ABSTRACT
In 2019, a team composed of medical and health economics educators and a family medicine trainee from the Department of Community and Family Medicine, Fukushima Medical University, and the School of International and Public Policy, Hitotsubashi University, Japan, embarked on a study tour to Toronto, Canada, a leading country in family medicine education and training. During this tour, the team visited the Department of Family and Community Medicine at the University of Toronto and affiliated hospitals to observe family medicine training in practice, which included video review and feedback for trainee development. In addition, they visited a practice attached to a legal clinic, with subsequent learning about the medico-legal interface and responsibilities of Canadian family doctors. The team gained first-hand insight into family medicine training along with an understanding of a healthcare system that values primary care.
ABSTRACT
In February 2017, general practitioners (GPs) from the Department of Community and Family Medicine of Fukushima Medical University in Japan visited Australia for a study tour where the tour participants met with local GPs, GP registrars and researchers. During this tour, we visited public hospitals and observed multiple GPs providing community-based health care. We also attended a new GP registrars' orientation where the two authors gave a presentation about the current status of primary care in Japan. We then visited an Aboriginal health research center, and learned about the cultural values of the Aboriginal people and the challenges of implementing large-scale cohort studies.
ABSTRACT
Introduction: Optimization of after-hours visits to medical institutions is one of the major problems in medical systems. The purpose of this study was to clarify the effects of the distribution of booklets about after-hours common symptom management to all residents on the number of after-hour consultations.Method: The Tadami town government distributed booklets to all town residents in July 2011. We analyzed the number of after-hours consultations per month at Tadami National Health Insurance Asahi Clinic, which is the only medical institution in the town, from January 2010 to December 2012. We employed an interrupted time series analysis.Result: The number of included after-hours consultations during the study period was 2,399. The baseline trend was 0.0071 (95% confidence interval −0.011, 0.025), and the slope change from the baseline trend was −0.0061 (−0.034, 0.022).Conclusion: On comparison of before and after the distribution of a booklet about after-hours common symptom management to all residents in the town, the number of after-hours consultations did not change significantly.
ABSTRACT
Every year, we tour a leading country for family medicine with new trainees and staff who join the Department of Community and Family Medicine at Fukushima Medical University. This time we visited Denmark. In Denmark, General Practitioners (GPs) see their patients by a list system. GPs work as a gatekeeper and solve many kinds of health problems. GP training is a 5-year program, and the training system is well established. It is usual for both GP trainees and their partners to work and raise their children during the training.
ABSTRACT
Introduction : <br> This article aims to explain the new Membership of Royal College of General Practitioners (nMRCGP), new postgraduate general practice training in the UK. It will also compare this with that of the Japan Primary Care Association to identify areas requiring further development in postgraduate family medicine training in Japan.<br>Methods : <br> The introduction of the nMRCGP based on the available literature, followed by discussion amongst family physicians and trainees in Japan.<br>Results : <br> Following a comparison between the postgraduate general practice training in the UK and Japan, the following three points were raised : 1) The need for a clear definition of the role that family physicians play in Japan. 2) The importance of formative assessment as part of the membership examination in the form of portfolios. 3) The need for clear competency areas to form the framework for formative assessment, and for the clear standard that trainees are judged against in each of those competency areas.<br>Conclusion : <br> The above results were highlighted and discussed as possible areas for further development in postgraduate family medicine training in Japan.
ABSTRACT
The aim of this research was to explore the educational effects of home-care training on resident trainees which have not previously been deliberately examined. We performed a qualitative study. Focus-group interviews were conducted to explore the views of residents who underwent medical training in 3 different settings: inpatient, outpatient, and home-care. Analysis of the interview data revealed 8 categories of resident experiences and their views on the effects of home-care training: 1)recognition of the importance of the concerns of the patient and the family in medical communication; 2)development of patient-centered and family-centered attitudes; 3)acquisition of the knowledge and skills of management, other than medical management, in home-care; 4)appropriate cooperation with other health professionals; 5)recognition of options for care settings; 6)knowledge of the community; 7)recognition of healthcare resources in the community; and 8)acquision of effective use of medical knowledge and skills. The findings of this study suggest that home-care training is effective for helping residents to develop patient-centered communication skills and attitudes and to develop management skills for a multidisciplinary team in the community to complement medical training in inpatient and outpatient settings.
ABSTRACT
1) “To live as a family physician” is the central value of the residency training program at the Hokkaido Centre for Family Medicine where the trainees practice specialty approaches of family practice everyday supervised by their family physician trainers in the communities in which they reside.<BR>2) Training at multiple facilities enables the trainees to experience family practice in different communities where their culture, social context, health resources, health issues and the age composition vary. The trainees can also enjoy their relationship with their trainers-role models for them who show the various practice and training styles.<BR>3) The definition-based curriculum in family practice is indispensable, enabling medical students and resident physicians in Japan wishing to become family physicians to understand that “family practice is a specialty in medicine that can be learned concretely.”<BR>4) Trainers can evaluate their trainees by using a “Core Component” curriculum, which is based on the new working definition of family practice, and a “Common Problems Component” curriculum, which covers all the specialties in clinical medicine.<BR>5) In addition to residency training programs in family practice, a residency review committee, an evaluation and certifying examination program, and programs for continuing professional development to allow certified family physicians to keep themselves up-to-date are needed.
ABSTRACT
We evaluated the interview skills of 46 sixth year medical students (32 men, 14 women) in our outpatient clinic. Six items were evaluated, including the manner in which students responded to patients, the number of times students interrupted patients' statements with closed-ended questions, and the extent to which students maintained eye contact with patients. We found that students interrupted patients every 46.2 seconds on average, and often did not make eye contact with tha patients. It became clear that, although we teach medical interview skills to students, students do not learn these skills very well. We suggest that in order to properly educate medical students, close cooperation between departments is needed.
ABSTRACT
We evaluated basic surgical skills in students using the Objective Structured Clinical Examination (OSCE). The study was conducted on 101 sixth-grade medical students (67 males, 34 females) at Kawasaki Medical School in 1993. Theme A (tying of a silk suture) was given to 44 students, and theme B (tying of nylon suture using surgical instruments) was given to 57 students. The following items were evaluated (1) handling of surgical instruments, (2) suturing, (3) knot tying, and (4) suture removal. The average score for theme B was slightly lower than that for theme A. The average score for knot tying was lower than scores for the other items. Thus, it was revealed that all students were not good at tying knots. These scores for minor surgery correlated with the scores for other skills as evaluated by the OSCE. In conclusion, the OSCE appears to be an appropriate method for evaluating basic surgical skills.