Host Institute: Department of Orthopedics and Traumatology B,
Cochin University Teaching Hospital , Paris V
Director: Professor Philippe ANRACT
Staying periods: August 31-October 30, 2006

Name: Akira KIDO, M.D.,Ph D.
Institute: Department of Orthopedic Surgery, Nara Medical University, Nara, Japan

   Since August the 31st, for a period of two months, I have stayed in a department of orthopedics B of Cochin hospital, a university teaching hospital of Paris V, under the direction of Professor Philippe Anract, having an intensive training mainly in a field of musculoskeletal tumor surgery. Previously, lots of fellows stayed here in the Cochin as an exchange fellow of this program of the SoFJO, French-Japanese orthopedic society, have already reported the location, the history, and the outstanding pioneers in the orthopedics who grew up in the Cochin.

   The orthopedic department has two divisions of A and B, sharing a not-specialized field of orthopedics, except tumor surgery. As for tumor surgery, only the division B was in a position. A few week before starting of my stay, Professor Bernard Tomeno, a famous tumor specialist in France, was retired and His young successor, Professor Philippe Anract began driving the orthopedics B. He published many manuscripts in international scientific journals focused on tumors as well as general orthopedics, with high reputation in Paris. I guess this is the first time for him to be an academic host, as a chief, for a exchange fellow; however, he was kind enough to send his oldest son to the airport to pick me up on my arrival, and showed his well understanding on Japanese culture and so on, owning a Honda motorcycle and two Japanese cars, being a holder of black belt in Judo, a traditional martial arts originated from Japan.

   It was quite nice for me that Dr. Bris Ilharreborde, a young leader of residents who stayed in Fukuoka, Japan as an exchange fellow of the SoFJO in 2004, was working in the orthopedics B. He is the best English speaker here, has an experience to stay in the United States for basic research, knows how we Japanese think and behave, and was kind enough to take care of me through my stay. In addition to him, with full of hospitality and friendship, another leader of residents, Dr. MacAntoine Rousseau, and two "Chef de Clinique", Dr. Kamel Ajoy and Dr. Alexandre Milet (he is also a black belt holder of shotokan karate-do) played important role to organize my comfortable stay. Furthermore, Professor Anract arranged me to join every two weeks oncological conference which has held between Curie Institute and Cochin Hospital, to join several operations of Dr Missenard and Prof. Court in Bicetre Hospital and Arago Clinique.

   As well as previous fellows stayed here in the Cochin, I stayed a very small room so called "resident d'orthopedie" on the end of the 5th floor in the Pavillon Ollier. It has been quite hot even in the beginning of September with elongated sunlight from west, thus it was unable to get in before 21:00. As the room was closed to their original ward (for patients with burns), a "maintenance use"-looking stair was required from the 4th floor so that access to the room was not easy. The room was not kept very clean with some reasons. Previous Japanese fellows equipped TV and small cooker to the room on their own expense, probably in order to make this plane room somehow a little more comfortable. Regarding the accommodation, several improvements are apparently required; However, considering the highly expensive costs on everything in Paris, I convinced that it is pleasant to use this kind of lodging facility (originally for former residents) and/or "Salle de Guard "without additional cost.

   "Salle de Guard" is a unique restaurant, especially intended to feed younger residents who are still in their education to be specialized. According to words of Dr. Rousseau, a young leader of residents, there've been traditional local rules to be keep on in this small restaurant, some of which are bizarre or strange. He showed his leadership during lunch especially on Friday with one of the rules, "do not open a wine bottle with corkscrew". These kinds of rules are somehow important for younger generation to keep their friendship and to bring up their attitude to be cooperative, probably, but I am not sure. In this small restaurant, they behave as if they were a big family, which might give strange impression to foreign visitors.

   Here in the Cochin, we have many interesting operative cases almost every day. As a routine, we had a trauma conference at 7:45 every morning in the seminar room, preoperative presentation at 8:00 in the othopedics B in the conference room, and started operation approximately at 8:30. Daily program proceeded very effective without stress. I joined a number of operation cases, mainly tumor cases with Professor Anract, Professor Tomeno or their colleagues. Besides several massive prosthesis for distal femur (Stanmore Implants), total hip replacement (THR) with originally modified trochanteric osteotomy, and accetablar reconstaruction of revison-THR were impressive. On every Tuesday afternoon and Wednesday morning, I have joined Professor Tomeno's out patients clinic (OPC), and observed many patients with long follow-up period.

   Regarding communication problems, it was not much severe than I expected. Generally, French doctor does not speak English very well. However, to some extends, even co-medical staff understands English, and a few medical doctors and students speak English fluently. In my opinion, we Japanese fellows have confronted less number of problems on communication than French fellows would have in Japan. In order to smooth communication for joining operation, however, we have to learn much more French domestic words and their usage, especially about names of operative tools like "ecarteur de Faraboeuf", "pince a discequer a griif", or "pince de Alstead".

   Among all, Professors Anract and Tomeno, his young colleagues and co-medical staffs were quite honest and friendly. I never found a severe problem during all the stay. At the end of this, with increased, lots of new knowledge and professional experience, I would say my stay was successful in the Cochin. Here I would like to thank all the people who cared my exchange fellowship for their time and efforts.