Beginning in 1999, students from the Aichi Prefectural College of Nursing & Health in Nagoya Japan have been participating in a cultural exchange program organized by Fredonia State University College. The Japanese students come to our community for two weeks to learn American culture, compare nursing and health care services, and to study English. In addition to the SUNY Fredonia college environment, students see a broad segment of our community including Brooks Memorial Hospital. A group of students accompanied their tour guide for a visit to Brooks Memorial Hospital recently to check out the clinical and non-clinical areas at Brooks. They had an opportunity to observe the many differences and similarities between the American and Japanese healthcare systems.