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研修医日記/医療法人社団 札幌皮膚病理診断科
Sapporo Dermatopathology Institute
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Gayle Opada/November diary
11 months have passed since I first arrived in Japan. My journey here did not just made me a better medical doctor but made me a better person in general. Aside from learning DERMATOPATHOLOGY, which is the major reason why I’m here, I have learned a lot... from handling my finances to dealing with other people’s cultural differences. 

Dermatopathology and Japan. It’s a dream come true for me. But it’s not all sushi and shu creams. I had my share of disappointments and frustrations as well. My major frustration is the language barrier. I should have learned more if I understood all those conferences and CPC that I have attended. Although I have studied “nihongo” before I came here, it was not enough. I also do not understand some people’s attitudes. Again, it could be cultural differences. I have learned to be more understanding and be more patient. Patient enough not to do or say something that might ruin a good relationship. Patient enough to survive my stay here in Japan. Living out of my comfort zone is a big challenge. I have to adjust with everything, the weather included. I have to familiarize myself with the new surroundings, the foreign language, the unique culture and the new people I met. 

But of course, it’s not just all frustrations and disappointments. There are actually a lot of things to thank for. I’m so glad and honored to be a trainee of Sapporo Dermatopathology Institute (SDPI). After almost a year of training, I could finally say that I’m confident enough to practice on my own when I go back to my country, my beloved Philippines. When I left my country, I still do not know how to diagnose some of the inflammatory diseases and tumors. I don’t even know what Spiradenoma is. I can not differentiate Follicular cyst, Infundibular type from the Isthmus type and Dilated pore (Winer). Desmoplastic trichoepithelioma from Syringoma. Trichoblastoma from BCC. Eccrine mixed tumor of the skin from apocrine mixed tumor of the skin. My training here exposed me to a lot of common cases and rare cases as well. I couldn’t believe how much knowledge I’ve gained in just one year. I will be going back with confidence that I can now diagnose on my own. Although one year is not enough to learn everything in Dermatopathology, continued learning can still be achieved with the help of SDPI’s virtual slides. 

I also greatly appreciate those people who in some way helped me translate the words that I couldn’t understand so I may understand. I know that’s it’s very hard for all of us to speak in english since it is not our native language but at least we all tried. 

I would like to thank Kimura sensei for allowing me to train in SDPI. It is a great honor and privilege to be trained under his guidance. And thank you for all the sponsors who gave financial assistance for my fellowship training. It is greatly appreciated. I also would like to thank Fukumoto sensei and Anan sensei. Despite them very busy, they still find time to teach us and give us interesting and challenging cases. I always look forward to our afternoon session of “snap-shot diagnosis” with Fukumoto sensei. It helped me with my diagnosing skills as well as introduce me to new cases I have never seen before. And to the staff, you have all been very nice and helpful. Some would really go out of their way to help me. Thank you all very much. 

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Gayle Opada/October Diary
It’s been 10 months, or let me say, it’s JUST 10 months since I arrived here in Sapporo. I may not learn EVERYTHING but I am trying my best to learn as much as I can to equip myself with knowledge that I may be able to use and share when I go back to the Philippines.


This month, I started writing a case report entitled “Viral Verruca with large atypical CD30 - positive lymphoid cells”. I presented this case last August 31 during the 93rd Hokkaido Medical Congress, in english. 


I have also encountered some new and interesting cases in the institute which I have never seen before and have only read on textbooks. One of it is Pacinian Perineural Cell Fibroma (PPCF) also known as Sclerosing or Fibrous Perineuroma. Sclerosing Perineuroma if it is located in the subcutaneous tissue and Fibrous Perineuroma if it is located in the dermis. It is EMA (Epithelial Membrane Antigen) positive. 

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Daily living:

I have a new housemate and friend, Yoko Momose, who is also a trainee of SIDP. I enjoyed Japan more and learned more of the cultures when she arrived. We cook together  our food for dinner which is mostly japanese foods. I even learned how to set the table and  which side should I place the soup and the rice.


Both of us are Macbook users and we are so amazed by the screensaver that featured the Blue pond. So, we decided to visit the Blue pond in Biei.  And made a screensaver of our own.


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Gayle Opada / September diary
Learning experience:

My first time to see a GLUMERULOID HEMANGIOMA. It could be part of POEMS syndrome which is an acronym for Polyneuropathy, Organomegaly, Endocrinopathy/Edema, Monoclonal protein and Skin abnormalities. Glumeroloid hemangioma is believed to be a reactive process rather than a neoplastic process. Small capillaries protrude into a dilated vascular space resembling a “glomerulus” with plump endothelial cells having PAS-positive hyaline globules containing immunoglobulins.

Glumeruloid hemangioma (PAS postive)
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Daily living:

This month is my birthday month. I celebrated it with friends. 
Autumn has started and the temperature is also starting to drop. A little difficult for me to move now. Sapporo celebrated the start of autumn with “autumn festival” in Odori Park where different kinds of ramen were served. Perfect for the cool weather.

Autumn Fest
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Miso-based Ramen
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Gayle Opada / August Diary
A challenging month. I was busy preparing my case presentation entitled, “Viral Verruca with CD30-positive Lymphoid cells” for the whole month of August and finally presented it last August 31, 2013 during the 93rd Hokkaido Medical Congress in Sapporo University. The feeling was liberating. I can now breathe. :-)

August is the last month of Yo Kaku as a trainee in Sapporo Dermatopathology Institute so we had a farewell party for him at the Sapporo Beer Garden. As always, the lamb taste so good. Oishi.


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Gayle Opada / July diary
Nothing much to say really. My study habit is still the same. I am trying to read all the Ackerman books that are in the collection of Kimura sensei. I hope to finish all of it before I go back to the Philippines which is quiet difficult to achieve but I’m crossing my fingers. I think Ackerman books are well organized. They have different books for different adnexal neoplasms and for a “scatterbrain” like me, I think I need to read those kind of books.

New cases that I have seen this month are Hidradenoma papilliferum, Eccrine angiomatous hyperplasia (EAH) and Superficial acral fibromyxoma.

I am also preparing a case presentation entitled “Viral verruca with large atypical CD30 positive lymphoid cells”. Thanks to all my sensei, Dr. Kimura, Dr. Anan and Dr. Fukumoto, and to my colleague, Yo Kaku, for all the help. I am almost done.

Quiet adjusted by the life here in Sapporo. Met many Filipino friends who are having their PhD in Hokkaido University. All of them are in the field of science like chemistry, biochemistry, chemical engineering, and microbiology. I am so surprised to know how fluent they speak and read Nihonggo. I wish I could do that too.

I experienced my first Marine Day (海の日, Umi no Hi), Cherry picking at Niki, Hanabi taikai and wearing Yukata for summer festival this month. Lots of fun!

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