Dr. Simon Downes is a psychologist and medical student who has been in living in Japan since 1992. He interviews Japanese doctors to learn more about medical practice in this country.

Noriko Noguchi, MD, is an OB/GYN physician in Japan.

Simon R. Downes: Is there a need for more OB/GYN physicians in Japan? Why would students not choose this specialty?

Yes, there is a great need. Students do not choose this specialty because it is very hard. Deliveries of babies, in particular, are difficult to predict, so students find themselves often staying overnight in the hospital. Compared to other specialties, we spend more time staying overnight in the hospital.

When do students decide their specialty?

First, a resident must rotate through all of the specialties for two years. We average three months per rotation, but it depends on the hospital. Then, the student may choose a specialty.

What made you chose this specialty?

When I was a med student and resident we were able to see many departments. I was interested in this specialty for two reasons. First, we can take care of women throughout their whole life. Second, our specialty includes many sub-specialties. Therefore, we can handle many issues within our department. For example, we can do surgeries such as cesareans, hysterectomies, cancer operations, myomectomies, etc. The patient does not need to change to a different department.

Please tell me more about the sub-specialties.

The four main specialties within OB/GYN are Cancer, Obstetrics, Endocrinology and Women’s health. While most OB/GYNs can do all of these, we chose one area. In my case, while I rotated in general surgery, and learned how to do these types of surgeries, I focused on endocrinology.

In conclusion, please summarize why you chose this specialty.

OB/GYN is a specialty that covers all areas, from birth to death…we take care of all women’s health needs from internal medicine to surgery – that is why I love this specialty!

Thank you, Dr. Noguchi.

I am afraid I might have a social anxiety disorder. I am not a very timid person, but I feel uncomfortable if I am the center of attention, such as speaking in front of a large group. I turn bright red and begin sweating and I can’t keep eye contact. It doesn’t happen when I am around friends. Because of that, I try to avoid those types of situations. My mom was diagnosed with OCD/schizophrenia. Is it a possibility that I can have this?

Hello and thank you for your question about whether you have either/both social anxiety disorder or OCD/schizophrenia. Before I answer your question, I would like to say that while I can provide you with essential information, to be properly diagnosed, you will need to see a psychologist or a psychiatrist.

While some psychiatrists will be more likely to prescribe medication, psychologists tend to prefer non-pharmacological treatments such as cognitive behavior therapy (see below).

That being said, there is a great deal that you can learn and do without visiting a doctor.First, let’s talk about social anxiety disorder. 

If you are diagnosed with social anxiety disorder, your doctor may prescribe either therapy only such as cognitive behavioral therapy, or drugs, or a combination. 

Example drugs used are selective serotonin reuptake inhibitors (SSRIs) such as Paroxetine (Paxil) or Sertraline (Zoloft). However, drugs are for very persistent social anxiety.

I prepared a number of links and videos that will help you understand this disorder more. 

1. This is what psychiatrists and psychologists look at to decide whether you fit into their category for diagnosis: DSM-5 Definition of Social Anxiety Disorder

2. Mayo Clinic on social anxiety disorder basics and treatment

VIDEO LINKS

1. Professional definition of social anxiety disorder and treatments

2. Types of social anxiety

By your own definition – you are not a very timid person. Therefore it may be possible that you do not have a severe form of social anxiety. It would be a good thing for you to consider trying cognitive behavioral therapy, which can be offered by psychologists (online, or in person). Another way to tackle this would be to search for video links on youtube that deal with the subject and see which works for you best. If none do, then you will need to see a professional.

Next, let’s consider OCD/schizophrenia. While OCD and schizophrenia are two distinct disorders, recent research has described them as being related. In addition, there seems to be some evidence that it runs in families.

1. Obsessive Compulsive Disorder Runs in Families

2. OCD Patients & Their Kids at Greater Risk of Schizophrenia By Traci Pedersen
~ 1 min read

Again, to properly diagnose this, you will need to visit a professional. However, I would like to share with you a video series that I think offers excellent advice and techniques on dealing with OCD.

Cognitive Behavioral Therapy for OCD (set of 15 videos)

Thank you for your question.