japan allowed me to see the advanced technology used in the country's medical field, which I hope to apply in Thailand. I also greatly admire Keio University's educational system, especially the division of students into different labs for research paper projects, allowing them to choose their areas of interest. This is something I would love to see implemented in the Faculty of Pharmacy in Thailand, as it not only provides hands-on lab and research experience but also fosters positive interactions within the lab environment.

Lastly, I find this international internship exchange program to be excellent. If given the opportunity, I would love to participate again in the future. I also aspire to pursue further studies at Keio University and possibly work in Japan.

I would have deeply regretted not coming to Japan for the internship abroad program. During my stay as an exchange student, I have been fortunate to immerse myself in the Japanese academic environment by interacting with students, faculty, and professionals. I also had the valuable opportunity to observe the workflow in the pharmacy departments across various hospitals and community pharmacies.

At the hospital, I attended multidisciplinary team conferences and engaged in insightful discussions with the infection control team about antibiotic stewardship. In the community pharmacies, I observed the significant role of Kampo medicine, which is akin to Western medication.

Furthermore, I was privileged to participate in an intensive course on PK/PD/PMx at the Tonomachi campus, where I performed hands-on experiments. This opportunity allowed me to gain a better understanding of dose adjustment to achieve the targeted therapeutic range of medicines. Engaging with the Drug Informatics laboratory, I learned to utilize the FAERs online database and analyze information using the SAS program, with Mari's invaluable assistance. This experience underscored the significance of online databases in the pharmaceutical field.

I also had the chance to build a professional network by attending workshops and conferences, learning from experts, and gaining insights into the latest trends in pharmacy. On weekends, AAPE students kindly escorted us to various tourist destinations such as Asakusa, Enoshima Island, Odaiba City, Kamakura, and Hakone. They thoughtfully tailored the travel program to suit both my and my friend's interests.

Living and studying in a foreign country has helped me grow through challenges and opportunities, making me more adaptable, independent, and resilient.

To the AAPE and Keio students, I would like to express my deepest gratitude. You have been exceptional hosts and dear friends. Thank you so much for your warm welcome.

Take whatever you believe happens while studying abroad and toss it away. No matter how much research I completed, my experience in Tokyo, Japan was something I could not have been prepared for. Keio University is a wonderful university filled with generous staff and students. From the moment I arrived, to the time I left, there was always someone who offered help. I got to explore the culture, history and taste the amazing food in just one month.

There are several differences between the United States compared to Japan when it involves pharmacy practice. From the process of how the patients receive care and treatment to who is completing tasks and providing that care. The education students go through is held by a high standard. Student pharmacists must complete four years of education, one year of on-site training, and one year of research prior to completing Pharmacy School. Every student I spoke with was extremely kind and intelligent with big dreams that I know each will accomplish.

One of the most fascinating things I learned during my time was the focus on Kampo medication. Japanese Kampo Medicine is a traditional herbal alternative that has been integrated into their healthcare system. There are several departments and groups of researchers that are working on clinical trials that will support the use of Kampo medicine world-wide. In addition to learning and seeing first-hand how Kampo is used in Japan's community, I also got to see student pharmacists work on their research, visit several healthcare facilities, and participate in educational events.

This was a valuable opportunity that allowed me to compare different perspectives and expand my knowledge about pharmacy practice in a different part of the world. I look forward to coming back to Japan in the future and seeing what other innovations are made!

Firstly, I would like to say that my memories at Keio university are full of impressions and appreciation which I could not forget. I have been interned in clinical rotation at Keio university for a total of 6 weeks. I have experience in various fields more than I expected such as case studies practice in campus, hospitals, laboratories, community pharmacies, museums, etc. Every single place that I visited gave me valuable experiences especially because of the well-organized system and the high technological machine that included in every part of the work. Apart from the honor opportunity that I gained a lot of knowledge and practices, I also found really good friends from Keio university. I feel so grateful to know them. They not only helped me when I had problems, but also being like my close friend who always took care of me. Moreover, teachers and people at Keio are all so kind. So, there is no day I feel lonely.
I also attached photos I took on my first and last day at Keio with this message.