Objectives: Every question of the national examination for medical practitioners is created in conformity to “the standards of the national examination for medical practitioners” (“the Standards.”) This means that the Standards function as guidelines of the knowledge which medical students are expected to acquire before graduation. The objective of the present study was to analyze the change of the Standards in these twenty years and to propose advice for more effective undergraduate education.
Methods: Numerical transitions of the items and changes in the content in each subject and each classification of the Standards in the six successive editions from 1993 to 2013 were examined.
Results: The total number of index entries in the Standards grew approximately 1.5-fold its original size. The index entries increased by 1756, while cumulatively by 2408. With regard to the content, while there has been a significant increase in both the small classification and remarks, there have been only a few changes in the large and middle classification. In particular the categories concerning medical safety, terminal care and palliative medicine, professionalism, adverse effects of smoking and significant pediatric diseases were newly described in detail in response to increasing the public awareness and the demands during those years.
Conclusion: Over the twenty years between 1993 and 2013, there was an approximately 1.5-fold increase in the total number of subject categories and index entries that appeared in the Standards. These data indicate that the volume of study items that medical student should acquire before graduation markedly increased during these twenty years. In the next revision of the Standards, drastic reduction of the volume of study items may be necessary to promote acquisition of other important competences such as communication and self-learning.