1）Japanese medical students’ exposure to the pharmaceutical industry was surveyed in 2012 by means of a 15–item questionnaire. 2）Responses were received from 5431 students（1755 in the 4th year, 2222 in the 5th year, and 1454 in the 6th year）. The number of preclinical and clinical students in each year was 1755 and 0, respectively, in the 4th year, 853 and 1,369 in the 5th year, and 53 and 1401 in the 6th year. 3）A total of 20% to 37% of preclinical students and more than 95% of clinical students received small gifts, drug brochures, and box lunches while attending a pharmaceutical product seminar. Approximately 10% of preclinical students and 60% of clinical students received a taxi ticket to attend an educational event. In total, 8% of preclinical students and 40% of clinical students attended a dinner party after these educational events. 4）Therefore, the rate of exposure to the pharmaceutical industry was significantly higher for clinical students than for preclinical students.
We performed a comparative analysis of 98 residents trained in our hospital from April 2003 through March 2012. Assessments of residents performed with interviews and a written test at entry to the training course showed a good correlation（r＝0.4 ; p＜0.005）with the final assessments performed by instructing physicians when the 2–year training course had ended. In contrast, the directing nurses’ summative evaluations were not correlated with entry assessments（r＝0.071 ; p＝0.485）. Evaluation of the attitudes of residents by nurses differed considerably from that by physicians. The physicians seemed to have successfully performed the entry examination using good selection criteria, such that residents with superior evaluations at entry achieved excellent results at the end of training; in contrast, the evaluation by nurses was not so straightforward. The physicians tended to assess residents’ attitudes from the viewpoint of performing practices, whereas the nurses evaluated residents mainly from the standpoint of receiving practices; therefore, differences in the assessment scores between physicians and nurses were understandable. Considering this difference and the results of this study, we suggest that the residents’ attitudes in light of professionalism should be evaluated from multiple directions, from both the “giving” and “receiving” vectors.
1）We instituted the “CHANGE Nagasaki University Hospital” project to improve both management and medical education and to boost the number of physicians recruited to this hospital. 2）We first identified the physicians’ problems and complaints via a questionnaire. Next, focusing on the most common complaints, we reduced secondary duties and methodically improved the educational environment by employing the a– b–c–d–strategy, which is based on the principles of medical education. 3）As a result, both, the hospital’s economic growth and the recruitment figures for resident physicians have increased continuously over the past 4 years.
To respond to the physician shortage, the capacity of medical schools has been increased through selective admission of student to practice in medically underserved areas; however, neither a system nor a curriculum for such students has been established. At Nagoya University, selected students have been admitted, and the division of Education for Community–Oriented Medicine was established in fiscal year 2009. We have introduced special curricula for these students, such as a seminar for community–oriented medicine, training for medical research, local hospital tours, and a special interprofessional education course. In fiscal year 2013, community medicine is expected to be implemented as a compulsory subject in the 4th year curriculum. For the education of students selected to practice in medically underserved areas, we believe that older students serving as role models and cooperation with other organizations and community are important.
The implementation status of problem–based learning （PBL） tutorial systems was surveyed in 2008, 2011, and 2012. The 2008 survey showed that the content of PBL tutorial systems differed greatly among universities. In response to a question in the 2011 survey of whether the PBL tutorial system would last for 5 years or more, more than 80% of universities agreed that the systems would likely last that long. In response to a question of whether PBL tutorial system had been changed around 2012, more than 80% universities said the system had not been unchanged. Furthermore, regarding the evaluation of tutors, the motivation of tutors as a whole did not increase. In the future, the implementation status might not be changed.