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Japan Accreditation Council for Medical Education, JACME, was established in 2015. Since then, JACME has evaluated education programs in medical schools based on the global standards set by World Federation for Medical Education. 54 medical schools have been recognized as of June 1, 2021.In this paper, we review past evaluations and discuss the impact and challenges of the field-specific evaluation of medical education.
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Recently, there has been an increase in the number of Japanese students who want to practice medicine in Japan after receiving their education in a Hungarian medical school and passing the Japanese national examination for medical practitioners. It is of great concern whether they received a sufficient amount of medical education to meet the public trust. Researchers from Japan visited Hungary and observed their medical education system. There are 4 national medical schools that have international courses for educating students from abroad in English. Three of those schools also offer education in German. The Japanese researchers observed international courses being taught in English at Semmerwise University in Budapest and Debrechen University in Debrechen, the 2nd biggest city in Hungary. Although the international education system is not much different from other European countries, some systems such as small group tutorial education, assessment via oral examination, and the requirement of a graduation thesis stood out as key strengths of the Hungarian education system.
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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.
ABSTRACT
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.
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<p>Introduction: Compared with faculties in clinical and medical research departments, those in medical departments are not appropriately evaluated in terms of their contributions to or achievements in medical education. Therefore, the aims of this study were to investigate the contributions of medical department faculties to medical education, and to examine differences in contributions according to duty positions and specialties.</p><p>Methods: Five-grade self-assessments in relation to 20 items on a rating form for performance in medical education, which was developed by the Japan Society for Medical Education's Committee for Performance Evaluation, were carried out by medical department faculties in Japanese universities. The data were then totalized and analyzed.</p><p>Results and Discussion: Although faculties belonging to departments other than medical education units did not actively participate in examinations or the education system, they still made contributions to lectures and practice. In addition, faculties with positions with more duties tended to show greater participation in the education system.</p><p></p><p>Conclusion: Based on these findings, we recommend the use of a rating form as a standard scale to evaluate performance in medical education.</p>
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<p> Accreditation for medical education has been introduced in several countries to ensure and improve the quality of education programs in medical schools. In the standards for accreditation, the assessment of faculty activity and development is described as important to improve medical education. The balance of teaching, research, and service functions is considered in the assessment. The results of the appraisal are reflected in the faculty's appointments, promotions, and compensation increases in many countries.</p>
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<p> The education program in all medical schools in Japan has been studied and analyzed every 2 years since 1974 by the curriculum committee of the Association of Japan Medical Colleges. Based on the most recent analysis in 2015, the marked innovation of medical education, such as an integrated curriculum, active learning, and clinical clerkship, was recognized.</p>
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<p> Based on our experience of visiting the Medical Council of Canada and observing large-scale OSCE (objective structured clinical examination) in Canadian Qualifying Examination Part II , we report differences operation system, implementation status, and examination questions compared to Japan. This very important examination after the post-graduate residency program may provide several invaluable tips when we introduce nation-wide clinical performance examinations.</p>
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Medical education in Germany has undergone significant reforms since the new law, “Regulation of the Licensing of Doctors,” was introduced in 2003. The major point of the reforms is the shift from theoretical education to practical clinical training. The national licensure examination consists of 2 parts: an examination for knowledge of basic medicine in the second year of medical school, and an examination for clinical knowledge and skills after clinical clerkships. These reforms should provide useful information for the reform of medical education in Japan.
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France’s sophisticated system of medical education achieves a seamless link between undergraduate education and postgraduate training and has eliminated the uneven distribution of physicians among disciplines and regions. The Épreuves Classantes Nationales (national ranking examination), introduced in 2004, improved the uneven distribution of physicians among disciplines and regions. Although the medical board examination is not used in France, the unique medical education system, which develops both general practitioners and specialists, provides useful information for improving medical education in Japan.
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Because Canada is an extremely large country, the main issue in medical education in Canada is fostering physicians who are highly competent in practical skills. For this reason, clinical clerkships and the national examination for evaluating clinical skills and attitudes in Canada are quite advanced. The Canadian medical education system can provide useful information for Japan.
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Background: Globalization urges us to discuss rationale and policy towards establishing a medical education accrediting body in Japan. Experience of General Medical Council (GMC) suggests us some useful lessons.<br>Method: Based on our visits and investigation into in GMC, we inquire how Quality Assurance (QA) was introduced in UK with what incentives and how QA has brought reforms in the medical schools in UK.<br>Result: Since 2003, GMC has changed its policy for QA from ‘inspection’ to ‘dialogue’. Dialogical QA asks a medical school to think critically of their education and consider vigorous actions for further improvements.<br>Discussion: Implications from the experience of GMC are: 1.QA process in GMC makes medical schools take robust steps towards changes, 2. Sharing the rational and policy for QA created the solid base for its effective implementation, 3. There are possible difficulties in establishing structure to do an enormous amount of coordinating work, which is necessary for constructing ‘dialogue with medical schools’.
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Because recent changes in medical care security policy have made clinical skills training difficult, even in teaching hospitals, training with suitable models and simulators is becoming essential for medical students to acquire clinical skills. On the basis of these changes, we performed a nationwide survey on the prevalence and application of clinical skills laboratories for clerkships in Japan. Registered questionnaires were sent to all medical schools in Japan (n=80) in December 2012. The response forms were filled out by clinical instructors and by the staff responsible for the skills laboratory. The response rate was 94% (75 of 80 schools). Seventy-one schools (95%) have already installed clinical skills laboratory; however, floor area and availability varied greatly among schools. Floor space ranged from 24 to 2,250 m2 (median, 214 m2). The number of uses of the facility by medical students in the 2011 school year ranged from less than 100 to more than 10,000 (median, 1,402). Forty-two schools (59%) had a resident director for the skills laboratory. Simulators of most universities (> 90%) were venopuncture simulators, lung-sound simulators, basic life support mannequins, heart-sound simulators, surgical suture trainers, and automated external defibrillator trainers, and all were frequently used. These results suggest considerable differences among schools in simulation-based learning environments during clinical clerkships. Although most medical schools in Japan have their own clinical skills laboratories, their size, service, and frequency of use vary greatly.
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・We visited the National Board of Medical Examiners and the Clinical Skills Evaluation Collaboration Center to discuss with the examiners the present state of the USMLE (United States Medical Licensing Examination), to which clinical skills evaluation has been introduced.<br>・Evidence that the introduction of clinical skills evaluation to the USMLE has affected the reform of medical schools curricula in the United States supports the necessity of introducing clinical skills evaluation to the Medical Board Examination of Japan.
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A case study of a clerkship at McGill University school of medicine was conducted based on the data such as an observation, interview, and documents. A clerkship was constructed by three components. The basis of the structure was competency–based education. Medical students starts learning from active observation and later by supervised practice. The curriculum was supported by the educational theory such as legitimate peripheral participation, zone of proximal development and TARGET model, which sheds the light on some key elements to transfer into Japanese clerkship.
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1)We visited the Duke–NUS Graduate Medical School Singapore to learn the administration and management of, and the theory behind, team–based learning (TBL), a candidate educational method to replace the problem–based learning tutorial.<br>2)TBL motivates students to prepare for and engage in discussion. The grading of performance in TBL, certain characteristics of assignments, and the use of peer evaluation all promote individual and group accountability for learning.<br>3)To obtain the maximum overall benefit from TBL and to exploit group dynamics for effective learning, well–designed assignments are the key.
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1)In the Netherlands, only high school graduates are accepted to medical schools.2) Several medical schools divide their courses into a bachelor's course and a master's course, according to the Bologna process.
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1)In Spain, only high school graduates are accepted to medical schools.2) Although the reform of medical education is in progress, there are barriers to reform, especially at universities with a long history.
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1) We report on medical education programs in Malaysia on the basis of investigations of 2 national universities and 1 private medical college.2) Although the history of medical education in Malaysia is short, the education programs are efficient and conform to global standards.
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1) We visited 4 universities in Germany, from where medical systems were once introduced to Japan as a model of modern medicine, and investigated the present conditions of medical education.2) The reform of curricula and methods of medical education has been actively performed in Germany, as it has been in Japan.