Working to Change Systems: Repatriated U.S. Trained Japanese Physicians and the Reform of Generalist Fields in Japan

Heist, Brian S.; Torok, Haruka Matsubara; Elnicki, D. Michael

doi:10.1080/10401334.2019.1574580

Cited by 7 publications

(5 citation statements)

References 31 publications

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“…Although GM faculty members in many Japanese medical schools have important roles as clinician educators for medical students, the importance of GM in a postgraduate residency education has not been sufficiently recognized in Japan [4]. Thus, a 2-year training program for postgraduate junior resident physicians has become mandatory in Japan since 2004, but many junior residents are not required to have rotation training in GM department and are required to have rotations in internal medicine (mostly subspecialty internal medicine divisions), emergency medicine, community medicine, surgery, psychiatry, pediatrics, and obstetrics/gynecology.…”

Section: Introductionmentioning

confidence: 99%

Impact of general medicine rotation training on the in-training examination scores of 11, 244 Japanese resident physicians: a Nationwide multi-center cross-sectional study

et al. 2020

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Background Although general medicine (GM) faculty in Japanese medical schools have an important role in educating medical students, the importance of residents’ rotation training in GM in postgraduate education has not been sufficiently recognized in Japan. To evaluate the relationship between the rotation of resident physicians in the GM department and their In-Training Examination score. Methods This study is a nationwide multi-center cross-sectional study in Japan. Participants of this study are Japanese junior resident physicians [postgraduate year (PGY)-1 and PGY-2] who took the General Medicine In-Training Examination (GM-ITE) in fiscal years 2016 to 2018 at least once (n = 11,244). The numbers of participating hospitals in the GM-ITE were 381, 459, and 503 in 2016, 2017, and 2018.The GM-ITE score consisted of four categories (medical interview/professionalism, symptomatology/clinical reasoning, physical examination/procedure, and disease knowledge). We evaluated relationship between educational environment (including hospital information) and the GM-ITE score. Results A total of 4464 (39.7%) residents experienced GM department rotation training. Residents who rotated had higher total scores than residents who did not rotate (38.1 ± 12.1, 36.8 ± 11.7, and 36.5 ± 11.5 for residents who experienced GM rotation training, those who did not experience this training in hospitals with a GM department, and those who did not experience GM rotation training in hospitals without a GM department, p = 0.0038). The association between GM rotation and competency remained after multivariable adjustment in the multilevel model: the score difference between GM rotation training residents and non-GM rotation residents in hospitals without a GM department was estimated as 1.18 (standard error, 0.30, p = 0.0001), which was approximately half of the standard deviation of random effects due to hospital variation (estimated as 2.00). Conclusions GM rotation training improved the GM-ITE score of residents and should be considered mandatory for junior residents in Japan.

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Section: Introductionmentioning

confidence: 99%

Impact of general medicine rotation training on the in-training examination scores of 11, 244 Japanese resident physicians: a Nationwide multi-center cross-sectional study

et al. 2020

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“…However, supervisors commonly teach trainees in specialty programs in clinical settings by working alongside them. 22 Postgraduate residents and specialty trainees in general medicine could improve their clinical knowledge and skills and motivate their own learning by teaching junior residents and medical students in clinical clerkship. By doing so, they could elevate their status as good leaders.…”

Section: Discussionmentioning

confidence: 99%

“…However, the general medicine education offered by Japanese universities has been considered immature, providing medical students little exposure to general medicine and having insufficient related policies. 21 , 22 However, it is unclear how much effort Japanese university general medicine departments (whose personnel have basic medical skills and a high affinity for clinical practice) devote to medical education, particularly undergraduate education. Therefore, this study aimed to clarify the contribution of general medicine departments in Japanese universities to medical education and develop suggestions for future general medicine education at universities.…”

Section: Introductionmentioning

confidence: 99%

General Medicine Departments of Japanese Universities Contribute to Medical Education in Clinical Settings: A Descriptive Questionnaire Study

Tago¹,

Shikino²,

Hirata³

et al. 2022

IJGM

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Background It is unclear how much effort Japanese university general medicine (GM) departments, which teach basic medical skills and have a high affinity for clinical practice, devote to medical education, particularly undergraduate education. This study aimed to clarify the contribution of GM departments of Japanese universities to medical education. Patients and Methods This was a questionnaire-based descriptive study of GM departments of Japanese universities. We sent the questionnaire created using Google Forms by email, and the universities responded by Internet. The department chairperson of the universities’ main hospital was responsible for completing the questionnaire. It covered the number of staff, inpatients over the previous 3 years, affiliated hospitals, classroom lectures, and practical training sessions per year for each academic year in medical faculty and students accepted for clinical clerkship. Items also included the effort for clinical training, research, and education and the effort for undergraduate, initial clinical residency, and specialty program training. Results In all, 46 of 71 universities responded, and we included 43 in our analysis. The median number of medical staff was 7; the median number of inpatients over the previous 3 years was 76. The median number of classroom lectures of the GM department was 1 for 1st-year, 5 for 3rd-year, 9 for 4th-year, and 0 for 2nd-, 5th-, and 6th-year students. The median total number of accepted students for clinical clerkship was 120. The median educational effort of the GM department was 30. With total educational effort set at 100, the median effort for undergraduate education was 45, for postgraduate residency 30, and for specialty program training 20. Conclusion The undergraduate medical education by GM departments of Japanese universities was provided mainly in clinical settings for almost all medical students. A focus on exposing students to GM in early academic years would improve the educational environment.

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“…This attitude also applies to the non‐profit sector. One recent study reported that doctors who earned their medical degrees in Japan but pursued clinical training abroad met strong resistance by their employers who insisted that the repatriates practice medicine the “Japanese way” (Heist et al, 2019). At a personal level, one of us also found it difficult to reacclimatize after conducting research abroad.…”

Section: Industry Jobs Discourage Migrationmentioning

confidence: 99%

Konnichiwa: Japanese scientists and their struggle to speak English

Karagiannis

Yamanaka

2021

EMBO Reports

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Working to Change Systems: Repatriated U.S. Trained Japanese Physicians and the Reform of Generalist Fields in Japan

Cited by 7 publications

References 31 publications

Impact of general medicine rotation training on the in-training examination scores of 11, 244 Japanese resident physicians: a Nationwide multi-center cross-sectional study

Impact of general medicine rotation training on the in-training examination scores of 11, 244 Japanese resident physicians: a Nationwide multi-center cross-sectional study

General Medicine Departments of Japanese Universities Contribute to Medical Education in Clinical Settings: A Descriptive Questionnaire Study

Konnichiwa: Japanese scientists and their struggle to speak English

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