アメリカで学んできたことを生かして
近大ならではの救命システムを確立する

‘Chestnuts in the fire are my favorite,’ said the emergency physician who came from New York, astonished by the hidden strength of Kindai University.

“Getting tired of America yet?”
It was a message that popped up one day on SHINOZAKI Koichiro’s LINE from a senior alumnus at Chiba University Faculty of Medicine. A university in Japan, the senior wrote, was looking for an emergency medicine physician—at the rank of professor. It might not be a bad opportunity, the message added.
SHINOZAKI immediately typed back: “What are you talking about? This is the busiest time of my life.” He had absolutely no intention of returning to a Japanese university.
At the time, he was deeply immersed in research as an Assistant Professor at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. He was already setting his sights on the next step: a potential move to Harvard University.
About a year later, another LINE message arrived.
“It seems they’re still looking for someone. Why don’t you at least hear them out?”
By then, his circumstances had shifted. A research grant he had applied for had been rejected, and the setback made him pause. Perhaps it wouldn’t hurt to listen. He agreed to return briefly to Japan and meet a former high school classmate of his senior colleague. That man was NAKAZAWA Gaku, Chief Professor in the Department of Cardiology at Kindai University Faculty of Medicine.
NAKAZAWA explained candidly that emergency and critical care unit at Kindai University Hospital was critically understaffed and in a precarious state. “It feels like I’m asking you to pull chestnuts out of the fire,” he admitted apologetically.
SHINOZAKI laughed and replied: “Chestnuts from the fire are my favorite.”
It was the moment he decided to return to Japan after ten years abroad.
Looking back, he reflects, “My mentors in the U.S. told me I could win the grant if I applied again the next year. My move to Harvard was nearly finalized. I had come to America and, together with my family, spent ten years in relentless pursuit of this very position. I was just within reach. And yet, I let it all go, tossing it aside, to return to Japan.”
“Strangely, I didn’t feel any regret,” he adds quietly.
“As researchers, we place great value on reproducibility—the idea that if you follow the same steps, you’ll get the same results. But my encounter with Kindai University was not like that. If you ask whether it could happen again, I’d say no. It had no reproducibility. It was like meeting my wife. I can tell you where we met and when we married, but could I meet the same woman and marry her again? I don’t know,” SHINOZAKI says with a laugh. “It felt like destiny.”
He laughed as he said it, but the conviction in his words was unmistakable.

Being an emergency physician who strives to do his best with the personnel and resources at hand suited me well.

SHINOZAKI Koichiro was born in Kamakura City, Kanagawa Prefecture. His father was a psychiatrist who worked at the Ministry of Health, Labour and Welfare. He first decided to become a doctor during his first year of high school.
“I was torn between going into the humanities or the sciences. I loved working with people, so I thought maybe something glamorous like advertising, or maybe becoming a lawyer. But I was terrible at Japanese and social studies. My strengths were physics and chemistry. If I wanted to make the most of my strengths and work with people, medicine made sense—and I admired my father, too,” he recalls.
In April 1996, SHINOZAKI entered the Faculty of Medicine at Chiba University. Living away from home for the first time, he enjoyed a carefree student life.
“It was the era when the PlayStation had just come out. Since I was living alone, my apartment became a hangout spot for my friends. I dyed my hair brown, spent my time playing mahjong… for six years, I lived pretty freely,” he recalls.
He chose emergency and critical care medicine as his career path because he wanted to follow in the footsteps of a senior from the university yacht club.
“He was someone I looked up to, though he had a bit of a carefree streak,” SHINOZAKI laughs. “But seeing him take emergency medicine so seriously, I thought maybe I could handle it too.”
Another push came from the television drama Emergency Room 24 Hours.
“The doctors in that show were desperately trying to save people—not with logic, but with sheer will. I thought they were incredibly cool,” SHINOZAKI recalls.
After graduating in 2002, SHINOZAKI entered the Emergency and Intensive Care Unit at Chiba University Hospital.
The frontline of emergency medicine was brutal. Working 36-hour shifts and clocking over 100 hours a week was common.
“That kind of environment would never be tolerated today. But back then, I wanted to do something I loved, I wanted to be cool—and I threw myself into it, forgetting time completely.”
What sets emergency medicine apart from other specialties is its unpredictability—no one can foresee when or what kind of patient will arrive, and every case is urgent.
“Especially at night, or on weekends, sometimes I was the only doctor there. Of course, in an ideal world, every patient would be seen by a specialist. But if there was no one else, then we had no choice but to handle it ourselves. Within the limits of the staff and equipment available, we had to do our best. Maybe that suited my nature. They say it takes ten years after earning your medical license to become a fully-fledged surgeon. But in emergency medicine, after just three or four years, there are already patients relying on you. And when a patient you fought so hard to save said, ‘Dr. Shinozaki, you saved my life,’—that made me happy.”
“I didn’t want to compromise on treatment, so I was constantly training,” he adds.

It took me two years to be able to order a non-sugar iced café au lait.

A turning point came in 2013.
At the time, SHINOZAKI had moved from Chiba University Hospital to Chiba Aoba Municipal Hospital, where he served as Head of the Department of Emergency and Critical Care. Alongside his clinical duties, he had been pursuing graduate studies at Chiba University, and a paper he had written in the field of resuscitation medicine was highly evaluated. Then came an unexpected offer: the chance to study and conduct research in the United States.
But he hesitated.
“As a clinician, I was in a position of responsibility. There was so much work that I believed only I could do. I couldn’t bring myself to choose a life shut away in a lab doing experiments. The hospital, too, insisted that without me the emergency care system we had built could not be sustained. People around me were telling me, ‘Don’t go’,” he recalls.
The one who kicked him forward was his mentor at Chiba University, Professor Hiroyuki Hirasawa.
Over the phone, Hirasawa barked at him:
“Shinozaki, you’ve grown arrogant. The work you’re doing—anyone can do it. Thinking you’re indispensable is just conceit. Go to America and learn how powerless you really are.”
After SHINOZAKI crossed the ocean to the United States as a research fellow at the University of Pennsylvania, those words echoed in his mind again and again.
“At first, no one understood my English. Even something as simple as ordering a drink at a café—you had to specify the size, the flavor, and so on. It was completely different from Japan,” he says.
“It took me two years just to be able to order an iced café au lait with no sugar,” he adds with a laugh.
And it wasn’t just about ordering an iced café au lait.
“I had to set up a phone line, get the water turned on, install the internet. In the lab, I had to borrow equipment, track down tools—everything was a matter of asking. It took me two years before I could communicate those requests properly, without saying too much or too little.”
The next step was to move from being someone who asks to someone who provides—to be recognized and paid in the U.S. system.
“As a research fellow, you’re unpaid. After a while, I started to get a small stipend, pocket money really. By my third year, I was negotiating for a salary.”
In 2015, SHINOZAKI became a research associate at the Feinstein Institute for Medical Research, working on collaborative projects with Japanese companies and securing a paid position. As his research took off and his papers gained recognition, his ambitions grew.
He obtained a U.S. medical license, and in 2018, he returned to the clinical frontline as an emergency medicine resident at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.
“A resident is the equivalent of a specialist-in-training in Japan. And once again, I ran into the language barrier. By then I had learned how to negotiate for salary, how to argue for a position—to ‘make demands,’ you might say. But meeting patients’ needs—that requires a far more sophisticated level of communication.”
For SHINOZAKI, the lesson was clear: the practice of medicine is, at its heart, also about fulfilling the requests of patients.
“The first thing you have to do is grasp exactly what the other person is struggling with. If it’s something straightforward, like acute appendicitis, that’s easy enough to understand. However, there are also cases that are far less clear-cut—such as an elderly woman with dementia whose family has nowhere to place her. You might need to assign a provisional diagnosis just to get her admitted. You have to figure out what people are really asking for, and how to grant it—that was the hardest part,” he explains.
At the same time, SHINOZAKI was struck by the intensity and efficiency of the U.S. medical system.
“Compared to Japan, I worked about half the hours, but earned twice as much—or 2.5 to 3 times as much if you consider the exchange rate. The reason was simple: I was seeing four times as many patients per unit of time.”
To make it possible for physicians to see that many patients, the hospitals provided ample numbers of nurses and other staff, with clear role divisions.
“American healthcare is an incredibly well-designed system. The people who built it were brilliant. But at the same time, I felt like I was just another cog in the machine. There wasn’t the same kind of human connection with patients that I’d experienced back in Japan,” he reflects.
It was, without question, rewarding work. And yet, in quiet moments, he found himself recalling the faces of patients from his Chiba days—those who had looked at him with relief and said, “Dr. Shinozaki, you saved my life.”
That longing to help people in distress, to see their smiles again, was still alive deep within him. Perhaps it was that hidden impulse that nudged him toward the decision to return to Japan.

Kindai University has a system of collaboration and potential that even America does not have.

In April 2023, SHINOZAKI became Chief Professor, Department of Emergency & Critical Care Medicine, and Director of the Emergency and Critical Care Center at Kindai University Faculty of Medicine.
Just one month later, in May, a patient burned in a restaurant fire was rushed in. More than 40 percent of the patient’s body was covered in severe burns. Looking over the case, SHINOZAKI remarked to the attending physician, “This is going to be tough.” But the doctor replied, “No, I think he’ll make it.”
The patient did survive and moved on to rehabilitation. He could not speak due to the burns, but the attending physician, sat with him every day, asking about his hobbies and encouraging him through the rehabilitation process.
Seeing this moved SHINOZAKI deeply. The staff may have been few, but they were holding the line with incredible dedication.
“I thought if I could apply what I learned in America about education systems and work structures, I could build a system unique to Kindai University,” he says.
He was equally astonished by the collaboration between emergency medicine and the “heart team” led by cardiologist NAKAZAWA Gaku, the very colleague who had invited him to Kindai.
“When a patient with heart problems is brought in, a call goes out to the heart team. Immediately, everyone comes down at once and sets up ECMO (extracorporeal membrane oxygenation). The speed and precision are astounding. There’s no barrier at all between the heart team and the emergency center,” he says.
“Even in America, I never saw that level of integration. It blew me away.”
SHINOZAKI has also grown fond of the students of Kindai University Faculty of Medicine.
“They’re open and straightforward. They absorb knowledge with sincerity. And they’re diverse—different ages, different backgrounds. If this culture of medicine and education keeps accumulating for ten, twenty years, it will become a tremendous force.”
Looking off into the distance, he concludes with quiet conviction:
“I can feel the potential for Kindai to become not just a presence in South Osaka, but an indispensable name in all of Osaka—and in Japan itself.”