General education including basic science is closely related to clinical medicine. But most medical students are not interested in this subject. In order to promote high motivation for general education among new medical students, attempts were made at medical seminar in first year class. Testicular cancer was used as teaching materials. Students learned how the contents of general education were applied to clinical medicine in the diagnosis and treatment of testicular cancer. For example they could understand easily that the knowledge of physics and mathe-matics were indispensable to understand CT. To improve students' self-learning skill, student taught another students mutually. Teacher guided them as a tutor. Then a patient completely recovered from testicular cancer was invited as a lecturer. He talked about his life fighting against a disease and demands for medical students. When students knew the relationship between general education and medical practice, they could understand the importance of general education and their motivation for learning was promoted.
This paper discussed the introductory medical training system and medical team care problems at University Hospital of Tsukuba. The characteristics of this training system are that the duration of training is the fourth year medical students at the University of Tsukuba and to exercise the roles of nursing service at University Hospital. In this practice, medical students are expected to comprehend about the significance of team work in medical care, to practice in the work of nurses and c-medical workers for learning their roles. We introduce our purpose and practice of this medical team care. Problems of this trial are discussed in this paper. But we have confirmed that this experimental. Trial is useful experience to all medical students and the items of this practical exercise are one of the most effective training method for them.
For the purpose of learning the comprehensive medical team care. we tried for the fourth year medical students at University of Tsukuba to exercise the nursing service and the team care system in the Hospital of University of Tsukuba. These practice were already undergone during past twelve years. In this practice, students are expected to comprehend about the significance of team work in medical care, to understand the meaning of medical care, to learn especially the roles of nursing and rehabilitation medicine (in total medical care system), to practice in the work of nurses and co-medical workers for understanding their roles, to study the basic science and contribution in medical team care of rehabilitation medicine, to comprehend about the outline of the health, medical care system, and medical economics. As the items of this practical exercise, all students must work as follows: 1. collection of venous blood and check of vital signs. 2. practical work of nursing service. day time service: 8:00 a.m.-11:30 a.m.(fourtimes) 1:00 p.m.-4:30 p.m.(once) early night service: 5:00 p.m.-0:00 a.m.(once) midnight service: 0:00 a.m.-8:30 a.m.(once) Moreover 15 corelative lectures are prepared. For these twelve years, we researched motivating effects and impression of this exercise about both medical students and nurses by method of using questionnaire. We hope to grow kindly doctors having the mind of humanity.
The purpose of our lectures on “Igaku-gairon” as a series of medical education is to consider “ What is the medicine?”, “What is the medical treatment?”, “How should the doctor be?”, and “What should be learned at the medical school?”. Each group of the students consider “What should the doctor be?”, thus selecting the theme. The students in each group inquire into the theme, present the results thus obtained and discuss each other as a form of workshop. The teachers give some comments to supplement and amend the students' opinions, thus leading the workshop. While having these lectures, the students make a model committee on the ethics of medicine, watch videofilms showing patients in the vegetable state and those in the terminal stage of cancer, being sentensed as having cancer, and organize symposia on medicine on death problems including terminal care. On the other hand, as a early clinical exposue, the students, wearing eyemasks and getting on the wheelchair, experience the handicapped, or help such model patients. They also do some practice to help the severely mentally and physically disabled persons at the institutes, escort the outpatients at the university hospital and do the nurse practice as assistance of nurses at the ward. It is important for the students to think and experience a variety of medical problems by themselves, being motivated to learn medicine and treatment and not to be given lectures by the teachers passively.
The 82 nd and 83 rd National Examination for Physicians' License, which were held in 1988 and 1989 respectively, were evaluated from question to question as well as in all the questions as a whole to set minimum pass scores and analysis “relevance” and “difficulty” in a matrix utilizing a modified Ebel's method. The evaluators were teachers in different disciplines in nationwide medical schools and teaching hospitals and clinical trainees who had taken and passed the immediate past examinations. Following data processing, the questionable and difficult questions were on the decrease compared with the preceding year, and it was tentatively concluded that the National Examinations have gradually improved year by year.
This conference was held at Noguchi Memorial Hall, Tokyo, on September 9 th, 1989. Seventy five persons from fifty two medical schools and two high schools participated. In the first session, “Intrview-Methods and Evaluation”, Dr. H. Hasekura introduced recent trends in the interview test in general and his experiences at Shinshu University. Dr. M. Hirno stressed a clear relationship between the interview and performances of students of Yamanashi Medical College. Dr. I. Takeyama, Teikyo Univ., reported on the significance of the two-day interview including one overnight stay with the applicants. In the second session, “High School vs University”, Mr. H. Motohashi, Hibiya High School, explained about high school records, and Mr. T. Ohnuki, Mito Daiichi High School, analyzed recent behaviors of medical school applicants. Dr. T. Ogawa, Akita Univ., Dr. S. Sato, Nagoya Municipal Univ. and Dr. T. Takagaki, Juntendo Univ., pointed out that high school records are more predictable than the entrance examination scores through follow up studies. This meeting impressed upon the participants the importance of communication and reliability between high schools and universities.
We stayed at Jefferson medical College for two weeks to observe what was going on in American medical schools and hospitals. What a marvelous experience it was! Since we have only completed basic sciences (two of us are in the 3 rd year and the other is in the 4 th year of Teikyo University School of Medicine in Tokyo), we did not understand clinical things well. Nevertheless, we were able to learn a great many things. In the hospital we were treated as though we were professional doctors and this, indeed, is the difference between the American and Japanese systems. American medical students are not only trusted and respected but make efforts to prove themselves worthy of others' trust. We were deeply impressed.
We visited the University of Newcastle to take clinical clerkships from April to June 1989. We tried to experience what we had not had in our medical educational system; for example, geriatrics or medical ethics. We also compared the difference of medical educational program between Japan and Australia, especially, the way of examining students.