Owing to shortages of primary-care physicians, increasing their numbers has been recognized as an urgent issue in Japan and other countries. However, it is unclear which factors in medical education influence the decision of residents to go into primary care. We investigated the factors associated with residents' choosing to practice primary care. Of 281 randomly selected medical facilities designated as residency training hospitals, 137 facilities answered. Self-administered questionnaires were completed by 724 residents in the third or fourth postgraduate year. Responses were compared between residents who intended to choose a career in primary care (n=175, 24.2%) and residents who intended to choose a career in other specialties (n=549, 75.8%). In addition, for residents who had intended during their undergraduate years to enter a non-primary-care specialty (n=442, 61.1%), responses were compared between those who now intended to go into primary care (n=33, 7.5%) and those who did not (n=409, 92.5%). Residents who had planned during their undergraduate years to choose a career in primary care (adjusted odds ratio [95% confidence interval]: 9.85 [6.24-15.5]), residents who were working as primary-care physicians at the time of the survey (7.58 [4.92-11.7]), and residents who wanted to enter rural practices in the future (2.24 [1.36-3.68]) were significantly more likely to plan to choose a career as a primary-care physician in the future. Residents who had worked at a rural practice during residency training were significantly more likely to change their career plans from other specialties to primary care (crude odds ratio [95% confidence interval]: 2.18 [1.05-4.49]). Exposure to a rural practice during residency training may affect residents' career plans. Integrating rural primary-care practice into residency training may help increase the number of primary-care physicians in the future.
1) Physicians who graduated from medical school less than 5 years earlier hoped that they could be satisfied with both their work and private life. They considered the choosing of a specialty suited to their lifestyle to be a strategy for continuing to work. Previous studies have suggested that this idea is specific to this generation. 2) Physicians who had graduated more than 31 years earlier had entered a medical university at a time when female students were rare; they continued to work with the belief that they must work hard so that female physicians could be seen to be actively employed. However, some of them had regrets about working continuously or child rearing. 3) The problems that female physicians faced concerning gender discrimination, child birth, and child rearing were common among both age groups.
1) A BLS training program was held for the first-year students of Tokai University School of Medicine in 2007/08. 2) The training program was based on the objective structured clinical examination. In 2007, our faculty directly instructed first-year students. In 2008, under the guidance of faculty members, fifth-year medical students doing clinical clerkships served as student-instructors for teaching first-year students. 3) To assess the BLS training program, questionnaires were completed by both the first-year students and the fifth-year students. The results of the survey showed that all students participated in this program with high motivation and intensity. The first-year students rated the guidance given by student-instructors more highly than that given by faculty members. Moreover, the program appeared to be enjoyable and challenging for the fifth-year medical students. Thus, the preceptor-based BLS training program (the Yanegawara method) potentially motivates both first-year and fifth-year medical students.
1) The aim of this study was to develop a training method for pre-educational clinical pharmacy in a 6-year curriculum. In the evaluation of training in a prepractical pharmacy by pharmacy students after completing clinical training in a 4-year curriculum, the average scores for the necessity and usefulness of training in a prepractical pharmacy were 4.5 and 3.9, respectively (maximum score, 5; minimum score, 1). 2) The average scores for usefulness in the subcategories of knowledge, technique, and attitude were 3.5, 4.2 and 3.8, respectively. The percentages of scores of 4 or 5 in these subcategories were 60.1%, 83.2%, and 64.1%, respectively. 3) The students recognized the necessity and usefulness of training in a prepractical pharmacy, but dissociation was seen in both scores. Therefore, the amount of attitude education in training in a prepractical pharmacy was thought to be insufficient. The strong desire for education by clinical pharmacists and the development of educational programs are future challenges for the Faculty of Pharmaceutical Sciences.
In the present study, surveys regarding the philosophy of learning were administered just after the entrance ceremony to all students entering the Fujita Health University School of Medicine in 2005 and then, once more, to the same students during the last term of the fourth year, so that the data could be subsequently analyzed. The 87 fourth-year students who completed the surveys were divided into 3 groups(top, middle, and bottom thirds)on the basis of their examination scores in the previous years. 1) Results of the fourth-year survey suggested that students in the middle or bottom third did not develop a "learning-centered campus lifestyle" during their 4 years of medical studies, although the first-year survey indicated that most students in all 3 thirds had desired such a lifestyle. 2) The image of a physician had changed somewhat for students in middle or bottom third but not for students in the top third. 3) Attendance rates in all years of medical study were lower for students in the bottom third than for students in the middle or top third. Moreover, the motivation to study and attend lectures showed a downward trend over time for students in the bottom third.
1) As medicine matures, a more balanced management of human resources, medical skills and technology, and finance is required. Therefore, the importance of business administration as a subject of lifelong learning by physicians is increasing. 2) Japanese medical students and physicians have few opportunities to learn business administration. A distance-learning programme for a masters of business administration (MBA) degree provides a learning opportunity that does not interrupt careers. 3) For both providers and learners, much effort is needed to avoid leaving school without completing the MBA course: while learners need more time management and motivation, providers need to develop a better management system and provide virtual reality situations.
1) We attended the 14th annual meeting of the International Association of Medical Science Educators. Findings of research in medical education were presented. 2) Topics of the meeting included: assessment, curriculum, instructional methods, professional development/student support, team-based learning and problem-based learning/clinical skills, and technology/e-learning. 3) Preconference workshops, concurrent focus sessions, poster discussions by category, and other events were cleverly integrated into the program of this meeting. We obtained useful and applicable information for the management of meetings on education.