Medical education in paradise: another facet of Hawaii.

Hawaii is synonymous with paradise in the minds of many. Few know that it is also an environment where high quality medical education is thriving. This paper outlines medical education initiatives beginning with native Hawaiian healers of centuries ago, and continuing to present-day efforts to support top-notch multicultural United States medical education across the continuum of training. The undergraduate medical education program has as its core community-based problem-based learning. The community basis of training is continued in graduate medical education, with resident doctors in the various programs rotating through different clinical experiences at various hospitals and clinics. Continuing medical education is provided by nationally accredited entities, within the local context. Educational outreach activities extend into primary and secondary schools, homeless shelters, neighbouring islands, and to countries throughout the Pacific. Challenges facing the medical education community in Hawaii are similar to those faced elsewhere and include incorporating more technology to improve efficiency, strengthening the vertical integration of the training continuum, better meeting the needs of the state, and paying for it all. Readers are invited to join in addressing these challenges to further the realisation of medical education in paradise as a paradise of medical education.

A conceptual model of cultural predictors of anxiety among Japanese American and part-Japanese American adolescents.

A model integrating Japanese ethnicity, cultural identity, and anxiety was developed and assessed in Japanese American and part-Japanese American high school seniors (N = 141). Using measures from the Hawaiian High Schools Health Survey, the model incorporated the State-Trait Anxiety Inventory, the Major Life Events Scale, and the Japanese Culture Scale (JCS). Japanese American adolescents scored higher on the JCS and reported fewer anxiety symptoms than part-Japanese American adolescents. Predictors for anxiety were being Japanese American versus part-Japanese American, income, and culturally intensified events. A significant interaction of behavior by self-identification was obtained. The model had good overall fit, suggesting that cultural identity formation may contribute to anxiety experienced particularly by adolescents of mixed heritage.

Medical school hotline: A History of the University of Hawai'i Postgraduate Medical Education Program at Okinawa Chubu Hospital, 1966-2012.

The University of Hawai'i (UH) has been collaborating with Okinawa Prefectural Chubu Hospital for over 46 years. This collaboration started as a post-World War II effort to increase the physician workforce. At the initiation of the US Army and State Department, the University of Hawai'i was recruited, in cooperation with the government of the Ryukyus and USCAR, to initiate a US style postgraduate clinical training program. The Postgraduate Medical Training Program of University of Hawai'i at Okinawa Chubu Hospital introduced a style of training similar to that in the US by offering a rotating internship. The initial contract had UH establish and run the Postgraduate Medical Training Program of University of Hawaii at Okinawa Central Hospital. After Okinawa's reversion to Japan, under a new contract, UH physicians participated as consultants by providing lectures at "grand rounds" and guidance to faculty, staff, and students. To date, 895 physicians have completed the University of Hawai'i Postgraduate Medical Training Program with 74 currently training. Approximately 662 (74%) of the trainees have remained in Okinawa Prefecture to practice medicine. As a result, the program has enhanced the physician workforce for the islands of Okinawa and neighbor archipelagos of Miyako and Yaeyama Islands.