This study used a self-administered questionnaire to assess the likelihood of chiikiwaku medical student loan repayment and its associated factors. If chiikiwaku repayment is high, then it can have a negative effect on the chiikiwaku program, which was established to distribute doctors to outlying areas. A total of 112 students (37.8%) reported that the likelihood of repayment was "high" or "somewhat high." The factors statistically associated with repayment likelihood were female gender (odds ratio (OR) 3.2, 95% confidence interval (CI) 1.5-6.8), applying forchiikiwaku mainly due to the higher medical school acceptance rate (OR 2.9, 95%CI 1.2-6.8), private medical school (OR 10.3, 95%CI 2.6-40.3), and stress related to obligation or repayment (OR 2.4, 95%CI 1.3-4.3). The results suggest that to decrease the rate of loan repayment it is important to improve the process of selecting chiikiwaku students and to modify the chiikiwaku system to support students experiencing stress.
Optimal strategies for learning professionalism have not been established to date. For the purpose of resolving this problem, the author developed a novel workshop activity in which scenarios describing unprofessional behavior were represented. In the scenarios, participants performed role play followed by small group discussions. Key words chosen during discussion were pooled and reconstructed into an association chart using KJ method. From 2014 through 2017, a total of forty-four junior residents participated in the activity. To estimate the effectiveness of the workshop, participants completed a post-activity questionnaires composed of a ten-point rating scale (higher value denotes a positive evaluation) and free commentary. Most residents indicated interest in this workshop (mean rating, 8.5±1.25, median, 9). Similarly, a considerable number of residents reported that the activity allowed them an opportunity to reflect on their behavior (mean, 8.05±1.43;, median 8). Qualitative analyses of free commentary was performed using Steps for Coding and Theorization (SCAT). Consequently, 6 themes were extracted: interest in learning professionalism, exchange of diverse values, importance of reflection, recognition of objectives, difficulty in understanding professionalism, and proposals for the workshop. On association charts, key words were sorted into four to six categories; these were further arranged in such a way as to converge toward the concepts of patient-centered care. We consider that our scenario-based workshop may be an effective strategy to facilitate learning professionalism for residents.
Medical education at college is the very first step of life-long learning as a medical doctor. Curricular reforms in Japan took place in the early 21st century, and can be exampled by the development of a model core curriculum, the emergence of the CAT (common achievement test) examination, the development of clinical clerkship and so on. The International accreditation of medical schools has just started spring of 2017. It highlights outcome-based education, which accelerates the connection of undergraduate education with postgraduate training.
Introduction: Attention to undergraduate medical education on the relationship between physicians and the pharmaceutical industry has been increasing in North America and Europe. There are no reports, however, regarding this relationship in Japanese medical education.Methods: We conducted a cross-sectional survey using a self-administered questionnaire to investigate formal undergraduate curricula on the relationship between physicians and the pharmaceutical industry.Results: Forty-four of 80 medical schools approved participation in the study, with 16 (36.0%) reporting having a formal curriculum on drug promotion. Many of the themes included in the programs were related to research ethics or conflict of interest in research, with drug promotion covered in only a few programs.Discussion: More discussion and investigation into undergraduate education on the relationship between physicians and the pharmaceutical industry, especially on drug promotion, is warranted.
Japan Accreditation Council for Medical Education (JACME) was established in 2015 and recognized by the World Federation for Medical Education (WFME) in 2017. The accreditation by JACME for medical education programs formally and fairly started in April, 2017. It consists of internal quality assurance through self-evaluation by applying medical schools and external quality assurance by the JACME committee. Although it is tough work for medical schools to receive accreditation, it is mostly accepted as being useful for quality improvement and the enhancement of medical education.