ABSTRACT
<b>Purpose</b> : To examine the characteristics of second-year residents intending to become primary care physicians.<br><b>Methods</b> : Using a self-administered questionnaire, we surveyed 7344 second-year residents in March, 2006. Of the 4167 responders (response rate 56.7%), the 3838 who answered that they intended to make a career choice of being clinical practitioners were taken as subjects for analysis. The odds ratios (OR) for the intention of being a primary care physician was calculated, together with the 95% confidence interval (95% CI), using logistic regression models (primary care physicians intended=1 vs. specialist intended=0) <br><b>Results</b> : In total, 56% of the residents affirmed an interest in becoming primary care physicians. Multiple stepwise logistic models showed that residents intending to become primary care physicians planned to open their own clinics in the future (OR 1.44, 95% CI : 1.20-1.73), did not wish to obtain doctor of medical science (DMSc) degrees (OR 1.29, 95% CI : 1.07-1.55), and were more likely to choose internal medicine (OR 1.44, 95% CI : 1.07-1.94).<br><b>Conclusion</b> : This study demonstrated that second-year residents who aimed to be primary care physicians were associated with more interest in opening private clinics for their future practice, preferably in the field of internal medicine, and with less interest in earning DMSc degrees.
ABSTRACT
In Europe and the United States, residents develop“burnout syndrome”or depression because of stress, and these conditions are associated with withdrawal from training programs and undesirable clinical outcomes, such as unethical practices.How stress affects Japanese medical residents and their practice is uncertain, as are factors that relieve stress.Furthermore, a theoretical model of stress in Japanese medical resident is uncertain.<BR>1) Focus group interviews were performed for 25 junior residents at 10 institutions to explore their stress reactions and stress-relieving factors.A theoretical model of stress was then constructed.<BR>2) Adverse effects in patient care and in training, in addition to events in daily life, were found to occur as stress reactions.<BR>3) Improvements in the support system and positive feedback from patients were found to be stress-relieving factors.<BR>4) A theoretical model of stress for trainee physicians was constructed and was similar to a general occupational stress model.<BR>5) Stressors should be reduced and stress-relieving factors should be improved to improve the working conditions of residents and the quality of medical care.
ABSTRACT
In Europe and America, it is reported that residents develops burnout syndrome or depression by their stress, and these are connected with dropouts from their training program and undesirable outcomes of the patients such as unethical practice. Recently, though resident's poor working conditions and death from overwork, etc. become problems also in Japan.But, Japanese resident's stressor is uncertain.<BR>1) Focus group interview was executed for 25 junior residents in 10 facilities, and their stressor were explored.<BR>2) As a result, three cateogories ; physiological stressor as one human being, stressor as a new member of society, and stressor as a trainee doctor and beginner novice doctor was extracted.<BR>3) Three stressors were named the life gap, the society gap, and the profession gap respectively. The stressor of junior resident was described as the product what was born by the gap of medical student and becoming a doctor.<BR>4) Japanese residents have various stressors. Stressor as a trainee doctor was a stressor peculiar to Japanese junior residents.<BR>5) Stress management should be done considering such a stressor in the light of safety and effective clinical training.
ABSTRACT
Because new media have come onstage in the information technology period, also self-learning methods have been diversified. Recently, small group discussion such as clinical conference using the mailing list is lively performed among the primary care physicians, and it is considered to be useful for continuing medical education. To promote the mailing list for continuing medical education, we present as follows; 1) present situation: to show a good example of TFC-ML (total family care-mailing list), 2) usefulness: to know new medical knowledge, new medical information and literatures etc., to discuss clinical cases. 3) issues: a role of moderator, excess of information, correspondence with slander, 4) future: to reevaluate usefulness for continuing medical education. We would like to expect effectiveness of mailing list for continuing medical education.
ABSTRACT
The aim of this study is to clarify the present situation of activities of continuing medical education (CME) for the primary care physicians to whom the leading hospitals, such as universities and clinical trainee hospitals perform CME in their regions. A questionaire was designed for main 4 parts, as following: 1) On the purpose of CME for the physicians. 2) On the organization (office) managing CME in the hospitals. 3) On the strategies of CME. 4) On the evaluation of CME. Answers to a questionaire were replied from 234 institutions (58.1%). Analyzing the results, we recognized that the leading hospitals actively carried out CME for the primary care physicians in the community. Furthermore, conversion to experiential learning from passive learning and establishment of evaluation methods should be promoted in CME.
ABSTRACT
We investigated factors related to the perception of achievement and to the degree of satisfaction of junior residents in initial clinical training. Questionnaires were given to second-year postgraduate students at 13 teaching hospitals in Japan. The response rate was 50%(n=89). The perception of achievement and the degree of satisfaction were converted to a 100-point scale. The mean±standard deviation of the two scores were 70±11 and 68±16, respectively. The average number of inpatients and whether the junior resident had taken care of patients were related to both scores. However, gender, the number of departments rotated through, and salary were not associated with either score.
ABSTRACT
The committee of continuing medical education in Japan Society for Medical Education discussed on PRA of American Medical Association [AMA]. We have first analyzed the brochure of PRA for the members of AMA, and then prepared the questionnaire for AMA. We were able to obtained the answers to the questionnaire which were sent to AMA through courtesy of Japanese Medical Association (JMA). It was realized that AMA emphasizes an importance of PRA for medical practice to the patients; nevertheless acquisition rate of PRA is actually low, and so AMA proceeds with efforts towards completion of PRA.
ABSTRACT
The working group on the education of general medicine, Japan Society for Medical Education, has defined general medicine as a discipline which includes following three areas; 1) basic clinical skills which incorporate humane health care, 2) comprehensive community and family medicine and 3) general internal medicine which provides integrated services to solve clinical problems at any level. It has also issued a proposal on undergraduate education of general medicine at university hospitals. The working group now propose a detailed sample curriculum which describes the instruction in three areas mentioned above. Overview, General Instructional Objective (GTO), Specific Behavioral Objectives (SBOs), Learning Strategies (LS) and Evaluation are included in this sequence.
ABSTRACT
We have an outpatient department and a ward (52 beds) in the department of general internal medicine of the Second Tokyo National Hospital. During the rotation of interns for 8 weeks, interns are taught outpatient management by clinical educators one-on-one basis in the clinic, in addition to inpatient management on the wards, and series of lectures on the general internal medicine, emergency medicine and psychosocial issues. We have a residency program from PGY 3 through PGY 5, which emphasizes outpatient continuous management throughout residency. Our residents present their outpatient cases at the daily outpatient conference that all of us would attend. There are 17 graduates of our residency, many of whom are now clinical educators not only in our hospital but also in the university hospitals and teaching hospitals. Research on the way of training rotation of interns by the national hospitals group suggested superiority of the super-rotate training system of the intern. The residency of general internal medicine would become more important not only for the training of primary care physicians but for the training of clinical educators.
ABSTRACT
The aim of this study is to clarify the definition and recognition on continuing medical education for administrators (or leaders for residents) of 80 university hospitals and 266 clinical training hospitals as designated by the Ministry of Health and Welfare, using the questionaire consited of 5 main questions, as following:<BR>1) On the curriculum (program) of continuing medical education in their hospitals.<BR>2) On the continuing medical education system of Japan Medical Association.<BR>3) On the continuing medical education activity of the specified academic societies.<BR>4) On guide of continuing medical education for the residents.<BR>5) On definition of continuing medical education.<BR>Answers to a questionaire were returned from 227 institutions (65.6%)<BR>Analyzing the results, present situation of program curricula for continuing medical education in hospitals, participation to continuing medical education system of Japan Medical Association and Academic Societies, and consideration on continuing medical education as a hospital leader were comprehensible.
ABSTRACT
In April, 1995, 392 teaching hospitals were surveyed by questionnaire regarding status quo of general medicine in Japan. Independent department of general medicine was established in 11 university and 16 non-university teaching hospitals (11.6% of the respondents). There were another 23 hospitals-3 universtiy and 20 non-university hospitals-in which general medicine was practiced at other department. Therefore, 50 hospitals (21.5% of the respondents) had a group of physicians practicing general medicine in one way or another.<BR>Many problems surrounding general medicine, however, were raised, especially about conceptual gaps between generalist physicians and specialists or patients. It is mandatory for clinicians and educators in general medicine to make the concept of general medicine explicit in understandable words for other specialists and lay people. In addition, high quality practice, education and research products are essential to attract more doctors of younger generation.
ABSTRACT
Continuing medical education for the general practitioners has been activery performed. The former committee for continuing medical education of the Japan Society for Medical Education reported the objectives of continuing medical education for general practitioners. The present committee proposed learning strategies for continuing medical education for general practitioners in accordance with specific behavioral objectives of the curriculum.<BR>It was postulated that appropriate learning strategies are necessary for physicians to provide holistic medical care in their communities, in addition to improving their medical knowledge and skills.<BR>Learning strategies in the curriculum were also coordinated with the continuing medical education system of the Japan Medical Association.