Yoshiya Yamada will spend the next two weeks furiously studying for the licensing exam to become a resident nurse, hoping that a strong grade could lead to employment in a Bay Area hospital.
However, unlike most students studying for the NCLEX, Yamada is already a physician.
Yamada graduated May 28 from Samuel Merritt University's accelerated bachelor of science in nursing program.
"In Japan, you have to choose a direction before graduating high school," he said. "I couldn't find an organized nursing school, so I went to med school."
Yamada left Japan in 2004, after spending 18 years at a Tokyo hospital, where he specialized in gastrointestinal endoscopy procedures. After visiting San Francisco General Hospital in 1995 to research treatment methods for AIDS patients, observing the work of resident nurses rekindled his childhood ambitions.
"I was always interested in care of patients, so I was always observing how nurses work," he said. "I was so enchanted, and surprised, in the RN's job."
After leaving the United States in 1997, he spent seven more years at a Tokyo hospital. His role there was limited almost exclusively to diagnosis and treatment, which grew repetitive as his career progressed.
According to Yamada, specialization of care within the massive network of physicians in Tokyo made developing a connection with his patients difficult, and stunted his abilities as a doctor.
"If my patients had a problem outside my (gastrointestinal) field, I had to call another specialist in that field," he said. "My knowledge became very limited, and I forgot some things to be a general doctor."
As a young man, Yamada's father, a Presbyterian minister, had encouraged him to join a profession that involved helping others. While becoming a physician certainly fit that mold, it left him unfulfilled.
Yamada moved to San Francisco in 2004. He enrolled in English-intensive courses at Las Positas College and San Francisco State while brushing up on biology and anatomy. After six semesters, his English improved enough to pass a mandatory English 1B course, which allowed him to register in Samuel Merritt's accelerated bachelor of science in nursing program.
Outside the classroom, Yamada trained at St. Mary's Medical Center in San Francisco, where his background became an asset while adjusting to his new profession.
"I would say the hardest thing about nursing school is learning all that information; biology, anatomy, physiology. Because of his background, he already had that foundation," Regina Foronda, Yamada's preceptor, said. "I think his background, as a doctor, really helped him with his stamina for this."
Yamada's dedication to his new profession kept him in the United States during his father's funeral last year. He used the Skype.com website to view the service.
In the coming weeks, Yamada will study for the NCLEX while looking for jobs throughout the Bay Area. (NCLEX is the National Council of State Boards of Nursing's licensing exam.)
His visa will expire if he doesn't find employment by July, a daunting task in the current economy. He said that he hopes to find work before then, but that many of his best prospects won't be hiring until the fall.
"There are nurses out there who do it because it's a decent job, good pay, and there are others who believe it is an honor and privilege to perform patient care the way we do," Foronda said. "He's definitely one of those nurses who's in it for the passion."