There are 79 medical schools in Japan—42 national, 8 prefectural (i.e., founded by a local government), and 29 private—representing approximately one school for every 1.6 million people. Undergraduate medical education is six years long, typically consisting of four years of preclinical education and then two years of clinical education. High school graduates are eligible to enter medical school. In 36 schools, college graduates are offered admission, but they account for fewer than 10% of the available positions. There were 46,800 medical students in 2006; 32.8% were women.
Since 1990, Japanese medical education has undergone significant changes, with some medical schools implementing integrated curricula, problem-based learning tutorials, and clinical clerkships. A model core curriculum was proposed by the government in 2001 that outlined a core structure for undergraduate medical education, with 1,218 specific behavioral objectives. A nationwide common achievement test was instituted in 2005; students must pass this test to qualify for preclinical medical education. It is similar to the United States Medical Licensing Examination step 1, although the Japanese test is not a licensing examination.
The National Examination for Physicians is a 500-item examination that is administered once a year. In 2006, 8,602 applicants took the examination, and 7,742 of them (90.0%) passed. A new law requires postgraduate training for two years after graduation. Residents are paid reasonably, and the work hours are limited to 40 hours a week. In 2004, a matching system was started; the match rate was 95.6% (46.2% for the university hospitals and 49.4% for other teaching hospitals).
Sustained and meaningful change in Japanese medical education is continuing.
Dr. Kozu is professor emeritus (medical education/gastroenterology) and advisor, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Correspondence should be addressed to Dr. Kozu, Professor Emeritus and Advisor, Department of Medical Education, Tokyo Women's Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666. telephone: +81-(0)3-3353-8111, extension 38320 or 30111; fax: +81-(0)3-5269-7305; e-mail: (firstname.lastname@example.org).