Graduate schools of medicine in Japan: The status and problems of researcher training / 医学教育

1) Common training for the introduction of research and the elective and individual guidance for research should be devised in a manner attractive to graduate students of medicine.<BR>2) To train researchers, a graduate school of clinical medicine should be established as a professional school, separate from an ordinary graduate school.<BR>3) To promote basic medical sciences, the capacity of graduate schools of basic medical sciences should be reduced despite the number of teachers and the bold plan for the financial support of students.

An Evaluation Standard for Medical School Teachers / 医学教育

We, members of the working group for evaluation of a medical faculty in education ability and carrier, have herein proposed a standard for accomplishing such purpose, which was intended to be a fundamental standard applied possibly to all medical schools in Japan with some modifications based on educational goal of each school. The working group members would be very happy if this standard would be useful and valuable for developing better medical education.

Introduction of symposium-style learning in the undergraduate medical education program. An attempt to encourage the medical students intending to have motivation and interest in the research fields of medical sciences / 医学教育

In 1996, our medical school introduced symposium-style learning that is focused on recent advances in medical science as a regular undergraduate program for 6th-year students. The goals of this program are as follows: 1) to teach that good scientific research is essential to support high-quality medical education and medical care, 2) to have students enjoy research in a way they cannot in the ordinary curriculum, and 3) to stimulate interest in research in medical students who may become researchers in the future. Although a long-term survey is needed to evaluate the effects of this kind of learning strategy, an analysis of questionnaires showed that it was effective for the intended purposes. Today, the content of medical education has become diversified, and the social demands on medicine have changed greatly. Thus, we believe it is necessary to develop an education program separately from traditional ones that are primarily oriented to transmission of knowledge.

Report of the 16th Annual Conference on Medical Student Selection. Is Bachelor's Degree "Must" to Apply to Medical Schools? / 医学教育

This is a report of the 16th Annual Conference on Student Selection held on August 30, 1997 in Tokyo. The main topic of discussion was the subject whether bachelor's degree must be required to medical school applicants. Advantages, disadvantages and expected future problems concerning the proposal by the advisory committee of the Ministry of Education and Culture are widely discussed.

Education of Doctor's Attitudes toward Patients in Medical Education in Japan / 医学教育

We surveyed in every medical university in Japan on how attitudes development is adopted in its medical educational curriculum so far. There are several universities which in some way have already adopted attitudes development into curriculum or teaching items. However, hours of lesson and the contents are so differed among them. Moreover, both evaluation of these lessons by trainees and judgement as far the educational effect by trainers are not programmed satisfactorily. Some universities complain of manpower shortage, difficulties of fixing curriculum, or shortage of total lesson hours, so that they say they cannot dare work on this attempt. But, there are still an increasing number of universities ready to start their programs, where education arranged by non-medical teachers, practical medical experience at the real front, the introduction of simulated patient (SP) into education, and so on are considerd to be carried out.<BR>Thus, we suppose it is time to have and share some guideline for adequate attitudes development education at this moment. And at the same time, a national system to encourage the medical education, including trainning SP, is urgently required to be planned.

A Survey on Undergraduate Clinical Training with Special Reference to Clinical Procedures Performed by Medical Students on Patients / 医学教育

A questionnaire survey on clinical procedures performed by medical students on patients during undergraduate clinical training was conducted in february 1996. Responses were received from 1328 clinical departments of university cospitals at 80 medical schools. Basic clinical procedures that medical students were permitted to perform on patients were recommended by a committee of the Ministry of Health and Welfare. These procedures are divided into three categories: level 1; procedures that medical students are permitted to perform under the supervision of an instructor; level 2; procedures medical students are permitted to perform with supervision under certain conditions; and level 3; procedures for which medical students are generally limited to assisting instructors or to attending and observing patients. The status of performance of the procedures was investigated. Of level-1 procedures (36 procedures), 8 were performed by medical students at more than 80 % of university hospitals, 19 were performed at from 50% to 70%, 9 were performed at less than 50%. Of level-2 procedures (15 procedures), 8 were performed at from 55% to 79% of hospitals and 7 were performed at less than 50%. For level-3 procedures (15 procedures), medical students were permitted to assist and observe 4 procedures at from 82% to 86% of hospitals, 11 at from 50% to 79%, and 1 at40%. In addition, students were permitted to perform 13 level-3 procedures at from 10% to 44% of hospitals and to perform 3 at from 6% to 9%. In many clinical departments, other kinds of procedures specific to the departments were adopted. Teaching media, such as standardized patients' computer-assisted instruction models, and animal materials, were used, and facilities in the community cooperated in training. Respondents wrote many suggestions and opinions about the difficulties and concerns with the legality of students' performing clinical procedures, patients' consent or agreement, minimal essentials of clinical competence of students, the shortage of instructors, and the training and guidelines for instructors.

Results of a Survey on the Present Status of Undergraduate Clinical Training and Plans for Its Improvement / 医学教育

We used questionnaires to study the present status of undergraduate clinical training at medical schools in Japan in February 1996. Completed questionnaires were returned by 81%(65) of 80 medical schools and approximately 54%(1, 328 clinical departments) of the schools. The results were as follows. Courses for early clinical exposure in the 1st or 2nd year were provided at 83% of the 65 schools; clinical clerkships in the 5th and 6th years were provided at 28%. Specific behavioral objectives for clinical training were clearly shown to students and teaching staff at 75% of schools. Clinical procedures that medical students were permitted to perform were listed and announced to students and teaching staffs at 66% of schools. Patients were informed and gave consent for clinical training of students at 77% of schools. Essential knowledge and skills of students were assessed before the start of clinical training at 40% of schools, and summative assessment was made at the end of the training at 72%. Training of clinical teaching staff for faculty development was conducted at 51% of schools. Eightynine percent of schools reported a shortage of clinical teaching staff. Similar results were obtained in the survey of clinical departments of university hospitals: most departments complained of a shortage of teaching staff, of students not being active, and of students not being competent to enter clinical training courses. To improve clinical training, the introduction of clinical clerkships and cooperation with community facilities outside universities were the main issues.

Medical Student Selection on the Standpoint from Applicants and Social Needs. Activities of the Committee on Student Selection, 1994-1996 / 医学教育

This is a report of the activities of the committee on medical student selection 1994-1996, particularly focused on the 15th Conference on Medical-Student Admission held 1996/8/31 with the subjects of social needs and influences upon high school education for the purpose of improving student selection system in Japan. We must consider how largely admission tests have being influenced high school students at the time of decision making, what medical schools they submit their applications to, and what ability the society or community requires physicians, for creating better system of evaluation for admission in Japan.

Factors Influencing School Choice by Medical Students / 医学教育

In order to appropriately obtain information for the purpose of reforming the school selection process, we analyzed questionaires from 1, 641 students in their first year of medical school. Twenty-five percent of the subjects were women and the 20 participating medical schools consisted of 4 newer national schools, 6 older national schools, 3 provincial or municipal schools, 4 newer private schools, and 3 older private schools.<BR>As expected the medical students admitted to a strong desire to enter the specific profession of medicine. Important factors influencing their decision to apply to a particular medical school included (1) geographical location, (2) general public reputation, (3) whether or not the school was part of a university, and (4) the cost of tuition. Students did not appear to pay much attention to specific educational programs, facilities and environment, or the teaching staff of individual schools. The Committee proposes that medical schools make a greater effort to acquaint applicants with the history, purpose, and educational environment of their institution in order to aid the students in their selection process.

Report of the 8th conference on student selection / 医学教育

This conference was held at Noguchi Memorial Hall, Tokyo, on September 9 th, 1989. Seventy five persons from fifty two medical schools and two high schools participated.<BR>In the first session, “Intrview-Methods and Evaluation”, Dr. H. Hasekura introduced recent trends in the interview test in general and his experiences at Shinshu University. Dr. M. Hirno stressed a clear relationship between the interview and performances of students of Yamanashi Medical College. Dr. I. Takeyama, Teikyo Univ., reported on the significance of the two-day interview including one overnight stay with the applicants.<BR>In the second session, “High School vs University”, Mr. H. Motohashi, Hibiya High School, explained about high school records, and Mr. T. Ohnuki, Mito Daiichi High School, analyzed recent behaviors of medical school applicants. Dr. T. Ogawa, Akita Univ., Dr. S. Sato, Nagoya Municipal Univ. and Dr. T. Takagaki, Juntendo Univ., pointed out that high school records are more predictable than the entrance examination scores through follow up studies.<BR>This meeting impressed upon the participants the importance of communication and reliability between high schools and universities.