We conduct an outpatient escort program as a part of our early exposure curriculum for first-year medical students. Each student escorts one patient at the University of Tsukuba Hospital throughout his or her first visit. We evaluated this program from the points of view of both students and patients. 1) A questionnaire was distributed to all participating patients and students in 2006. 2) In their questionnaires, many students commented on the long waiting time, the structural problems of the hospital, and the attitudes of physicians. 3) Results of the questionnaire showed that both students and patients rated this program highly. 4) No significant differences were noted between the comments of the students and those of the patients. The patients tended to rate this program more highly than did the students. One patient, however, commented that being constantly accompanied by a stranger was somewhat stressful. 5) We conclude that this program can be efficiently carried out without being too much of a burden to patients and is a valuable part of an early exposure program for first-year medical students.
More than 2 years have passed since the new postgraduate clinical training program was instituted in 2004 to improve the clinical ability of Japanese physicians. However, there have already been discussions about whether the undergraduate curriculum and the postgraduate program should be improved. After the first physicians finished their training under the new program in the spring of 2006, questions were raised about whether the identical final goals of training could be achieved by transferring some items of postgraduate clinical training to the undergraduate period. Such a change might invigorate the undergraduate curriculum and enhance the effectiveness of the postgraduate program. 1) Are-evaluation of the final goals of postgraduate clinical training might allow some items to be taught during the undergraduate period. 2) Several questionnaires were sent to 211 supervising physicians and 184 first-year residents who had just completed the new internship program at 25 teaching hospitals (university hospitals and postgraduate training hospitals). 3) Both trainees and supervising physicians reacted positively about and expressed a willingness to participate in training items, including noninvasive diagnostic procedures and laboratory studies not harmful to patients, during advanced courses in the undergraduate period. 4) Both trainees and supervising physicians reacted negatively to participating in any invasive procedures that might affect a patient's welfare or sense of shame during the undergraduate period. 5) In the future, training with simulated procedures before actual patients are encountered and enlisting enough supervising physicians are essential for unifying the undergraduate medical school curriculum and postgraduate clinical training programs.
1) To improve the quality of medical care and to ensure patient safety, physicians have the professional duty and responsibility to constantly study the newest medical knowledge and technology. 2) The terminology for “continuing education”for physicians differs in meaning from that generally used to refer to “life-long education.” 3) Continuing medical education (CME) in Japan is independently carried out by medical associations and by numerous academic medical societies. Present CME activities in Japan are reviewed, and CME in the United States is explained. 4) Continuing professional development is introduced as a new paradigm of CME for physicians, created to improve the health-care system in the United Kingdom. 5) To further improve CME for physicians in Japan, prospective issues are discussed. Establishment of a third-party organization that discusses, manages, and operates the CME system for physicians, is strongly recommended.
1) The clinical training system in our hospital was evaluated with a questionnaire by 49 trainees. 2) Overall, our clinical training system received high scores, but the scores varied significantly depending on the clinical department. 3) The scores of clinical departments did not correlate with the ratios of supervising physicians to trainees. 4) To provide the best training system possible, the current system must be evaluated and improved.
1) The Japanese term “kenshui”was officially defined in2004when the new postgraduate medical education system began. 2) Although“kenshui”is often translated into English as “resident, ”it is best translated as “intern, ”because a kenshui rotates through many different departments. 3) A United States-style residency is more akin to what is called “koki-kenshu” in Japanese. 4) The “postgraduate year”naming system is the most precise way to describe the position of a physician in postgraduate training.
1) We investigated the patients'evaluations of the students, our management of the medical training, and the patients' recognition of our outpatient clinic education. We then requested the patients to give their opinions regarding such interviews. 2) The patients'evaluations of the outpatient clinic and the patients'recognition of our outpatient clinic education were relatively good, but some patients complained about the short duration of medical care and also expressed anxiety over the students'medical interview. 3) Many patients expressed the desire to positively participate in medical education because the patients had high expectations of the medical students.In addition, this interview training fulfilled the patients'desire to be listened to and have their concerns acknowledged.