The current state of medical education in Japan: a system under reform

Context: Not since just after World War II has there been as dramatic a change in the system of medical education in Japan as in the last several years. Medical school curricula are including more education that mimics clinical practice through problem-based learning, organ-based curricula and implementation of the objective structured clinical examination (OSCE). In response to criticism and concerns, the Japanese government has also implemented 2 major changes in the system of postgraduate medical education. First, a 2-year structured internship has been required of all medical school graduates; the first cohort to undertake this completed it in April 2006. Second, an internship matching system was adopted and first implemented in 2003. Discussion: These reforms are leading to significant shifts in clinical education in Japan. Increasing numbers of medical graduates are entering residency programmes outside specialised university hospitals and core rotations place an increased emphasis on primary care. Conclusions: These changes in the training of young doctors suggest that the general clinical competency of doctors in Japan will improve in the coming years.