Gender equality in Japanese medicine / 医学教育

　Although the problem of improving the retention rate of female physicians in Japan has been vigorously discussed, a more comprehensive discussion on gender equality has been lacking. This paper provides an overview of gender inequality in Japanese medicine and discusses measures to promote gender equality. The main causes of gender inequality include gender stereotype, bias, discrimination, women’s double burden of paid and domestic work, and a working system of long and irregular hours based on the gender division of labor. Measures to promote gender equality are necessary to create a working environment that does not disadvantage female physicians.

Medical screening system for refugees resettling in the United States / 国際保健医療

The health assessment of refugees is an essential component of the refugee resettlement process from both humanitarian and public health perspectives. In 2010, Japan became the first country in Asia to initiate a third country resettlement program and the number of refugees accepted to Japan may increase in the future. In this article, we provide an overview of the US refugee admission program with an emphasis on the overseas and domestic medical management to serve as useful information for development of better medical management system for Japan-bound refugees.<BR>Refugees are screened and admitted to the US through the US Refugee Resettlement Program which is an interagency effort involving international organizations such as the Office of the United Nations High Commissioner for Refugees and International Organization for Migration, US governmental, and non-governmental agencies. In pre-departure medical screening, refugees are screened for communicable diseases of public health significance such as active tuberculosis and untreated sexually transmitted diseases, physical or mental disorders with associated harmful behaviors, and drug abuse and addiction using technical instructions provided by the Centers for Disease Control and Prevention. Sputum culture and sensitivity tests were added to the tuberculosis screening protocol in 2007 and the number of tuberculosis cases among refugees has been decreasing. Domestic medical health assessment is recommended within 90 days after arrival. Recommendations for the initial medical screening are tailored based on country of origin and receipt of presumptive treatment. Sponsoring volunteer agencies and the provision of medical interpretation service play important roles in facilitating medical visits for refugees.<BR>While the US medical screening system has many strengths including the presence of well-developed screening guidelines and medical interpretation systems, areas of improvement include communication across the continuum of care, standardization of medical screening processes across states, and screening and treatment of psychiatric disorders.

The division of labor by sex among Japanese physicians / 医学教育

1）To evaluate the division of labor by sex among Japanese physicians, we used anonymous, voluntary questionnaires to survey the alumni of a private medical school about the time spent weekly on clinical activities and unpaid domestic work.<br>2）Although the median time spent per week on clinical activities was less for women physicians （40 hours） than for men （50 hours）, the time spent on unpaid domestic work was significantly more for women （30 hours） than for men （3 hours）.<br>3）When the time spent on both clinical activities and domestic activities was totaled, women physicians worked more hours per week than did men physicians.<br>4）Our study showed a division of labor by sex among Japanese physicians.

Learning from Rural Physician Associate Program at the University of Minnesota / 医学教育

1)Rural Physician Associate Program (RPAP) at the University of Minnesota is a 9–month rural medicine program whose primary goal is to increase the supply of rural primary care physicians.<br>2)Over 40% of RPAP graduates practice in non–metropolitan areas and contribute significantly to the supply of physicians in rural areas.<br>3)In recent years, Japanese medical schools are admitting more students with a rural background. It is important to develop systematic and comprehensive rural medicine programs for students interested in rural medicine in order to increase the supply of rural physicians.