Abstract
In Japan, new medical graduates are likely to choose to enter special medical disciplines directly even at the initial stage of postgraduate training. This often means that they lose their opportunity to have comprehensive primary care training which is essential for all physicians. From the patient's viewpoint, it is inconvenient and confusing for medical specialities to be highly diversified. Patients often have multipathological conditions and often have questions such as “Which clinic should j go to and who is my doctor?”.
In these circumstances, the Ministry of Health and Welfare has been emphasizing the importance of primary care training for physicians, sending young physicians working for National Hospitals to the United States to learn primary care and ancillary education and research since 1979.
For this reason, National Hospitals are now among the best centers for training of young physicians in primary care and the establishment of primary care training programs.
There are also several advantages for hospitals that have established primary care departments or divisions of general medical clinics.
(1) Comprehensive and continuous care can be provided.
(2) Education and training of primary care for interns and residents can be undertaken.
(3) The process of development and advancement of a primary care department would improve the level of clinical competence of specialists, since they would be able to concentrate more on their own field and provide more support to the primary care department.
(4) Continuous education would be provided for private practitioners, giving new information about primary care to support their practice.
These advantages, together with the current status and problems of the departments of primary care in National Hospitals are discussed.
