Cross-cultural communication （99）　

99) Making Money with Cross-cultural communication
The title of this article may seem a little off-putting, but it's not about studying a foreign language or other different culture with the aim of making money. However, indirectly, it is my own experience that if you are interested in different cultures and maintain that interest for a long time, you can make a little money.

Let's start with Episode 1.
I think I've written several times in this blog that I had been aiming to study abroad in the US for residency training since I entered medical school. I also wrote about how I passed the exam, Educational Commission for Foreign Medical Graduate while I was still a student, having attended an English language school three times a week after classes. After graduating, I undertook training in the 3rd department of Internal Medicine at my alma mater, which had the largest number of doctors having studied abroad in the United States. As you would expect, the 3rd department of Internal Medicine had many doctors who were keen to study, and in addition to the journal club (a meeting to read and discuss the latest medical papers) held once a week in the department, there was also a voluntary journal club held once a week.

The textbook used at the time was the New England Journal of Medicine (NEJM), which is ranked at the top of medical journals worldwide. This was a weekly journal, and even at the time I think the annual subscription fee was around 20,000 yen. As of 2019, it is 38,500 yen. When I was in my second year of residency, a rather unusual notice was published in this journal. It said that if I paid a one-off fee of around 70,000 yen at the time, I could get a life subscription. 40 years ago, 70,000 yen was certainly worth a lot more than it is now, but even as a resident doctor, I had some extra income from weekend on-call work, so it wasn't such an exorbitant price. Without hesitation, I sent the money and started my life-time subscription. At the time, all of my friends in the voluntary journal club and other hard-studying senior doctors had read the notice, and it had become something of a minor incident. However, the number of applications for life-time subscriptions was surprisingly low worldwide. The reason for this is said to be that people suspected that the NEJM was in financial difficulty and that this was a desperate measure to make up for the shortfall. While it is true that this may have been a factor, the NEJM has been delivered faithfully every week for the past 40 years. Even when I was a resident in Brooklyn for three years and when I was running my own practice in Paris for two and a half years, I only had to change my address to have the NEJM delivered to me every week. So, for 41 years from 1978, the year after I graduated, until 2019, I received it for free. If you assume that it costs 30,000 yen per year, that's 1,230,000 yen (minus 70,000 yen?). And even now, the NEJM continues to be one of the world's most highly regarded medical journals.

Next, Episode 2. In 2006, when I was still working as a general practitioner in Osaka, I became a medical advisor for a European airline company. My job was to look after the physical sometimes mental health of the pilots and cabin crew in Japan. As they are basically a young and healthy group, I only hear from them once a month or so, so the remuneration for my work is very small. To make up for this, the contract includes a provision for a round-trip ticket for a couple to travel from Japan to Europe in business class once a year. Unfortunately, when I was a general practitioner at my office, I never got the chance to take a long trip to Europe, so I never got to use this privilege. In 2016, I quit my job as a general practitioner and started working as a physician in charge at a nursing home, which gave me a lot more freedom, so in 2018 I took a week off, and in 2019 ,10 days off and went on a trip to Europe with my wife. There are still so many places in Europe that I want to visit, so I'm thinking of exercising this privilege every year for another 10 years or so. To do that, I need to keep myself in good health and continue to be an advisor to the company. That is why I'm also continuing to study English and French (or rather, as a hobby) every day.

If you continue to be interested in different cultures and, if possible, continue to study multiple foreign languages for many years, you will often be offered lucrative offers and job opportunities with small privileges. Of course, if you only have qualifications in foreign languages, you will have few opportunities, so having a profession with some kind of specialization is almost a prerequisite.

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