General practice departments of university hospitals and certified training programs for general practitioners in Japan: A nationwide questionnaire survey

Abstract

BackgroundIn the reform of specialist training by Japanese Medical Specialty Board, general practice is expected to be one of 19 core specialties. University departments of general practice can play a central role in training board‐certified generalists, but whether they are actually preparing to do so is unknown.MethodWe sent a questionnaire to 79 universities and requested to forward it to the general practice department. Fifty‐six departments of general practice (37 public and 19 private universities) completed the questionnaire (response rate 71%).ResultsFifty‐one (91.9%) universities planned to be the base institutes of certified programs. The annual seats per program ranged from 2 to 20 (median 5). In these 51 university‐based programs, 33 (64.7%) departments provide the general practice II element. Twenty‐eight (54.9%) require the program trainees to belong to the departments (do nyukyoku) and 11 (21.6%) recommend that they do so. Forty‐seven (92.2%) programs had affiliated institutions in rural areas. Thirty‐nine (76.5%) were willing to accept graduates of regional quota (chiikiwaku). Twenty‐nine (56.9%) program directors took into account the obligatory service of regional quota when making the programs. Programs that accept regional quota graduates were more likely to be affiliated with rural institutions (P=.002) and conscious of the obligatory service in making the program than other programs (P<.001).ConclusionMost of the university departments have their own training programs. Many of them are willing to accept nyukyoku doctors and regional quota graduates. Universities intend to play an important role in graduating generalists and supporting their careers.

Students’ perceptions of general medicine following community‐based medical education in rural Japan

“…For effective learning, medical universities and community hospitals need to collaborate and share the content of their educational programs . In Japan, education about general medicine has started only recently, and collaborations between educational programs may be negligent . The next step in Japanese general medicine education is to solidify connections between community hospitals and medical universities regarding CBME.…”

“…We used paired t tests to assess the changes between pre‐ and postlearning achievements in the questionnaire responses. To analyze the content of the one‐on‐one interviews, we used a thematic analysis . The analysis comprised familiarization with the data, generation of the initial codes, searching for themes, reviewing the themes, defining and naming the categories, and producing a report that includes the selection of exemplification data and quotations .…”

“…Establishing a general physician educational system that appeals to medical students and residents is essential. Despite this need, in recent years and especially in Japan, most medical students have become organ‐specific specialists and not general physicians . To increase the number of general physicians, well‐established educational programs are essential .…”

“…For students in medical universities, hands‐on training in community hospitals and clinics can be an effective pedagogical tool to learn more about general medicine . Through training in these settings, medical students can learn the various competencies required to be a general physician.…”

“…Through training in these settings, medical students can learn the various competencies required to be a general physician. Furthermore, in these clinical settings, the students can expand on their knowledge of general medicine obtained in medical universities . Improved training in community medical institutes could be the key to increasing the number of general physicians.…”