07Dr. FUJIWARA YasuhiroBorn in the State of Illinois, USA, in 1960, Dr. Fujiwara graduated from the School of Medicine, Hiroshima University in 1984. In 1989, he joined the Division of Experimental Therapeutics of the National Cancer Center Research Institute as a re-searcher. He later became an assistant professor at Hiroshima University Hospitalʼs General Medicine Division. During his years at the hospital, Dr. Fuji-wara furthered his research in the areas of clinical pharmacology and medical oncology at the University of Chicago Medical Center, the Johns Hopkins Oncology Center, and the University of Maryland Cancer Center. After his return to Japan, he joined the Pharmaceuticals and Medical Devic-es Evaluation Center of the National Institute of Health Sciences (predecessor of the Pharmaceuti-cals and Medical Devices Agency). In April 2002, he moved to the National Cancer Center Hospital, where he assumed the post of Deputy Director in 2010. In 2011, he doubled as the Deputy Director of the Cabinet Secretariat Office for Promotion of Healthcare Innovation. In 2019, he became Chief Executive of PMDA. Since 2020, he has been a member of the Science Council of Japan (25th and 26th).the University of Maryland for about a year. When I was at the General Medicine Division of Hiroshima University Hospital, in the mornings, I saw patients who could not be admitted by specialized departments. In the afternoons, I and the assistants handled the initial consultations of primary or secondary emergency walk-in patients, assigning them to the appropriate departments, often using our network of junior and senior colleagues from university days. In the evenings, I had inpatient consultations and conferences of my unit, and from the late evening to the morn-ing, I worked on my research and instructed graduate students in my charge. The General Medicine Division was a special place with top-notch personnel with a similar outlook and aspiration. I really enjoyed working there.Ochi: You were born in the United States, if Iʼm not mistaken. So youʼve never experi-enced any difficulty with English?Fujiwara: I was born in the United States, but we left when I was only a year old or so. If I didnʼt have much difficulty with English, thatʼs because my English teachers at Hiroshima Gakuin, who were native English speakers, taught us well, building a solid base, especial-ly vocabulary and pronunciation.Ochi: Did you get into Clinical Pharmacology after returning from the United States?Fujiwara: Yes. In those days, a lot of attention was focused on pharmacokinetics and pharmacodynamics. For asthma treatment, the best treatment was ensured based on the concentration of Neophyllin in the blood, and we were discussing the possibility of adopting a similar approach to anticancer drugs. The ability to handle intravenous drips largely varies from one cancer patient to another, and differences affect efficacy and side effects. I wanted to delve deeper into this research area during my study abroad in the U.S.Ochi: And that led you to go into Clinical Pharmacology. You were active in various research areas, but what would you consider as your primary research subject?Fujiwara: I must say itʼs definitely the mecha-nism of anticancer drug resistance. On this subject, I instructed many young researchers and wrote many papers, some of which were published in relatively high impact factor English-language journals. But I was never published in Nature or Science. Thatʼs why I gave up being a researcher.Ochi: I see. It seems quite regrettable, though. For five consecutive years, in the Chugoku-Shikoku region, Hiroshima Univer-sityʼs School of Medicine has had the highest numbers of papers that are written in English and are “top 10” papers, that is, papers ranked among the top 10% in their respective fields in terms of the number of times they have been cited. But it was still hard to get your papers published in some prestigious journals like Nature. How did your career pan out after that?Fujiwara: I decided to become a specialist in Phase I treatment at the National Cancer Center Hospital, for chemotherapy for lung cancer, in particular. At the National Cancer Center Hospital, you can do research in a relatively favorable environment and also engage in human resource development. I was in charge of the education and training of young doctors who had gathered from all over the country. So today I know many doctors who are active across Japan. I know some in Hiroshima and Shimane, too.Ochi: After that, you served as a chief physi-cian and then the head of the Clinical Trial Department at the National Cancer Center Hospital. You were also the Deputy Director of the Hospital twice.Fujiwara: Thatʼs right. The first time I served as Deputy Director, it was for two years from 2010, and I was in charge of hospital manage-ment first and then the overall operation of the Cancer Center. Around 2017, I was appointed Deputy Director once again, and I was put in charge of research because there was a need for know-how to get activities off the ground after applying and obtaining des-ignation as a clinical research core hospital.Ochi: You had to oversee hospital manage-ment. It was a huge transformation for a researcher/physician to become a manager. Didnʼt you feel a little lost or uneasy in a com-pletely different position of responsibility?Fujiwara: I certainly did. On top of that, I was in charge of the hospitalʼs management exactly when it was undergoing status transition from a national organization to an independent corporation, and it was getting into serious debt. The management team of a dozen or so people was entirely replaced by a team of only three, including myself. I had no choice but focus all my energy on running the hospital.Ochi: How did you overcome such a drastic situation?Fujiwara: I was not a manager by training, so I sought advice from an acquaintance who worked at McKinsey & Company (a major American management consulting firm), who provided assistance and guidance in operational analysis and profit generation. Later, when we decided to launch a clinical research project, we asked the same person, who was now with Boston Consulting Group, to advise us because we wanted to run an organization that can generate profit from its research. For about six months, a team of several consultants analyzed the project and its management and shared with us cases of some well-known American hospitals. It helped us enormously.Ochi: I see. You learned directly from profes-sionals. It is indeed important not to hesitate to seek professionalsʼ help when you have to explore an unknown territory.Ochi: I think teamwork is essential for any or-ganization to function to its full potential. Are there any things that you take special care of on a daily basis to nurture teamwork?At the University of Maryland Cancer Center, where he worked as a staff member of the Advanced Treatment DivisionI was very interested in finding out how such Seeking professional assis-tance following a sudden switch to a managerial postJapanese not attractive to overseas pharma/medical businesses?From a researcher to a doctor specializing in medical oncology
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