— Johns Hopkins University (JHU), located in Baltimore, Maryland, is renowned for its exceptional research and education and known as one of the world's leading medical schools. You both spent four months studying abroad in research labs at the JHU School of Medicine between July and October 2023. What motivated you to study abroad there?

Miyauchi: I chose to study abroad at JHU because there was a lab there researching the mechanisms of breast cancer invasion and metastasis. I wanted to work in cancer research, but I was also curious about conducting research and pursuing a career abroad. JHU is globally leading the medical field. And, I thought spending four months there would be an incredible opportunity. Since it was part of the Laboratory and Field Studies program, I was able to balance this program and my studies for degree.

Miyake: I have always been very interested in studying abroad. In my first-year seminar, I studied with Prof. Minoru Ko (former professor at the Keio University School of Medicine), who has a company located on the JHU campus. The more I heard about JHU through his stories, the more I wanted to join the JHU study abroad program. So, Prof. Ko was a great help, both at Keio and during my time at JHU.

— Miyauchi-san, what did you study while you were at JHU?

Miyauchi: I was luckily able to work in Dr. Andrew J. Ewald’s lab, where I had hoped to study, focusing on the invasion and metastasis of breast cancer. It’s a large lab with about 15 people, each working on independent research projects. I also got to have a small project of my own, studying the impact of certain immune-related molecules on invasion using a mouse model. A graduate student kindly became my mentor and taughtme experimental techniques and more.

— Were you working with your mentor the whole time?

Miyauchi: No, I was primarily on my own. Every lab member had their own project, so I did preliminary research online before asking them for help with specific techniques. I had discussions with my mentor and biweekly meetings with my PI other professors where I received guidance, but I had to plan everything by myself. Having the autonomy to manage everything on my own was a significant learning experience for me.

— What was the environment in the research lab like?

Miyauchi: It was very open. All of our desks were together in one large room, which encouraged interactions and discussions with people working on different research projects and allowed me to ask for feedback from people other than my mentor as well. I think the openness of the lab really helped me improve my thought processes.

— Miyake-san, what was your lab like?

Miyake: I was in Susan Michaelis’ lab, which studies the premature aging disease Hutchinson-Gilford progeria syndrome (HGPS). It was a small lab with just one postdoc and one graduate student, but the professor was very passionate about involving undergraduates in their research. They welcomed many local university students hoping to study at medical school as interns, so I was able to work and grow with local interns around the same age as me. I was thoroughly impressed by the guidance and leadership in the lab.

— What kind of research did you work on?

Miyake: The initial goal of my research was to conduct a comprehensive analysis of the abnormalities in cells affected by progeria. However, it took a considerable amount of time to cultivate the cells, so I switched to a different project midway and began studying a new protein.

The lab was initially focused on studying proteins in yeast, and in the process, they discovered a new protein implicated in the onset of progeria and premature aging. Recently, there's been evidence suggesting that this protein might be involved in viral defense, and my research ended up focusing on this defensive function.

As a result, by utilizing two different types of experiments—cultured cells and yeast—I was able to acquire a broad range of molecular biology techniques. Similar to what Miyauchi-san mentioned, I was treated like a graduate student, which meant being responsible for a research project and thinking independently about what experiments to conduct. I really connected with Johns Hopkins University's educational philosophy of taking the lead and doing things on your own.

— Miyake-san, what did you learn during your time at JHU?

Miyake: In terms of technical skills, the most significant gain for me was developing the ability to conceptualize experimental setups. I've become better at predicting what might work and, conversely, what might not. When conducting experiments, it's crucial to have a sense of what seems feasible in theory but might pose problems in practice. I think I've acquired a sense for that initial gut feeling.

In terms of research, as I discussed with Miyauchi-san, my time at JHU helped me realize the importance of how we go about formulating our research questions. I get lots of ideas through my daily studies about exploring how something might work, but I’m still inexperienced and not always sure if these questions are necessarily relevant to society.

Being in medical school, I believe we should engage in work that has a meaningful impact on improving health care. Whenever I stumble upon a question, I feel it's critical to consider how important it is and whether I can provide answers using the techniques I have at my disposal. At JHU, I learned that we need to be deliberate in acquiring knowledge and approach research with these considerations in mind.

— Miyauchi-san, how did you feel after completing your research?

Miyauchi: I learned so many things, but the most significant was developing a sense of planning. Having my own project allowed me to formulate everything independently. I had to think about what results I wanted to achieve by when and then schedule my experiments accordingly.

In my research, I had the opportunity to explore the possibility that the immune molecules I was focusing on could alter the properties of breast cancer cells. In experiments using mouse models, I observed phenomena where invasion was suppressed, even though the quantity of a molecule previously reported to promote invasion was upregulated. It's difficult to interpret, but I feel there's something exciting there.

My four months at JHU were entirely dedicated to research with no classes or extracurricular activities. By examining a range of research papers and reanalyzing data from multiple perspectives, I had been able to come up with the next steps one after another. It was a gratifying process that let me experience the joy of research.

I also learned the value of following my curiosity. Encountering a phenomenon that sparked my curiosity was an opportunity to connect tomy next research question. JHU provided an environment that allowed me to pursue research guided by my curiosity.

— How will this incredible study abroad experience affect what you focus on back at the Keio University School of Medicine?

Miyauchi: My interest has always been in cancer research, and since my second year, I've been part of a lab working on organoids (a technology that allows the cultivation of tissues in three dimensions while maintaining their biological characteristics) under the guidance of Professor Toshiro Sato from the Department of Biochemistry. At JHU, I learned a slightly different method for establishing organoids, which I used in my experiments.

Although I don't have a clearly defined vision yet, I am interested in studying the development of mammary gland by replicating normal breast tissue in vitro. The breast is an organ that undergoes significant changes during puberty, pregnancy, and other life stages. By exploring the process of cellular changes in the mammary gland, I aim to contribute to the understanding of the mechanisms behind cancer development and malignancy.

Miyake: During my time studying abroad, people often asked me why I had chosen to go to medical school. In the US, entering medical school requires an almost unimaginable amount of money, time, and effort, so everyone who chooses this path does so with a very strong will and clear purpose. This experience gave me an opportunity to reflect on why I chose to pursue a career in medicine.

At the core of my motivation is a desire to serve others. That’s something I’ve felt since childhood. Growing up with parents in the restaurant industry, the topic of living a healthier and longer life frequently came up in our household. I am considering engaging in research and medical practice that can prevent lifestyle-related diseases, with the aim of using my knowledge and skills to contribute to society from a healthcare perspective.

— Was it challenging to communicate in English while conducting research at a world-class university?

Miyake: I had never studied abroad before, but I had been preparing for a long time, so I think things went well, both in my research discussions and everyday conversations. JHU brings together a truly diverse range of students from various countries and regions, and they are all exceptionally talented. Of course, they are also fluent in English.
Being on a campus with people from all over the world, we weren’t treated as foreigners—we were part of the mix, and we had a lot of fun talking about American culture.

Miyauchi: I didn’t have any problems with research communication either, as the specialized terminologies are pretty universal. Even if I didn't understand something, someone always kindly explain it to me, so there was no problem.
I chose to stay in the university-affiliated housing and, midway through, switched from a single room to a double, where my roommate was a graduate student of JHU. We often had meals together. Also in the lab, I got to interact with Chinese, European, and Indianstudents , and we chatted and talked together about our identities as international students.

Miyake: Speaking of which, you had to negotiate quite a bit regarding the apartment situation, didn't you?

Miyauchi: Yes, I did. [laughs] I had to talk with the management about all kinds of things, both before moving in and when changing to the double room. My negotiation skills have definitely improved as a result. [laughs]

— How are you feeling now that you have completed your study abroad program?

Miyauchi: Before I knew about this program, I imagined that medical student exchange would be centered around clinical training, like interacting with patients in overseas hospitals. But my four months of research while studying abroad felt more like working than merely observing.

I was able to immerse myself in the research methodologies and approaches of JHU, and I was inspired by the perspectives of the world-leading scientists there. The opportunity to experience firsthand how they work was immensely valuable.

Miyake: I was able to learn how graduate students manage their projects on a daily basis, as well as understand the thoughts and aspirations of students my own age. Gaining insights from a variety of individuals was a significant part of my experience. I also had the opportunity to learn from the research methodologies of postdocs and got to know some of the professors. I also gained an understanding of the workload that is expected of researchers in a lab setting.
I feel like those insights are something you can only truly grasp by being there and engaging directly with people, so it was an incredibly valuable opportunity to have the chance to study at JHU, one of the top medical schools in the US, if not in the world.

— Finally, do you feel like studying abroad changed you in some way?

Miyauchi: Yes, it really broadened my worldview. And as I felt my world expanding, I began to think long and hard about what I would be capable of doing and to reconsider what I should do for my future from scratch.I am really fortunate that I had this opportunity.

Miyake: Studying abroad led me to reflect deeply on the significance of pursuing a career in medicine. As a medical student, I think being overwhelmed with the influx of knowledge led me to lose sight of some things. Being exposed to the world’s top scientists working on the cutting-edge of medicine, I was inspired to clarify my own mission in pursuing medicine. And, of course, I'd love to study abroad again!

*Learn about the Laboratory and Field Studies program on the School of Medicine website*

https://www.med.keio.ac.jp/en/education/undergraduate/professionalism.html