Referencing to one hundred and thirty years history of the modernized medical education in Japan, the author analyzed the stream of its renovation by classified it into four phases according to an old Chinese proverb, “They who want to know what shall be must consider what have been.” The change during sixty years after the World War II (the second phase) had been much more remarkable than that of seventy years before the War (the first phase). The unified medical education at all the new-system universities in the second phase had been diversified multidirectionally at many newlyestablished medical schools in order to meet the nation-wide demand to increase the number of young able physicians who became impulsive power group to innovate the traditional conservative medical society. The third phase had begun in 1991 when the university chartering standards law was liberalized vastly and every medical school could compose its curriculum more freely depending on its and student's demands like as order-made programs. Recent ten years, the fourth phase, are continuing up to today becoming the structure reform of medical education more remarkable and the education curricula core-oriented toward tomorrow's physician training. Now time has changed, “They who want to know what shall be must consider what will be.”
The fourth reports of the discussion group on 21st century medicine and health care proposed that it was necessary to establish in medical education a core curriculum emphasizing carefully selected basic content and to expand the number of subjects that students might take electively in great numbers. Following this report, medical education model core curriculum was made by the research and development project committee for medical educational programs. This guidelines were prepared to serve as the basis for development of new medical education in the 21st century, and educational content was proposed to serve as the essential basis of material to be mastered at present and a reference for curricula constructed by individual universities. This guideline have several new viewpoint such as medical ethics, undivided basic and clinical education, pre-clinical basic skill education and clinical clerkship. In addition to this basic curriculum it will be required to addition of an elective curriculum, which is provided individual or unique training programs based on student needs and the educational principles of the each university.
The first trial of nation-wide medical and dental student evaluation system has begun from this January. This system is consisted of computer-based testing (CBT) using multiple choice questions, and objective structured clinical examination (OSCE). The purpose is to measure a student's competence to learn at clinical settings. This paper mentioned about an outline of CBT and OSCE in this system, and issues to be solved in future.
Objective structured clinical examination (OSCE) before and after the bedside learning in Saitama Medical School was reviewed with reference to its subject, the aim, the number of stations, the time schedule, human resources, contents of the task of each station, evaluation method and the results. The need for preparatory clinical education for bedside learning in the context of model core curriculum, the nationwide OSCE as a prerequisite for bedside learning and the importance of clinical clerkship in bedside learning and its relationship to the introduction of OSCE into the national board examination were discussed.
Problem-based learning (PBL) tutorial follows the learning attitude of adult characterized as a self-directed learner. PBL may be applied to facilitate learning of signs, symptoms and pathophysiology that are defined in the Japanese Model Core Curriculum for the undergraduate medical education. When signs, symptoms and pathophysiology are the learning objectives in the PBL, the learners may integrate the related problems to understand the basic mechanisms of the diseases. Whereas didactic lecture-based learning facilitates systematic understanding. Thus, construction of curriculum to accommodate the Model Core Curriculum with learning objectives of signs, symptoms and pathophysiology require through consideration for the characteristics of PBL as one educational modality in the medical education.
Characteristics of clinical training of Tsukuba University School of Medicine are pre-BSL, essential and elective training, out of university clinical training, new medical science course, electives, and overseas clinical training. The main problems of this clinical training are some students have insufficient motivation or basic knowlegde for learning, and some tutors have insufficient passion or skill for teaching. These problems might be common with the problems of core curriculum of clinical training.
We proposed the curriculum plan of medical ethics in the medical school in our country. That was the curriculum throughout a few years and the participating education. Now we present the manual for one case of the each six strategies. When the teacher holds classes according to this manual or with some modifications, the medical students will probably participate the education with high motivation to learn.